Document by the Health Committee and the Bioethics Committee of the Accademia Nazionale dei Lincei
Abstract
Inequalities in access to paediatric care are one of the most striking manifestations of the structural weaknesses in our health and social care system, as they have a direct impact on children’s growth, development and future health. Scientific evidence shows that disadvantages experienced in early life tend to accumulate, increasing the risk of chronic diseases, disability and premature death. Children’s health is influenced not only by biological factors, but also by social, economic and environmental conditions, and by the quality and accessibility of healthcare services.
In Italy, despite a universal healthcare system, significant regional and social inequalities persist: infant mortality rates, which are among the lowest on average internationally, are higher in the South and among children of foreign parents. Child poverty and socio-economic disadvantage are associated with a higher incidence of disease and poorer health outcomes. Differences in access to preventive care persist, both in terms of vaccination coverage and the adoption of healthy lifestyles, with the most critical issues affecting the most vulnerable groups, a situation further exacerbated by the spread of misinformation, particularly regarding vaccinations.
These inequalities are further exacerbated by organisational shortcomings within the healthcare system, such as the migration of paediatric patients from the south to the centre and north, and difficulties in accessing palliative care, networks for rare diseases, neonatal screening and innovative therapies. In these areas, a person’s place of birth or residence continues to have a significant impact on their opportunities for diagnosis and treatment.
Furthermore, significant limitations persist in paediatric research: the lack of specific studies and adequately evaluated treatments in children represents a structural form of inequality and limits access to safe and effective care.
These critical issues highlight limits in the governance and organisation of the healthcare system; addressing them requires not only adequate resources, but also more effective coordination and better integration between hospitals and local communities.
Investing in children’s health is a constitutional and ethical responsibility and requires a concrete commitment to tackling social and health inequalities and strengthening the National Health Service. Children’s health is one of the most sensitive indicators of social equity and the democratic quality of a country.
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attached the document in pdf format (italian version)