Abstract
Purpose: Gynecologic and obstetric health and intimate partner violence are particularly influenced by social determinants of health, such as poverty, low education, and poor nutritional status, and by ethnic and racial factors. In this study, we evaluated health and social inequalities of women living in disadvantaged neighborhoods in the city of Rome, Italy.Methods: The study included 128 women living in socioeconomically disadvantaged neighborhoods. For each woman, a medical record was compiled and a gynecologic examination with screening for cervical cancer was performed. Family network, risk factors for gender-based violence, and psychological abuse were also evaluated.Results: The largest part of the sample, although had adequate schooling, was unemployed or had a low-status job; this was at the basis of intimate partner violence in about one-third of our sample. Nearly 35% of our sample was composed of pregnant women; about half of them were not assisted by the public health system for routine obstetric examinations. Common findings at gynecologic examination for nonpregnant women were infections (n=18, 19.9%), pregnancy planning (n=13, 13.7%), menopause management (n=12, 12.6%), ovarian fibromas (n=6, 6.3%), and post-partum assistance (n=3, 3.2%). Screening for cervical cancer was executed in 62 women; 9 (14.5%) had low- or high-grade squamous intraepithelial lesion or cervical carcinoma.Conclusions: Health and social inequalities are frequent in women living in disadvantaged conditions, with serious consequences for health and quality of life of women and of their children. Prevention and treatment, especially for the most vulnerable subjects, should be a priority for the public health system.
Highlights
We evaluated several key elements of women living in socioeconomically disadvantaged neighborhoods in the city of Rome, Italy, with special focus on gynecologic and obstetric health and intimate partner violence
Network and intimate partner violence The presence of a family network, its socioeconomic status, and potential intimate partner violence were evaluated through an interview with a psychologist
Our study allowed a precise evaluation of demographic characteristics, availability of a family network, intimate partner violence, gynecologic and obstetric health, and access to public health care system of women living in disadvantaged socioeconomic conditions
Summary
Gender differences have a significant impact on physical, psychological, and socioeconomic status.[1,2] Women have higher chances to get sick and consume more drugs, and are socially disadvantaged compared to men for physical and psychological violence, higher unemployment rates, and economic freedom.[1,2,3,4] In the United States, women’s poverty rates are substantially above the rates for men, with a poverty rate of 14.5% for women and 11% for men, and nearly 18 million women living in poverty.[5,6] Similar rates have been reported in Europe.[7,8]Living in disadvantaged neighborhoods may further increase the gender gap, as groups of population with socioeconomic disadvantages are more likely to have bad health conditions and suffer more from chronic diseases; in addition, they have less chances to receive proper health assistance and develop more frequently acute and chronic diseases.[9,10,11]Gynecologic and obstetric health of women is strongly influenced by social determinants of health, such as poverty, low education, and poor nutritional status, and by ethnic and racial factors.[12,13,14,15] Evidence has shown that women with lower socioeconomic status have significantly higher incidence of benign and malignant gynecologic conditions compared to those with higher socioeconomic status, regardless of demographic factors such as race and ethnicity.[16]. Gender differences have a significant impact on physical, psychological, and socioeconomic status.[1,2] Women have higher chances to get sick and consume more drugs, and are socially disadvantaged compared to men for physical and psychological violence, higher unemployment rates, and economic freedom.[1,2,3,4] In the United States, women’s poverty rates are substantially above the rates for men, with a poverty rate of 14.5% for women and 11% for men, and nearly 18 million women living in poverty.[5,6] Similar rates have been reported in Europe.[7,8].
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