Closing the gap: a multi-stakeholder initiative of health promotion in 20 suburban Roman districts

Issue In the last decade the economic crisis, in addition to urban, demographic and ethnic changes, led to an important reduction in preventive services access and social-healthcare pathways, impacting more on disadvantage groups, especially elderly and frail people. In a complex city such as Rome, where over 65 population with average income less than 11.000 €a year is 28,6%, social isolation and related health issues represent a focal question. In order to strengthen health promotion and prevention in elderly, a multi-stakeholder project has started in Parishes of 20 socially disadvantaged Roman districts. Description of the problem To assess social and health needs of the elderly, a counselling service composed by a psychologist, a social assistant and local volunteers, trained in health determinants and empathy skills, has been set up in each Parish. A Mobile Health Unit (MHU) with a general practitioner and a nurse offer free medical visits focused on nutrition, cardiovascular diseases, diabetes and active ageing. A functional network among counselling services in Parishes, the Vicariatus Urbis, MHU team and district’s services has been structured in order to address user’s needs. Health promotion meetings have also been proposed in the Parishes to empower, enable and increase elderly health literacy. Previous informed consent, data about user’s social-health status are collected in order to provide a better assessment and support. Results From February 2017, MHU provided more than 120 medical visits and an average of 10 elders per week in each Parish require counselling services. MHU’s users have a mean age of 70 ± 10.3 SD (68.6% female and 31.4% male), 51% living with relatives and 30% alone. Lessons First results suggest that the project has correctly identified latent social and health needs of elderly people living in suburban areas trying to close the gap between ease/dis-ease condition. Follow-up data analysis will assess the project’s effectiveness. Key messages: Focused social inclusion and health promotion programs have to be implemented on disadvantaged groups living in suburban districts, especially elderly living alone or in a margined condition. Multi-stakeholder network can be considered a driver to support health promotion and reduce inequalities in access to healthcare.