[Epidemiology and health needs of immigrants in Milano]

The current Italian policy on immigration tends to force immigrants coming from non-EEC countries into an illegal position. This tendency has delayed and in many cases obstructed their benefiting from the existing services. Without proper knowledge of the users, their needs and individual cultures, the problem has been faced in terms of inclusion-exclusion from the actual system without evaluating the eventual success or coherence. This study is intended as a first step towards the analysis of the meeting point between the demand of the immigrant to lead a healthy existence and the response of the Public Health Service and the Voluntary Associations operating in the Milan area. The observational study carried out from March to June 1990 involved the casualty departments of 4 of the city hospitals, public services (family and paediatric clinics) and "NAGA", an Association of volunteers which has been operating in Milan since 1987, and which offers social and health assistance to immigrants and nomads who, for legal, economical or cultural reasons cannot benefit from the Public Health Service. 2088 cards have been compiled containing social and demographic data and characteristics, description of the health problem presented and the response of the service involved. For each case the operator registered a subjective opinion regarding the adequacy of the intervention and the difficulties incurred. The information collected, highlights the various types of users of each individual service and the legal and social differences which greatly influence the approach to these services and the subsequent usage. In particular the results seem to confirm that the Public Service tends to favour groups already having a certain privilege and delegates the more "complex" problems to the Voluntary Associations.