Impact of Ethnicity on COVID-19 Related Hospitalizations in Children During the First Pandemic Wave in Northern Italy

There is increasing evidence that black people and other minorities have a higher incidence of severe COVID-19 disease, but little is known about the situation of children, especially in Europe. In general children are less infected and if so, frequently show mild or asymptomatic disease, making conclusions difficult. We collected data on SARS-CoV-2 associated hospitalizations in a well-defined population of 550,180 children up to 15 years in five hub-centers during the “first wave” at the heart of the pandemic in Northern Italy. Among the 451,053 Italian citizens 80 were hospitalized as compared to 31 out of 99,127 foreign citizens, giving a significantly higher risk (odds ratio 1.76; 95% CI: 1.16–2.66) for the foreign children. The risk was highest for children of African ethnicity as compared to Italians with an odds ratio of 2.76 (95% CI: 1.56–4.87). None of the patients deceased. There was no significant difference in age (thou infants regardless of ethnicity had a 10-fold higher risk), sex, length of hospitalization or comorbidities, namely overweight. As bureaucratic, cultural and information barriers mostly affect preventive and adult services and considering that in contrast to other countries, in Italy pediatric care is guaranteed free of (out-of-pocket) charge to all people <16 years, and hospitals are densely spaced, access to health care seems to be a minor problem. Thus, other possible root causes are discussed. We believe that this is an unbiased starting point to understand and overcome the reasons for the higher risk those children experience.

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Migration and access to health care in English medical law: a rhetorical critique

International Journal of Law in Context ◽

10.1017/s1744552309004029 ◽

2008 ◽

Vol 4 (4) ◽

pp. 315-335 ◽

Cited By ~ 6

Author(s):

John Harrington

Keyword(s):

Health Care ◽

Access To Health Care ◽

Medical Law ◽

The European Union ◽

Persuasive Strategies ◽

Access To Health ◽

Starting Point ◽

The One ◽

The Individual ◽

The Uk

This paper develops a rhetorical critique of recent cases on migration and access to health care in Britain. It argues that the national territory, once a taken-for-granted starting point for reasoning in medical law, has lost its common-sense status as a result of neoliberal globalisation. This is evident in recent decisions involving on the one hand HIV-positive asylum seekers coming to the UK and on the other hand British ‘health tourists’ seeking funding for treatment elsewhere in the European Union. Courts are aware that many of these cases are likely to call forth the sympathy of audiences for the individual concerned, further undermining their privileging of the national scale. In curbing this ‘politics of pity’ they adopt a range of persuasive strategies.

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Outcome of African-American (AA) Multiple Myeloma (MM) Patients after Autologous Stem Cell Transplantation (ASCT): A Single-Center Experience.

Blood ◽

10.1182/blood.v112.11.3327.3327 ◽

2008 ◽

Vol 112 (11) ◽

pp. 3327-3327

Author(s):

Yin Wu ◽

Olga Goloubeva ◽

Kathleen Ruehle ◽

Saul Yanovich ◽

Aaron P. Rapoport ◽

...

Keyword(s):

Mortality Rate ◽

Access To Health Care ◽

Cox Regression ◽

The Past ◽

Single Center Experience ◽

Time Period ◽

Younger Age ◽

Access To Health ◽

Significant Difference ◽

Caucasian Patients

Abstract The incidence of MM in African-Americans is more than double that in Caucasians. Historically AAs have had a higher mortality rate than Caucasians; but over the past 10 yrs, the age-adjusted mortality rate has been on the decline for AAs while it has been stable for Caucasians as a result of ASCT and novel agents. Previous studies (n=74 AA patients) suggested that response to ASCT is similar, if not better, for AA patients (Verma et al 2008, Saraf et al 2006). We retrospectively analyzed the clinical presentation of a large cohort of AA patients (n=103) who underwent ASCT at our center between 1998 and 2008 and compared their outcome to that of Caucasians patients (n=183) transplanted in the same time period. AA patients were significantly younger than Caucasian patients at diagnosis with median age 53 (range: 32–75) vs 59 (range: 27–80), respectively (p<0.0001). The distribution of isotype and stage of MM at diagnosis were similar between the two groups. Approximately 20% patients in each group presented with renal insufficiency. Among the AA patients, 45% had albumin < 3.5 g/dL; 14% and 18% had beta2-microglobulin > 3.5 mg/L and > 5.5 mg/L, respectively. Initial cytogenetic data were not available for the majority of patients. Median time from diagnosis to ASCT was significantly longer for AA than for Caucasian patients at 0.8 yrs (range: 0.23–9.2) vs 0.5 yrs (range: 0.1– 7.0), respectively (p<0.0001). There was no difference in incidence of transplant-related complications, as reflected by similar lengths of hospital stay, with a median of 15 days for both groups. No significant difference in response to ASCT was found between the two groups. Median EFS was 1.7 yrs (range: 1.5–2.7) for AAs and 1.8 yrs (range: 1.5–2.4) for Caucasians (p=NS). At a median follow up of 5 yrs, 74% of AA and 70% of Caucasian patients were alive. Median OS was also not significantly different at 9 yrs (range: 6.7- not reached) for AAs and 8 yrs (range: 5.9-not reached) for Caucasians (p=NS). Cox regression model for prognostic markers: albumin, calcium, creatinine, hemoglobin, and platelet count were significant for OS in AA patients (p range 0.004–0.0001). The current study is the largest one of AA patients undergoing SCT at a single institution. AA patients with MM present at a younger age, but undergo ASCT at a significantly later time from diagnosis than Caucasian patients. This delay may reflect a disparity in referral pattern and access to health care. AA patients have similar EFS and OS after ASCT. It is likely that better responses to the newer anti-myeloma agents, as well as favorable impact of ASCT, even if delayed, may explain the improvement of AA patients with MM over the past decade. Further studies of responses of AA patients to novel myeloma agents are needed.

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PROSPECTS FOR REFORM OF MEDICAL COVERAGE IN MOROCCO

International Journal of Advanced Research ◽

10.21474/ijar01/12388 ◽

2021 ◽

Vol 9 (01) ◽

pp. 1039-1055

Author(s):

Kaoutar Chiheb ◽

◽

Mohamed Sbihi ◽

Keyword(s):

Health Care ◽

Health Insurance ◽

Access To Health Care ◽

Health Sector ◽

Healthcare Services ◽

Equal Access ◽

Basic Health Insurance ◽

Government Institutions ◽

Access To Health ◽

Starting Point

For equal access to health care and to allow citizens greater access to the health system, Law 65-00 relating to Basic Health Insurance (BHI) was created in Morocco in 2005. The development of this law marks the starting point for all optimized actions with measurable objectives in the health sector. Even if this law has evolved gradually to try to generalize medical coverage, but it currently remains obsolete, because fifteen years after its implementation, it has not allowed the universalization of medical coverage to all citizens. However, further reform is called for. Government, institutions and society are under increasing pressure to ensure further reform. The constraints of implementing solid governance, financing, equal access to healthcare services are challenges to be taken up in order to reform the regulations relating to medical coverage in Morocco.

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A MCDA/GIS-Based Approach for Evaluating Accessibility to Health Facilities

10.1007/978-3-030-86973-1_22 ◽

2021 ◽

pp. 311-322

Author(s):

D. F. Lopes ◽

J. L. Marques ◽

E. A. Castro

Keyword(s):

Policy Making ◽

Access To Health Care ◽

Health Care Services ◽

Health Facilities ◽

Special Focus ◽

Care Services ◽

Access To Health ◽

Starting Point ◽

New Variant ◽

Good Starting Point

AbstractAccess to health care services is a key concept in the formulation of health policies to improve the population’s health status and to mitigate inequities in health. Previous studies have significantly enhanced our understanding and knowledge of the role played by spatial distribution of health facilities in sustaining population health, with extensive research being devoted to the place-based accessibility theory, with special focus on the gravity-based methods. Although they represent a good starting point to analyse disparities across different regions, the results are not intelligible for policy-making purposes. Given the weaknesses of these methods and the multidimensional nature of the topic, this study intends to: (i) highlight the main measurements of access and their major challenges; and (ii) propose a framework based on multiple criteria decision analysis methods and GIS to appraise the population’s accessibility to health facilities. In particular, this framework is based on a new variant of the UTASTAR method, which requires decision makers and/or experts preference information, in the form of an ordinal ranking, similarly to the UTASTAR method, but to which cardinal information is also added. A numerical example is presented to illustrate the application of the proposed methodology.

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PERLINDUNGAN HAK DAN PEMENUHAN AKSES ATAS KESEHATAN BAGI TENAGA KERJA INDONESIA DI LUAR NEGERI

Mimbar Hukum - Fakultas Hukum Universitas Gadjah Mada ◽

10.22146/jmh.17651 ◽

2017 ◽

Vol 29 (1) ◽

pp. 54

Author(s):

Aktieva Tri Tjitrawati

Keyword(s):

Health Insurance ◽

Migrant Workers ◽

Access To Health Care ◽

Poor Quality ◽

Health Coverage ◽

Access To Health ◽

Starting Point ◽

The Right ◽

Universal Health

AbstractMillions of Indonesian migrant workers living in other countries, most of them are illegal workers and are not covered by health insurance. They are very susceptible to disease because of poor quality of life and does not have access to health care. Sovereignty of the recipient State confine Indonesia to provide health protection for them,, as it has been provided by all the citizens in Indonesia through the mechanism of National Health Insurance (JKN). Protection of the right to health as part of human rights in this study is used as a starting point the imposition of obligations of the state, both sending and receiving, to cooperate in improving the health of migrant workers. Cooperation can be done through the establishment of international agreements on the implementation of Universal Health Coverag, both in the sending and receiving States.IntisariJutaan buruh migran Indonesia tinggal di luar negeri, sebagian besar dari mereka adalah ilegal dan tidak tercakup oleh asuransi kesehatan. Mereka sangat rentan terhadap penyakit akibat buruknya kualitas hidup dan tidak dimilikinya akses terhadap sarana kesehatan. Kedaulatan negara penerima menghalangi tangan negara pengirim untuk memberikan perlindungan kesehatan, sebagaimana yang telah diterima oleh semua warga di Indonesia melalui mekanisme Jaminan Kesehatan Nasional (JKN). Perlindungan hak atas kesehatan sebagai bagian dari hak asasi manusia dalam penelitian ini digunakan sebagai titik awal pengenaan kewajiban negara, baik negara pengirim maupun negara penerima, untuk bekerja sama dalam meningkatkan derajat kesehatan pekerja migran. Kerjasama dapat dilakukan melalui pembentukan perjanjian internasional mengenai penerapan Universal Health Coverage yang berlaku, baik di negara pengirim maupun negara penerima.

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Using Technology to Improve Access to Health Care for Culturally and Linguistically Diverse Populations

Perspectives on Communication Disorders and Sciences in Culturally and Linguistically Diverse Populations ◽

10.1044/cds19.3.71 ◽

2012 ◽

Vol 19 (3) ◽

pp. 71-76 ◽

Cited By ~ 1

Author(s):

Pauline A. Mashima

Keyword(s):

Health Care ◽

Health Care Providers ◽

Access To Health Care ◽

Underserved Populations ◽

Linguistically Diverse ◽

Care Providers ◽

Department Of Health ◽

Use Of Technology ◽

Access To Health ◽

Improve Access

Important initiatives in health care include (a) improving access to services for disadvantaged populations, (b) providing equal access for individuals with limited or non-English proficiency, and (c) ensuring cultural competence of health-care providers to facilitate effective services for individuals from diverse racial and ethnic backgrounds (U.S. Department of Health and Human Services, Office of Minority Health, 2001). This article provides a brief overview of the use of technology by speech-language pathologists and audiologists to extend their services to underserved populations who live in remote geographic areas, or when cultural and linguistic differences impact service delivery.

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