Where to make a difference: research and the social determinants in pediatrics and child health in the COVID-19 era

Lachman, Peter

doi:10.1038/s41390-020-01253-0

Cited by 18 publications

(17 citation statements)

References 48 publications

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“…Thus, improving preventing measures (such as decreasing class sizes, organizing different timetables, holding lessons outdoors, physical distancing, hygiene measures, face masks and the obligation to stay at home when sick) are crucial to minimizing the risk of in-class transmission [ 46 , 47 , 59 , 60 ]. It is important to remember that social activities closures can lead to potential harmful consequences for the school-aged population and their families, concerning obesity and malnutrition, immunization rates, domestic violence and child abuse [ 57 ], delays or precocity in cognitive, physical or social growth, later diagnoses of developmental conditions and overall health inequity [ 61 , 62 , 63 , 64 , 65 , 66 ]. Thus, school closures should be correctly assessed balancing the risk/benefit ratio, protecting, on the one side, the child health and, on the other side, their crucial growth milestones.…”

Section: Discussionmentioning

confidence: 99%

Effects of Relaxed Lockdown on Pediatric ER Visits during SARS-CoV-2 Pandemic in Italy

Matera

Nenna

Morini

et al. 2021

IJERPH

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Previously, we demonstrated an 81% reduction in pediatric Emergency Room (ER) visits in Italy during the strict lockdown due to the SARS-CoV-2 pandemic. Since May 2020, lockdown measures were relaxed until 6 November 2020, when a strict lockdown was patchily reintroduced. Our aim was to evaluate the impact of the relaxed lockdown on pediatric ER visits in Italy. We performed a retrospective multicenter study involving 14 Italian pediatric ERs. We compared total ER visits from 24 September 2020 to 6 November 2020 with those during the corresponding timeframe in 2019. We evaluated 17 ER specific diagnoses grouped in air communicable and non-air communicable diseases. We recognized four different triage categories: white, green, yellow and red. In 2020 total ER visits were reduced by 51% compared to 2019 (16,088 vs. 32,568, respectively). The decrease in air communicable diseases was significantly higher if compared to non-air communicable diseases (−64% vs. −42%, respectively). ER visits in each triage category decreased in 2020 compared to 2019, but in percentage, white and red codes remained stable, while yellow codes slightly increased and green codes slightly decreased. Our results suggest that preventive measures drastically reduced the circulation of air communicable diseases even during the reopening of social activities but to a lesser extent with regard to the strict lockdown period (March–May 2020).

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Section: Discussionmentioning

confidence: 99%

Effects of Relaxed Lockdown on Pediatric ER Visits during SARS-CoV-2 Pandemic in Italy

Matera

Nenna

Morini

et al. 2021

IJERPH

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“…These include structural racism 49 and the social determinants of health 50 , including food insecurity 51 , gender inequality 52 and inherent violence 53 , 54 within many societies. COVID-19 has unmasked these 55 , and we think the new model is a response to the past failures of society to address these issues. Some may say that this is politicisation of health.…”

Section: Why Now?mentioning

confidence: 99%

A multidimensional quality model: an opportunity for patients, their kin, healthcare providers and professionals to coproduce health

2021

Self Cite

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Background: It is twenty years since the US Institute of Medicine (IOM) defined quality in healthcare, as comprising six domains: person-centredness, timeliness, efficiency, effectiveness, safety and equity. Since then, a new quality movement has emerged, with the development of numerous interventions aimed at improving quality, with a focus on accessibility, safety and effectiveness of care. Further gains in equity and timeliness have proven even more challenging. The challenge: With the emergence of “service-oriented” systems, complexity science, the challenges of climate change, the growth of social media and the internet and the new reality of COVID-19, the original domains proposed by the IOM invite reflection on their relevance and possibility for improvement. The possible solution: In this paper we propose a revised model of quality that is built on never-ending learning and includes new domains, such as Ecology and Transparency, which reflect the changing worldview of healthcare. We also introduce the concept of person- or “kin-centred care” to emphasise the shared humanity of people involved in the interdependent work. This is a more expansive view of what “person-centredness” began. The delivery of health and healthcare requires people working in differing roles, with explicit attention to the lived realities of the people in the roles of professional and patient. The new model will provide a construct that may make the attainment of equity in healthcare more possible with a focus on kindness for all.

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“…Sir Michael Marmot developed the concept of the Social Determinants of Health (SDH) finding that health outcomes are determined by “the conditions in which people are born, grow, live, work and age”. 13 The importance of SDH has been particularly stark during the pandemic as those who suffer inequality or are socioeconomically disadvantaged have been disproportionately affected. Rates of infection are four to five times higher in people of Native American, Hispanic, or Black American origin with similar patterns in the UK.…”

Section: Social Determinants Of Health and Covid-19mentioning

confidence: 99%

“…Although the causes for this disparity is not known, there is a higher prevalence of risk factors such as obesity, diabetes, and hypertension in these communities putting them at higher risk for infection. 13 …”

Section: Social Determinants Of Health and Covid-19mentioning

confidence: 99%

Pediatric Research and COVID-19: the changed landscape

Molloy

Bearer

2021

Pediatr Res

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Where to make a difference: research and the social determinants in pediatrics and child health in the COVID-19 era

Cited by 18 publications

References 48 publications

Effects of Relaxed Lockdown on Pediatric ER Visits during SARS-CoV-2 Pandemic in Italy

Effects of Relaxed Lockdown on Pediatric ER Visits during SARS-CoV-2 Pandemic in Italy

A multidimensional quality model: an opportunity for patients, their kin, healthcare providers and professionals to coproduce health

Pediatric Research and COVID-19: the changed landscape

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