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Epidemiol Prev. 2019 Sep-Dec;43(5-6 Suppl 1):1-80. doi: 10.19191/EP19.5-6.S1.112.

[Immigrants' health and socioeconomic inequalities of overall population residing in Italy evaluated through the Italian network of Longitudinal Metropolitan Studies].

[Article in Italian]

Author information

1
Istituto nazionale per la promozione della salute delle popolazioni migranti e per il contrasto delle malattie della povertà (INMP), Roma; alessio.petrelli@inmp.it.
2
Istituto nazionale per la promozione della salute delle popolazioni migranti e per il contrasto delle malattie della povertà (INMP), Roma; anteo.dinapoli@inmp.it.
3
Dipartimento di epidemiologia del Servizio sanitario regionale, Regione Lazio, ASL Roma 1, Roma.
4
Dipartimento di scienze cardio-toraco-vascolari e sanità pubblica, Università degli Studi di Padova.
5
Dipartimento di statistica, informatica, applicazioni "G. Parenti", Università di Firenze, Firenze.
6
Servizio di epidemiologia, Azienda unità sanitaria locale, IRCCS Reggio Emilia, Italia.
7
Agenzia sanitaria e sociale regionale, Regione Emilia-Romagna, Bologna.
8
SC a DU Servizio sovrazonale di epidemiologia, ASL TO3 Piemonte, Grugliasco (TO).
9
Dipartimento di scienze cliniche e biologiche, Università di Torino, Torino.
10
Dipartimento di scienze mediche e chirurgiche, Alma Mater Studiorum, Università di Bologna, Bologna.

Abstract

INTRODUCTION:

Describing and monitoring socioeconomic inequalities in health are the prerequisite for planning equity policies. In Italy, some cities have integrated personal information from the municipal registries with Census data and with data from healthcare information systems to set up Longitudinal Metropolitan Studies (LMS). Under the coordination of the Italian National Institute for Health, Migration, and Poverty (NIHMP), six cities in the LMS network have contributed to the present monograph: Turin, Venice, Reggio Emilia, Modena, Bologna, and Rome. MORTALITY RESULTS. Significant socioeconomic differences by level of education were seen in all the participating centres. People who live alone or in single-parent households are more likely to die, as are those living in a substandard dwelling. Immigrants resident in the six cities included in the study showed lower all-cause mortality than Italians (males: MRR 0.83; 95%CI 0.78-0.90 - females: MRR 0.70; 95%CI 0.64-0.77). Sub-Saharan Africans experienced a significant higher mortality than Italians (males: MRR 1.33; 95%CI 1.12-1.59 - females: MMR 1.69; 95%CI 1.31-2.17). Immigrants had a neonatal and post-neonatal mortality risk about 1.5 times higher than Italians (neonatal: OR 1.71; 95%CI 1.22-2.39 - post-neonatal: OR 1.63; 95%CI 1.03-2.57). A difference between Italians and immigrants was also observed for mortality in children aged 1-4 years, though less marked (OR 1.24; 95%CI 0.73-2.11). Excesses concerned particularly immigrants from North Africa and from sub-Saharan Africa as well as those residing in Italy for >5 years. HOSPITALISATION RESULTS. Hospitalisation rates are lower for immigrants than for Italians, except when due to infectious diseases, blood disorders, and, among women, for reasons linked to pregnancy and childbirth. Avoidable hospitalisation rates of adults from low migratory pressure Countries are lower than or equal to those of Italians. On the contrary, adults from low migratory pressure Countries show higher avoidable hospitalisation rates compared to Italians in every cohort, with the exception of Rome (RR 0.81; 95%CI 0.78-0.85), with RR ranging from 1.08 (95%CI 0.96-1.22) in Venice to 1.64 (95%CI 1.47-1.83) in Modena.

CONCLUSIONS:

Maternal and child health is the most critical area of health for immigrant population. Considering the importance that the issue of health equity has taken on in the political agenda, the data presented in this volume are a great asset, particularly in light of the long recession and the social crisis that have impacted the Country.

PMID:
31744272
DOI:
10.19191/EP19.5-6.S1.112
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