Ricerca
Rischio sociale e salute del bambino: il “Progetto Robin”
SOCIAL RISK AND CHILD HEALTH: THE “ROBIN PROJECT”
1GIANFRANCO MAZZARELLA, 2 CARLO SORELLA 1
Pediatra, ASL Napoli 5; 2Pediatra, ASL Napoli 1
Giugno 1997 - pagg. 373 -380
Abstract
A number of social and psychosocial conditions
such as poverty, family dysfunction,
low parental education etc. put children at
increased risk for disease or inadequate
use of health services. The identification of
simple and valid markers of these conditions
can be useful to define subgroups of
population for a more effective preventive
effort in interventions aimed at reducing the
risk.
The Authors carried out a cohort retrospective
study to evaluate the use of social services
as a risk indicator for ill health and
inappropriate use of health services, by
comparing risk for unfavourable events in
users and non users of health services. Bivariate,
multivariate and regression
methods were used to analyse the findings.
Results showed that children from families
that are users of social services have significantly
higher risk for a number of unfavourable
events ranging from poor antenatal
care (RR 2.0), to missed immunizations
(RR 1.3), accidents and admissions to hospital
(RR 1.8). On the basis of these findings
a project aimed at improving the effectiveness
of health services with respect to
these children and their families is proposed.
Parole chiave
Classificazione MeSH
Bibliografia
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12. Jolly DL, Nolan T, Moller J, Vimpani G: The impact of poverty and disadvantage on child health. J Paediatr Child Health 27, 203- 17, 1991.
13. Kliegman RM: Perpetual poverty: Child health and the Underclass. Pediatrics 89, 710- 3, 1992.
14. Liberatos P, Link BG, Kelsey JL: The measurement of social class in epidemiology. Epidemiol Rev 10, 87-121, 1988.
15. Rothman JK: Modern epidemiology. Little, Brown and Company, Boston, 1986.
16. Hosmer DW, Lemeshow S: Applied logistic regression. John Wiley and Sons, Inc, New York, 1989.
17. Kleinbaum DG, Kupper L, Muller KE: Applied regression analysis and other multivariable methods. PWS-Kent, Boston, 1988.
18. Blaxter M: Evidence on inequality in health from a national survey. Lancet ii, 30-3, 1987.
19. Le dimensioni della disuguaglianza; rapporto della fondazione CESPE. A cura di Paci M. Il Mulino, Bologna 1993.
20. Norell S: Principles of study design in epidemiology. Stockholm: Dept. of Epidemiology, Inst. of Environmental Medicine, Karolinska Institutet, 1988.
21. Morlicchio E, Spanň A: La povertŕ a Napoli. Inchiesta luglio-dicembre, 1992.
22. Mingione E, Zajczyk F: Le nuove povertŕ urbane in Italia. Inchiesta luglio-dicembre, 1992.
23. Black D: Deprivation and health. BMJ 307, 1630-1, 1993.
24. Hurowitz JC: Toward a social policy for health. N Engl J Med 329, 130-3, 1993. 25 . Ciccone G, Vineis P: Salute e classi sociali: accesso alla prevenzione o accesso alle cure? Epidemiologia e Prevenzione 18, 141-5, 1994.
26. Panizon F: Violenza giovanile: tra il dire e il fare(editoriale). Medico e Bambino 9, 7, 1996.
27. Negri N, Saraceno C: Le politiche contro la povertŕ in Italia. Il Mulino, Bologna, 1996.
2. Whitehead M: The health divide. In: Townsend P, Davidson N, Whitehead M, eds, Inequalities in health. Harmondsworth, Penguin Books, 1992.
3. Curtis SE: Use of survey data and small area statistics to assess the link between individual morbidity and neighbourhood deprivation. J Epidemiol Comm Health 44, 62-8, 1990.
4. Power C, Manor O, Fox J: Health and class: the early years. Chapman and Hall, London 1991.
5. Power C: Health and social inequality in Europe. BMJ 308, 1153-6, 1994.
6. Reading R, Iarvis S, Openshaw S: Measurement of social inequalities in health and use of health services among children in Northumberland. Arch Dis Child 68, 626-31, 1993.
7. Epidemiologia della diseguaglianza nell’infanzia. A cura di Corchia C, Baronciani D. Istituto Italiano di Medicina Sociale, Roma 1995.
8. Cirillo G, Siani P, Tamburlini G: I bambini a rischio sociale: generazione a perdere o investimento sociale. Edizioni Scientifiche Italiane, Napoli 1995.
9. From birth to five: a study of the health and behaviour of Britain’s five year olds. Edited by Butler NR, Golding J. Pergamon Press, Oxford 1986.
10. Reading R: Equity and community child health. Arch Dis Child 68, 686-90, 1993.
11. Baronciani D: La tutela della salute e del rischio di povertŕ e disuguaglinaza. In: Cirillo G, Siani P, Tamburlini G: I bambini a rischio sociale: generazione a perdere o investimento sociale. Edizioni Scientifiche Italiane, Napoli 1995.
12. Jolly DL, Nolan T, Moller J, Vimpani G: The impact of poverty and disadvantage on child health. J Paediatr Child Health 27, 203- 17, 1991.
13. Kliegman RM: Perpetual poverty: Child health and the Underclass. Pediatrics 89, 710- 3, 1992.
14. Liberatos P, Link BG, Kelsey JL: The measurement of social class in epidemiology. Epidemiol Rev 10, 87-121, 1988.
15. Rothman JK: Modern epidemiology. Little, Brown and Company, Boston, 1986.
16. Hosmer DW, Lemeshow S: Applied logistic regression. John Wiley and Sons, Inc, New York, 1989.
17. Kleinbaum DG, Kupper L, Muller KE: Applied regression analysis and other multivariable methods. PWS-Kent, Boston, 1988.
18. Blaxter M: Evidence on inequality in health from a national survey. Lancet ii, 30-3, 1987.
19. Le dimensioni della disuguaglianza; rapporto della fondazione CESPE. A cura di Paci M. Il Mulino, Bologna 1993.
20. Norell S: Principles of study design in epidemiology. Stockholm: Dept. of Epidemiology, Inst. of Environmental Medicine, Karolinska Institutet, 1988.
21. Morlicchio E, Spanň A: La povertŕ a Napoli. Inchiesta luglio-dicembre, 1992.
22. Mingione E, Zajczyk F: Le nuove povertŕ urbane in Italia. Inchiesta luglio-dicembre, 1992.
23. Black D: Deprivation and health. BMJ 307, 1630-1, 1993.
24. Hurowitz JC: Toward a social policy for health. N Engl J Med 329, 130-3, 1993. 25 . Ciccone G, Vineis P: Salute e classi sociali: accesso alla prevenzione o accesso alle cure? Epidemiologia e Prevenzione 18, 141-5, 1994.
26. Panizon F: Violenza giovanile: tra il dire e il fare(editoriale). Medico e Bambino 9, 7, 1996.
27. Negri N, Saraceno C: Le politiche contro la povertŕ in Italia. Il Mulino, Bologna, 1996.