“The scenario we find ourselves in today, especially for our children and adolescents, is not very comforting. Being born in one region or another is not the same thing in a patchy Italy and Covid has aggravated and amplified an already unacceptable situation. The critical issues that existed before have been amplified and aggravated by the pandemic”. This was stated by Carla Garlatti, Authority for Childhood and Adolescence, speaking today at the Ministry of Health at the General States of Pediatrics 2023 entitled ‘The child at the center of the pediatric area’, promoted by the Italian Society of Pediatrics (Sip ) with the participation of institutions, the main scientific societies and organizations in the pediatric area, family associations and the media.
“We have experienced a serious pandemic period with very strong repercussions on everyone, but especially on minors – underlines Garlatti – The war in Europe has a negative influence, as does the climate crisis. In all of this we must have a vision towards a situation of well-being. From where to start?Investing in the first thousand days of life, which is essential because it will lead to cascading consequences.The same 2000 Nobel Prize in Economics, James Heckman, points out that investments in the very first years of life affect the ability to earn in the future. The inequalities of his family, of the social network in which he lives, material poverty, but often also educational poverty, negatively reverberates in the child and in his growth with a very high cost for the whole of society”.
On the regional differences between North and South, “life expectancy – recalls the Guarantor citing Istat data – in 2021 was estimated at around 82 years, but there is a difference of 3 years and 7 months if you were born in Bolzano or in Caltanissetta. Life expectancy in health varies up to 12 years if born in Calabria or Trentino, a value that reaches 15 years for girls”. And again: “1.4 million minors are in absolute poverty, that is, they live in unhealthy, overcrowded environments without the primary goods of a meal a day, a heated house, a dignified life. This is 14% of the minor population, which in the South rises to 16%”. Another figure is infant mortality: “If you were born in Tuscany – Garlatti points out – it is 1.45 for every 1,000 live births, in Sicily it is 3.34 and in Calabria 4.42. Furthermore, a child who falls ill in Southern Italy has a 70% higher percentage, compared to that which arises in the Centre-North, of facing healthcare migration. This does not mean a lack of excellent doctors – he points out – but a lack of structure. We know the importance of screening neo and perinatal, but there are structures that do not have the instruments to intercept these diseases that could be treated”.
On mental health, “the report of the Child Jesus – continues the Guarantor – shows a very severe increase in access to the neuropsychiatric emergency room”. Citing data from the Atlas of childhood at risk, published by Save Tue Children in 2022, Garlatti recalls “a 40% increase in accesses to the pediatric neuropsychiatry emergency room for cutting (cutting the skin, ed), suicidal intent and eating disorders, with a 4-fold increase in males, and social withdrawal (Hikikomori).Requests for admissions to Neuropsychiatry have increased by 70%, but not the places.Already before there was an important shortage: now it has increased. However, let’s consider that in Calabria, Molise, Umbria, Basilicata and Valle D’Aosta there are really no places.The lack of home support structures makes the shortage even more serious”.
The suicidal risk “has increased significantly – the doctor reiterates – In the Bambino Gesù report we read that the depression of children, if promptly intercepted, has excellent possibilities of cure. A situation that cannot fail to alarm. As a guarantor Authority I have activated, During the year, a three-year scientific study, with intermediate steps, on the effects of Covid on mental health. The first phase was published in May and shows a real emergency on mental health. Now the second phase is activated, quantitative, for evaluate the differences.The study is carried out with the Higher Institute of Health (ISS), the Ministry of Education and Merit, and” the results “evaluated by a scientific committee of absolute excellence”.
Another “alarming” data, Garlatti notes, is the expenditure dedicated to health care. “If we remove the investments made to stem the pandemic, the expenditure dedicated to health care has decreased more and more: in 2019 it was 6.4% of GDP, while Germany was 9.8% and France 9 3%. But spending on minor children is 2.3% of GDP in Italy, while in France it is 1.9% and in Germany 1.8%”. In addition, “the wealthiest families can afford 250 euros a month for healthcare by turning mainly to private individuals – the lack of places in Neuropsychiatry leads to moving to the private sector – In the South, 50 euros are not reached or slightly exceeded: addresses the health service, if it exists and if it works. Despite the severe demographic decline, there are a lack of 1,400 paediatricians and, if by law each should have no more than 800 patients, there is an average of 883”.