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      Low level of attention to health inequalities in prevention planning activities of the Italian Regions

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          Abstract

          Background

          Health promotion and prevention activities should tackle health inequalities to reduce disparities in health among disadvantaged populations. This study aimed to assess the extent to which the Italian Regions considered health inequalities during the planning of prevention activities, to detect geographical differences and to identify the possible determinants of differences in attention to health inequalities.

          Methods

          The 19 Regional Prevention Plans (RPPs) developed by Italian Regions within the National Prevention Plan (NPP) 2010–2013 were assessed using a specific tool to address the level of attention to health inequalities. Univariate and multivariate analyses were performed to identify regional characteristics associated with a higher level of attention to health inequalities.

          Results

          Of the 702 projects included in the 19 RPPs, only 56 (8.0 %) specifically addressed issues related to health inequalities. The results of the multivariate analysis showed that a higher level of attention was associated with the macroarea of intervention ‘prevention in high-risk groups’, with the higher quality of the Strategic Plan Section of the RPP and with the higher percentage of migrants in the Region in 2010. Moreover, projects that addressed the topic of health inequalities were more likely to be developed in the Northern Regions, in Regions with a lower level of ‘linking social capital’ and with a Higher Regional Health Care Expenditure (RHCE) as a percentage of Regional Gross Domestic Product (RGDP) in 2010.

          Conclusions

          The level of attention to health inequalities in the regional planning process of prevention activities 2010–2013 in Italy is low. The results of this study supported the new round of prevention planning in Italy, and highlight the urgent need to increase the number of policies and interventions able to reduce health inequalities.

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          Most cited references44

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          Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013

          Up-to-date evidence about levels and trends in disease and injury incidence, prevalence, and years lived with disability (YLDs) is an essential input into global, regional, and national health policies. In the Global Burden of Disease Study 2013 (GBD 2013), we estimated these quantities for acute and chronic diseases and injuries for 188 countries between 1990 and 2013.
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            Migration-related health inequalities: showing the complex interactions between gender, social class and place of origin.

            In this paper, we briefly review theories and findings on migration and health from the health equity perspective, and then analyse migration-related health inequalities taking into account gender, social class and migration characteristics in the adult population aged 25-64 living in Catalonia, Spain. On the basis of the characterisation of migration types derived from the review, we distinguished between immigrants from other regions of Spain and those from other countries, and within each group, those from richer or poorer areas; foreign immigrants from low-income countries were also distinguished according to duration of residence. Further stratification by sex and social class was applied. Groups were compared in relation to self-assessed health in two cross-sectional population-based surveys, and in relation to indicators of socio-economic conditions (individual income, an index of material and financial assets, and an index of employment precariousness) in one survey. Social class and gender inequalities were evident in both health and socio-economic conditions, and within both the native and immigrant subgroups. Migration-related health inequalities affected both internal and international immigrants, but were mainly limited to those from poor areas, were generally consistent with their socio-economic deprivation, and apparently more pronounced in manual social classes and especially for women. Foreign immigrants from poor countries had the poorest socio-economic situation but relatively better health (especially men with shorter length of residence). Our findings on immigrants from Spain highlight the transitory nature of the 'healthy immigrant effect', and that action on inequality in socio-economic determinants affecting migrant groups should not be deferred. Copyright © 2010 Elsevier Ltd. All rights reserved.
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              Test of the 'healthy migrant hypothesis': a longitudinal analysis of health selectivity of internal migration in Indonesia.

              Yao Lu (2008)
              Previous studies show migrants are generally healthier than the populations in receiving societies, a result generally attributed to the positive selection of migrants on health. This hypothesis, however, has not been adequately evaluated due to lack of adequate data. In this article, using high-quality longitudinal data from Indonesia, the health selectivity hypothesis, also referred to as the healthy migrant hypothesis, is examined with respect to internal migration. Specifically, this study explores whether pre-migration health status affects the likelihood of migration by comparing those from the sending population who do and do not move. Results show that migrants in Indonesia tend to be selected with respect to health and that this selection is robust to household unobserved heterogeneity. However, the strength and direction of the health-migration association vary by types of migration and dimensions of health.
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                Author and article information

                Contributors
                corrado.devito@uniroma1.it
                azzurra.massimi@uniroma1.it
                dotilla@libero.it
                annalisa.rosso@uniroma1.it
                elvira.dandrea@gmail.com
                rosaria.vacchio@uniroma1.it
                +39 06 49914886 , paolo.villari@uniroma1.it
                carolina.marzuillo@uniroma1.it
                Journal
                Int J Equity Health
                Int J Equity Health
                International Journal for Equity in Health
                BioMed Central (London )
                1475-9276
                19 February 2016
                19 February 2016
                2016
                : 15
                : 28
                Affiliations
                Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, Rome, 00185 Italy
                Article
                318
                10.1186/s12939-016-0318-8
                4759742
                26892002
                088d6158-de98-46bd-91d4-4d58d16af862
                © De Vito et al. 2016

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 15 August 2015
                : 11 February 2016
                Funding
                Funded by: Italian Ministry of Health
                Categories
                Research
                Custom metadata
                © The Author(s) 2016

                Health & Social care
                prevention,health inequalities,national prevention plan
                Health & Social care
                prevention, health inequalities, national prevention plan

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