De Vito Corrado, Massimi Azzurra, Di Thiene Domitilla, Rosso Annalisa, D'Andrea Elvira, Vacchio Maria Rosaria, Villari Paolo, Marzuillo Carolina
Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, Rome, 00185, Italy.
Int J Equity Health. 2016 Feb 19;15:28. doi: 10.1186/s12939-016-0318-8.
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.
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.
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.
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.
健康促进和预防活动应解决健康不平等问题，以减少弱势群体之间的健康差距。本研究旨在评估意大利各地区在预防活动规划过程中对健康不平等的考虑程度，发现地理差异，并确定对健康不平等关注差异的可能决定因素。
使用一种特定工具评估意大利各地区在2010 - 2013年国家预防计划（NPP）内制定的19份地区预防计划（RPP），以了解对健康不平等的关注程度。进行单变量和多变量分析，以确定与对健康不平等更高关注水平相关的地区特征。
在19份RPP中包含的702个项目中，只有56个（8.0%）专门涉及与健康不平等相关的问题。多变量分析结果表明，更高的关注水平与“高危人群预防”干预宏观领域、RPP战略计划部分的更高质量以及2010年该地区移民的更高比例相关。此外，涉及健康不平等主题的项目更有可能在北部地区、“联系社会资本”水平较低且2010年地区医疗保健支出（RHCE）占地区国内生产总值（RGDP）比例较高的地区开展。
意大利2010 - 2013年预防活动区域规划过程中对健康不平等的关注程度较低。本研究结果为意大利新一轮预防规划提供了支持，并突出了迫切需要增加能够减少健康不平等的政策和干预措施的数量。
