Health assistance for people living in highly marginalized social and sanitary conditions, such as homeless persons, detainees, and irregular migrants, remains an underexplored issue. This topic was discussed at a conference held at the Italian National Institute of Health (Istituto Superiore di Sanità, ISS) in Rome on June 25, during the presentation of a special issue of the National Epidemiological Bulletin (BEN) on this subject.

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Situation in Capitanata di Foggia area

During the conference, various experiences related to assisting "excluded or invisible" individuals were presented and shared.

One notable example came from an inquiry conducted by the NGO Intersos, which provides daily primary care and health interventions in the Capitanata di Foggia area. Here, mostly irregular migrants are exploited in the agro-food sector and live in permanently isolated and overcrowded shantytowns, or "ghettos".

The inquiry shows that the health profile of those living in the area is characterized mainly by non-transmissible conditions, such as digestive system and musculoskeletal disorders. There is no evidence of contagious imported or tropical diseases, although work-related traumas are frequent.

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Health issues of marginalized in greater urban areas

Concerning the health status of those excluded in the greater urban areas, the Caritas organization of Rome found that, during the last 40 years, there has been an increase in chronic diseases, in particular cardiovascular and metabolic ones, and a reduction in infectious ones.

The Opera San Francesco association in Milan instead explored the frequency of chronic diseases of those it assists and it estimated a prevalence of cardiovascular, mental, and metabolic (diabetes) diseases among migrants of South America and Asia compared to European populations.

Another topic discussed at the conference was the health of detainees. As reported in a special issue presented at the event, this area "has yet to be studied well."

"Unfortunately, in this context, the epidemiological research still appears to be under-explored. There is lack or need to perfect infrastructures for the systematic collection of data" and "there are few training initiatives for health workers in the territorial services", was underscored by the authors of this special research.

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