International Journal of Environmental Research and Public Health

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Special Issue Editors

Dr. Teresa Spadea

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Guest Editor

Department of Epidemiology, ASL TO3 Piedmont Region, 10095 Grugliasco, TO, Italy
Interests: epidemiology of social inequalities in health and healthcare; health of migrants; maternal and child health

Dr. Giulia Cesaroni

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Co-Guest Editor

Department of Epidemiology—Lazio Regional Health Service, 00147 Roma, Italy
Interests: social and environmental epidemiology

Dr. Nicolás Zengarini

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Co-Guest Editor

Department of Epidemiology, ASL TO3 Piedmont Region, 10095 Grugliasco (TO), Italy
Interests: epidemiological research; social determinants of health

Special Issue Information

Dear Colleagues,

It is well known that access and quality of prevention and treatment may vary according to the socio-economic position of individuals, even in countries where there is a universal public health service, as in most European countries. This phenomenon appears to have been further exacerbated with the recent covid-19 pandemic. However, in some countries evidence on the existence of health inequalities have only recently begun to be collected. This monograph therefore, following the WHO-Europe recommendation calling on countries to “Do something, do more, do better” in tackling health inequalities, aims to gather more evidence on this topic in all European countries.

We welcome contributions on the extent, nature and determinants of socio-economic inequalities in access, quality and outcomes of health care. Space will also be given to studies concerning subgroups of the population in situations of greater vulnerability, such as immigrants, refugees, the elderly and disabled, using also a gender perspective. The second objective is to collect evidence on good practices, interventions or strategies that have been shown to have a significant impact on reducing inequalities in the access and quality of health services.

In line with the "Leaving no one behind" goal of the Joint Action on Health Equity Europe, this special issue will therefore attempt to promote awareness and knowledge on inequalities in health care and on the best strategies to reduce them.

Dr. Teresa Spadea
Dr. Giulia Cesaroni
Dr. Nicolás Zengarini
Guest Editors

Manuscript Submission Information

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

access to healthcare
healthcare quality and outcomes
prevention
inequalities
socioeconomic factors
vulnerable populations
immigrants
interventions and policies
health impact assessment

Published Papers (2 papers)

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Research

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10 pages, 505 KiB

Open AccessArticle

Healthcare Services for Undocumented Migrants: Organisation and Costs from the Italian NHS Perspective

by Elisabetta Listorti, Aleksandra Torbica, Silvano G. Cella, Gianfrancesco Fiorini, Giovanni Corrao and Matteo Franchi

Int. J. Environ. Res. Public Health 2022, 19(24), 16447; https://doi.org/10.3390/ijerph192416447 - 8 Dec 2022

Cited by 5 | Viewed by 1508

Abstract

Based on the principle of health equity, the Italian National Health Service is known worldwide for being a universalistic system that guarantees healthcare services for all its population, among which there are undocumented migrants. A commitment for their health needs is further motivated by their lower utilisation rates of healthcare services, which becomes even more crucial when considering chronic conditions such as diabetes that require adherence and continuity of care. However, the need for more official data has resulted in little research documenting these healthcare usage patterns. For this reason, our objective has been to deepen, from the Italian NHS perspective, the quantity, costs, type, preventability and organisation of healthcare services directed to undocumented migrants. We used official healthcare data from the Lombardy Region, which enable the identification of people receiving the STP code (undocumented migrants) and of people with foreign citizenship (documented migrants). After quantifying the average annual amount and expenditure for healthcare services grouped by Italian citizens, documented migrants and undocumented migrants for all clinical conditions (quantity and costs), we performed three primary investigations where we enlightened differences between the three mentioned groups focusing on the diagnosis of diabetes: (i) mapping the types of healthcare services used and their characteristics (type); (ii) quantifying the impact of preventable hospital admissions (preventability); (iii) examining the healthcare patterns linking pharmaceutical prescriptions with hospital accesses (organisation). Our results reveal significant differences among the three groups, such as more urgent hospital admissions, more preventable complications, and a higher recurrence in terms of access and costs to hospital services rather than pharmaceutical prescriptions for undocumented migrants. These findings can represent the leverage to raise awareness toward the emerging challenges of the migrant health burden. Full article

(This article belongs to the Special Issue Health Services for Migrants, Socioeconomically Disadvantaged Groups and Other Vulnerable Populations)

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14 pages, 2216 KiB

Open AccessSystematic Review

Adherence to Cervical Cancer Screening Programs in Migrant Populations: A Systematic Review and Meta-Analysis

by Isabella Rosato, Teresa Dalla Zuanna, Valentina Tricarico, Claudio Barbiellini Amidei and Cristina Canova

Int. J. Environ. Res. Public Health 2023, 20(3), 2200; https://doi.org/10.3390/ijerph20032200 - 26 Jan 2023

Cited by 5 | Viewed by 2059

Abstract

Organized cervical cancer screening programs to promote the early identification of precancerous lesions have proven to be effective in decreasing the burden associated with cervical cancer, but knowledge regarding screening adherence among migrant women compared to that of native women has not been summarized. A systematic search of the literature on PubMed, Scopus and Embase led to the identification of 772 papers that were published up to July 2022 and reported population-based data regarding adherence to cervical screening. The screening participation rates among migrant women, compared to native women, were pooled using a random-effects meta-analysis. A total of 18 papers were included in the review, with most of them being conducted in Europe (83.3%). Overall, migrants showed a significantly lower participation rate compared to native women (OR for screening adherence: 0.54, 95% CI = 0.42–0.70). This discrepancy was especially evident for migrant women from North Africa and Sub-Saharan Africa (OR = 0.47, 95% CI = 0.35–0.63, and OR = 0.35, 95% CI = 0.24–0.49, respectively). The results of this systematic review emphasize the importance of increasing cervical cancer screening adherence among migrant women. A significant heterogeneity in screening adherence was observed based on the country of origin. Interventions aimed at reducing the disparities in screening participation should specifically consider how to improve the recruitment of migrant women. Full article

(This article belongs to the Special Issue Health Services for Migrants, Socioeconomically Disadvantaged Groups and Other Vulnerable Populations)

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