Gender health and policies: the state of the art from exposure to solutions.

OBJECTIVE: To synthesize the determinants of gender inequalities through a narrative review that: (i) describes gender related variables that can create different levels of health; (ii) describes key points that may assist in policy development and its reorientation towards gender differences; (iii) debates potential approaches in understanding gender issues. METHODS: Review of the international literature through online databases (Pubmed), search engines, publications and documents from "grey literature". INCLUSION CRITERIA: publications from 1997, English language; keywords used: gender based analysis; gender and public policy; women's health; gender differences; health policy; gender impact assessment. Among the 300 papers retrieved, 55 were selected for relevance. RESULTS: We performed a narrative synthesis of the included literature, regarding: (i) gender differences and their determinants; (ii) elements for the changing; (iii) possible approaches; (iv) gender influences the pursuit of health and health care access through specific variables; (v) health policies can modify these variables only by a minimal percentage. These interventions should guarantee equity and allow efficient resources allocation. The gap between political announcements and real policy implementation remains unchanged. (vi) Standard approaches to the topic are not feasible due to the scarcity of a specific literature and the numerous cultural differences. CONCLUSIONS: . Gender analysis of policies suggests they can differently affect women in comparison to men. However, reforms, strategies and interventions introduced in the last two decades, have achieved a limited success towards better gender equality in health. The main aim is to attack the structural sources of gender inequity in the society.

Recreational drug consumers: who seeks treatment?

BACKGROUND: Recreational drug consumption represents a complex issue, because of the lack of a shared definition, settings and patterns of consumptions, and poorness of evidence-based treatments. In spite of the great number of users, just few seek specific treatment, probably representing those at major risk of continuing and problematic use. The general objective of this study was to report the characteristics and main consumption patterns of recreational drug consumers treated in Regione Piemonte (Italy), in order to formulate hypotheses suitable for further research aimed at establishing more effective preventive intervention and treatment. METHODS: All addiction treatment services in the region were required to fill in, for each user, a questionnaire reporting: contact of the user with the service, socio-demographic data, drugs consumption and interventions/treatments. RESULTS: Among 441 users, 70.3% were new users, 85.5% were males and the average age of consumption onset was 22 years. Psychiatric and traumatics events were present in 13.3% and in 17.9% of cases, respectively. The most frequent primary substances were cocaine (76.9%) and ecstasy (13.8%). Substances taken in association with primary drug are quoted in 75% of cases. CONCLUSIONS: The users that get in touch with services are those showing greater problems, representing, therefore, the main target for preventive public health interventions. Some interesting points can be noted: among patients treated, cocaine represents the main issue; females seem to be more sensitive to recreational drug effects; social class (education), settings and use habits are similar for recreational drugs users and heroin users.

Decennial trends of social differentials in smoking habits in Italy.

OBJECTIVE: To present social trends of smoking habits in Italy during the period 1980-1994. METHODS: Data from five national health surveys (1980, 1983, 1986-1987, 1990-1991, 1994) were analyzed in order to calculate smoking prevalences. Education attained was used as social class indicator. MAIN MEASURES: SDPs (prevalence rate standardized on the 1981 Italian population) and PRs (prevalence ratios primary school/degree). Confidence intervals and p-values were calculated as indicators of statistical significance. RESULTS: Among men SDP decreased from 59.5% in 1980 to 37.3% in 1994 and PRs for social classes varied from 1.21 in 1980 to 1.47 in 1994. Corresponding results for women were 17.9% to 20.0% and 0.36 to 0.73. CONCLUSIONS: Lower-educated men smoke more than those in higher social categories, and data collected during 1980-1994 in Italy show a tendency to increase such differentials. Among women this pattern was the opposite in 1980, with a tendency to reduce differences over time. Therefore, for both genders data show a progressive disadvantage for the low-educated categories. The greater compliance of better-educated groups with anti-smoking interventions must be taken into account, and should suggest "unequal" interventions that can be more effective among disadvantaged social groups.