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儿童健康不平等的社会和经济决定因素:慢性肾脏病模型

Social and economic determinants of pediatric health inequalities: the model of chronic kidney disease.

作者信息

Sereni Fabio, Edefonti Alberto, Lepore Marta, Agostoni Carlo, Sandoval Diaz Mabel, Silva Galan Yajaira, Montini Giovanni, Tognoni Gianni

机构信息

Department of Clinical Science and Community Health, University of Milan, Milan, Italy.

Pediatric Nephrology and Dialysis Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy.

出版信息

Pediatr Res. 2016 Jan;79(1-2):159-68. doi: 10.1038/pr.2015.194. Epub 2015 Oct 14.

Abstract

Purpose of this review is to deal with priorities and strategies to significantly tackle inequalities in the management of pediatric diseases in low-middle-income countries. This issue has become a focal point of epidemiological and public health, with special reference to chronic nontransmissible diseases. We will provide our readership with an essential overview of the cultural, institutional, and political events, which have occurred over the last 20 y and which have produced the current general framework for epidemiology and public health. Then the most recent epidemiological data will be evaluated, in order to quantify the interaction between the medical components of the disease profiles and their socioeconomic determinants. Finally, a focus will be added on models of pediatric chronic kidney diseases, which are in our opinion amongst the most sensitive markers of the interplay between health and society. Collaborative, pediatrician-initiated, multicentre projects in these fields should be given priority in calls for grants supported by public agencies. The involvement of a critical mass of those working in the "fringes" of pediatric care is a final, essential mean by which significant results can be produced under the sole responsibility and research interest of centers of excellence.

摘要

本综述的目的是探讨在低收入和中等收入国家显著解决儿科疾病管理不平等问题的优先事项和策略。这个问题已成为流行病学和公共卫生的焦点,尤其是慢性非传染性疾病方面。我们将为读者提供过去20年发生的文化、机构和政治事件的基本概述,这些事件形成了当前流行病学和公共卫生的总体框架。然后将评估最新的流行病学数据,以量化疾病谱的医学组成部分与其社会经济决定因素之间的相互作用。最后,将重点关注儿科慢性肾脏病模型,我们认为这些模型是健康与社会相互作用中最敏感的指标之一。在公共机构支持的拨款申请中,应优先考虑这些领域由儿科医生发起的多中心合作项目。让大量从事儿科护理“边缘”工作的人员参与进来,是在卓越中心的唯一责任和研究兴趣下取得显著成果的最终关键手段。

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