title: Unequal access, low vaccination coverage, growth retardation rates among immigrants children in Italy exacerbated in Roma immigrants.
abstract: OBJECTIVE
  Currently children of immigrants are the fastest growing segment of the Italian population under the age of 18. The present study reports the challenges to health services access, the vaccination coverage, the health and nutritional status of a sample of 1310 children of immigrants attended from February 2004 to May 2012 the health center "Medicina Solidale" of the "Policlinico Tor Vergata" in the suburban area of the VIII Municipality of Rome.
  
  
  METHODS
  The data were collected using clinical archives of the health center. We analyzed the socio-demographic conditions, health problems and nutritional status on admission to the health center. The anthropometric evaluation was carried out according to international standards of child growth WHO 2006 and the statistical analysis was performed using SPSS version 19, and including risk estimation, Mantel Haentzel statistics and t-test.
  
  
  RESULTS
  Sixty-six percent of the children were born in Italy, 62% had never had regular health care and 3.4% of children older than six months had never received any of the immunizations. It has been estimated that being Roma the risk of not been vaccinated is equal to OR=5.4 (IC95%: 2.8-10.1). Seventy-seven percent of unvaccinated children had at least one illiterate parent. This condition was strongly associated with non-immunization (OR=15:36 [IC95%: 6.4-36.4]). Growth retardation was common in Roma children as compared to other ethnicities.
  
  
  CONCLUSIONS
  Significant public health efforts are needed to improve access to health services for immigrant populations and to solve relevant inequalities.
authors.affiliation: Department of Biomedicine and Prevention University of Rome "Tor Vergata", Rome, Italy - ersilia.buonomo@uniroma2.it.
authors.forename: L
authors.initials: L
authors.lastname: Ercoli
authors.forename: G
authors.initials: G
authors.lastname: Iacovone
authors.forename: S
authors.initials: S
authors.lastname: De Luca
authors.forename: S
authors.initials: S
authors.lastname: Mancinelli
authors.forename: F
authors.initials: F
authors.lastname: Gilardi
authors.forename: B
authors.initials: B
authors.lastname: Boscherini
authors.forename: L
authors.initials: L
authors.lastname: Palombi
authors.forename: E
authors.initials: E
authors.lastname: Buonomo
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004522:Educational Status; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data*; D005260:Female; D006130:Growth Disorders / Q000453:epidemiology / Q000208:ethnology; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006304:Health Status; D054625:Healthcare Disparities / Q000208:ethnology / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007558:Italy / Q000453:epidemiology; D008297:Male; D009752:Nutritional Status; D012189:Retrospective Studies; D006178:Romani People / Q000706:statistics & numerical data*; D014611:Vaccination / Q000706:statistics & numerical data*