ATS Val Padana Launches Child Health Study: Insights for U.S. parents
An in-depth look at a European initiative exploring critical factors in early childhood growth, with relevance for
American families.
Published:
A European Study with Global implications
in April 2024,coinciding with World Health Day on April 7th,ATS Val Padana,a regional health agency in Italy,
launched the 2025 edition of its “0-2 years surveillance system on the main health determinants in the child”
study. This initiative, supported by the Istituto Superiore di Sanità (Italian National Institute of Health) and the
Italian Ministry of Health, and coordinated by the Lombardy Region, aims to gather crucial data on factors influencing
the health and well-being of infants and toddlers. While the study is based in Italy, the issues it addresses—from
vaccinations to environmental risks—are highly relevant to parents and healthcare professionals in the United States.
The study’s focus on early childhood aligns with growing recognition in the U.S.of the critical importance of the
first 1,000 days of a child’s life. Research consistently demonstrates that experiences during this period profoundly
impact long-term health, development, and well-being. understanding the determinants explored in the ATS Val Padana
study can offer valuable insights for American parents and policymakers alike.
Key Areas of Inquiry
The “0-2 years surveillance system” comprehensively examines various factors influencing child health. These include:
- Folic Acid Intake: Monitoring folic acid supplementation during pregnancy, crucial for preventing neural
tube defects. In the U.S., the CDC recommends that all women of reproductive age consume 400 micrograms of folic acid
daily. - Postpartum Care: Assessing the frequency and quality of postpartum visits, essential for maternal and
infant health. American Academy of Pediatrics recommends that all newborns be examined by a doctor or other health
care professional within 48 to 72 hours of discharge. - Substance use During Pregnancy and Breastfeeding: Tracking tobacco and alcohol use, both known to
have detrimental effects on infant development. The Surgeon General of the United States advises complete abstinence
from alcohol during pregnancy. - Vaccinations: Monitoring vaccination rates and adherence to recommended immunization schedules.
Vaccination rates in the U.S. have seen some decline, particularly since the COVID-19 pandemic, raising concerns about
potential outbreaks of preventable diseases. - Car Seat Safety: Evaluating the proper use of car seats, a critical factor in preventing injuries
during car accidents. The National Highway Traffic Safety Administration (NHTSA) provides detailed guidelines on car
seat safety for children of all ages. - Safe Sleep Practices: Assessing the infant’s sleeping position,with an emphasis on back sleeping to
reduce the risk of Sudden Infant Death Syndrome (SIDS). The American Academy of Pediatrics (AAP) strongly recommends
that infants sleep on their backs on a firm surface. - Home Safety: Investigating the incidence of domestic accidents, a leading cause of injury in young
children. According to the CDC, falls are the most common cause of non-fatal injuries in children. - Early Literacy: Examining the practice of early reading in the family,known to promote language
development and cognitive skills. Research from the American Academy of Pediatrics suggests that reading aloud to
children from infancy can considerably boost their literacy skills. - Screen Exposure: Monitoring exposure to screens, an increasingly relevant concern given the
proliferation of digital devices. The American Academy of Pediatrics recommends limiting screen time for children aged
2-5 to 1 hour per day of high-quality programming. - Environmental Risk Perception: New to the 2025 edition, this assesses parents’ awareness of
environmental hazards in their residential area, such as air or water pollution. Concerns about environmental toxins
and their impact on children’s health are growing in the U.S., particularly in communities near industrial sites or
with aging infrastructure. - Parental Well-being: Another new addition, this explores parents’ perceived well-being, recognizing
the crucial link between parental mental health and child development. Postpartum depression affects a significant
percentage of new mothers in the U.S., highlighting the need for increased support and resources for parents. - Parental Leave: Examining the availability and utilization of parental leave, a key factor in
supporting parents and promoting early bonding. The U.S. is one of the few developed countries without a national
paid parental leave policy, putting American families at a disadvantage compared to their counterparts in many other
nations.
Data Collection and Methodology
The ATS Val Padana study collects data through a questionnaire developed in conjunction with the World Health
Organization (WHO). This questionnaire is administered to a representative sample of mothers in the region, ensuring
the findings are generalizable to the broader population. The questionnaire is available in multiple languages to
accommodate the diverse population within the region.
Data collection occurs at vaccination centers within the ASSTs (Local Health Service Agencies) of Crema, Cremona, and
Mantua. Mothers are approached while waiting for their children to receive their 1st, 2nd, or 3rd dose of the
diphtheria-tetanus-pertussis (DTP) vaccine or the 1st dose of the measles-mumps-rubella-varicella (MMRV) vaccine.
Participation is voluntary and anonymous, ensuring the privacy and confidentiality of respondents.
Mothers complete the questionnaire online in a private setting, with the option to receive assistance from trained
staff. A paper version of the questionnaire is also available. This multi-modal approach ensures accessibility and
accommodates different preferences and levels of digital literacy.
Expert Perspectives
Laura Rubagotti,Head of the Health Promotion and Prevention Structure of ATS behavioral risk factors,emphasized the
importance of parental participation,stating: “1,704 questionnaires will be distributed on the Cremonese and
Mantuan territory (796 in the province of Cremona and 908 in that of Mantua),while the data collection,coordinated
by the ATS Val Padana,will begin in April to end in June. The staff has already been trained by the Higher Institute
of Health and the Region to support mothers. We trust that parents adhere with enthusiasm, since the collected data
will contribute to strengthening national and regional prevention strategies.”
matteo Conca, a health assistant of the ATS infectious diseases structure, highlighted the educational aspect of the
study, noting: “Free and anonymous adhesion to the initiative represents, through the distribution of information
material and, above all, dialog with operators, an possibility for reflection for parents on the correct behaviors
to be adopted towards their children, in particular in the first 1000 days of life, a period of basic
importance to lay the foundations for the development and health of the whole arc of life.”
Relevance for U.S. Parents and policymakers
While the ATS Val Padana study is conducted in italy, its findings have significant implications for the United
States. The determinants of child health are universal, and understanding the challenges and successes experienced in
other countries can inform our own policies and practices.
For example, the study’s focus on environmental risk perception highlights the growing awareness of the impact of
environmental factors on child health.In the U.S.,communities facing environmental injustices,such as exposure to
lead in drinking water or air pollution from industrial facilities,are disproportionately affected by health disparities.
Data from the ATS Val Padana study could provide valuable insights into how to effectively communicate environmental
risks to parents and empower them to take protective measures.
Similarly, the study’s inclusion of parental well-being as a key determinant underscores the importance of
supporting parents’ mental health. The U.S. faces a significant challenge in addressing postpartum depression and other
mental health issues among new parents. Findings from the ATS val Padana study could inform the development of more
effective interventions and support services for American families.
the study’s examination of parental leave policies highlights the need for the U.S. to adopt a national
paid parental leave program. The lack of such a policy puts American families at a disadvantage and contributes to
economic insecurity and gender inequality. Data from the ATS Val Padana study could strengthen the case for paid
parental leave in the U.S. by demonstrating its positive impact on child health and family well-being.
Comparative Data: U.S. vs. Italy
The table below presents a brief comparison of key child health indicators between the United States and Italy. Data
sources include the World Health Organization, the Centers for Disease Control and Prevention (CDC), and UNICEF.
| Indicator | United States | Italy |
|---|---|---|
| Infant Mortality Rate (per 1,000 live births) | 5.4 | 2.8 |
| Under-5 Mortality Rate (per 1,000 live births) | 6.5 | 3.2 |
| Vaccination Coverage (MMR, %) | 91 | 95 |
| Maternal Mortality Ratio (per 100,000 live births) | 23.8 | 4.0 |
| Paid Maternity Leave | 0 weeks (federal mandate) | 5 months (80% pay) |
Conclusion
The ATS Val Padana’s “0-2 years surveillance system” provides a valuable framework for understanding the complex
factors that influence child health. By examining a wide range of determinants, from folic acid intake to environmental
risk perception, the study offers insights that are relevant to parents, healthcare professionals, and policymakers
worldwide.
While the study is based in Italy,its findings have significant implications for the United States.By learning
from the experiences of other countries, we can improve our own policies and practices and ensure that all children have
the opportunity to thrive.
