A regional equity profile to assess the impact of social inequalities on determinants and health outcomes in the population residing in Sicily Region (Southern Italy)

Augusta-Priolo (SR), Gela (CL), and Milazzo (ME) cities, located in Sicily Region (Southern Italy), are included among the areas at high environmental risk in Italy and the national legislation classifies them among the polluted sites of national interest for environmental remediation. In the past, these areas had high contamination from industrial complexes. assessment of reproductive health through the analysis of data from the birth reports of all hospital of Sicily Region in 2007-2013. geographical population study; analysis of reproductive health through analysis of pregnancy outcomes occurred in Sicily from women of childbearing age (10-55 years; excluding women who remain anonymous) with record linkage with population data (neighbouring municipalities and whole region, considered as not exposed areas). sex ratio, stillbirth rates, proportion of multiple births, low birth weight, very low birth weight, gestational age <37 weeks, proportion of small for gestational age. in the period 2007-2013, an average annual number of 43,000 births (51.4% males) occurred. Sex ratio was not significantly modified in comparison with local and regional values. Several indicators in each area were similar when compared with the local reference population or with regional population. Stillbirths were significantly higher only in Augusta-Priolo area vs. the local population (OR: 2.26; CI95% 1.07-4.80), and slightly higher vs. regional population. Multiple births were significantly higher in Augusta-Priolo area (OR: 1.19; CI95% 1.01-1.41) and in the town of Siracusa (OR: 1.15; CI95% 1.01-1.316) when compared with regional population, and slightly higher vs. local population. Prematurity was significantly higher only in the area of Milazzo compared to the regional population (OR: 1.20; CI95% 1.02-1.41), and slightly higher compared to the local population. No excess of low birth weight (<2,500 grams) and small for gestational age (almost 37 weeks) babies was observed in these areas. according to this study, pregnancy outcomes were not clearly affected in these areas although some modifications were noted in Augusta and in Milazzo. The surveillance of reproductive health is of paramount importance to understand the effects of air pollution on morbidity and mortality in these areas.

The role that area deprivation, family poverty, and austerity policies play in the demand for and supply of children's services has been a contested issue in England in recent years. These relationships have begun to be explored through the concept of inequalities in child welfare, in parallel to the established fields of inequalities in education and health. This article focuses on the relationship between economic inequality and out‐of‐home care and child protection interventions. The work scales up a pilot study in the West Midlands to an all‐England sample, representative of English regions and different levels of deprivation at a local authority (LA) level. The analysis evidences a strong relationship between deprivation and intervention rates and large inequalities between ethnic categories. There is further evidence of the inverse intervention law (Bywaters et al., 2015): For any given level of neighbourhood deprivation, higher rates of child welfare interventions are found in LAs that are less deprived overall. These patterns are taking place in the context of cuts in spending on English children's services between 2010–2011 and 2014–2015 that have been greatest in more deprived LAs. Implications for policy and practice to reduce such inequalities are suggested.

Purpose– The purpose of this paper is to present deprivation in urban Brazil in a multidimensional perspective with dimensions related to household’s objective information, assets in the household, subjective evaluation concerning the dwelling and expenses.Design/methodology/approach– The author used factorial analysis applied to the Brazilian Household Budget Survey. Most dimensions showed a positive correlation with income, while for others it was not observed any significant difference between income ranges. Some types of deprivation specially touched low-income households, while other dimensions differentiated middle-income households, or even higher income households. The author applied a fuzzy perspective to define deprivation membership in each dimension with the use of a modified logistic function. The author observed that households with similar income faced different levels of deprivation in many dimensions.Findings– The author showed that there were significant differences in household’s expense preferences and profiles linked to these findings. Households with high levels of food deprivation relatively spend more on household’s rent, taxes and services, indicating that shelter and then food in the household are the very basic goods. Larger relative expenses with food in the household indicated higher levels of deprivation in all other dimensions, indicating that due to these higher food expenditures, the households could not overcome the deprivation in other dimensions. Households that spend more on smoke and gambling faced higher deprivation in most dimensions, suggesting different expenses priorities, less household oriented.Originality/value– To the best of the knowledge, this is the first attempt to link multidimensional deprivation and expenses profile for Brazilian data.

the Coronavirus disease 2019 (COVID-19) pandemic may have aggravated existing social and healthcare inequalities among particular population groups, such as ethnic minorities, who showed increased susceptibility to SARS-CoV-2 infection. to characterize risk profiles or determinants of delayed healthcare access, as well as knowledge, risk perception, behaviour, and social stigma concerning SARS-CoV-2 infection in the immigrant population in the city of Catania (Sicily Region, Southern Italy). pilot, descriptive study. the immigrant population in Catania. an ad-hoc questionnaire was prepared and administered to the participants of the target population. In addition, a web-based data collection platform and a web-based survey addressed to healthcare providers were developed. 74 immigrant subjects (mean age: 39 years) voluntarily compiled the questionnaire with varying response rates per question: 77% of the participants were male, 59.5% were from Africa, 29.7% from Asia, 6.7% from South America, and 4.1% did not specify their origin. Fifty-three percent (35/66 responses) found it easy to access healthcare services. However, 25.8% (17/66 responses) found it difficult to understand written information concerning their health. Regarding vaccination services, 67.3% of subjects (35/62 responses) had no difficulty in receiving information on mandatory vaccinations and/or vaccination centres in Italy, and 79.7% (51/64 responses) were vaccinated against COVID-19. In relation to other primary prevention issues, 71.4% of participants (45/63 responses) stated they did not know or had never been tested for HIV, 64.4% (38/59 responses) declared they had not heard of or knew nothing about antibiotic resistance, and 30.4% (21/69 responses) had not heard or knew nothing about antibiotic use. health services seem to be accessible and effective among the immigrant population in Catania. However, identified determinants of delayed healthcare access included factors concerning mainly health literacy and possibly the socioeconomic status of the population studied. Primary prevention issues that need to be addressed due to low awareness or stigmatization among the immigrant population include antibiotic use and resistance, and infectious diseases such as HIV/AIDS.

Neighbourhood deprivation, changes in walking attitudes during the COVID-19 pandemic and walking demand in the post-pandemic period

BackgroundHealth and inequalities in health among inhabitants of European cities are of major importance for European public health and there is great interest in how different health care systems in Europe perform in the reduction of health inequalities. However, evidence on the spatial distribution of cause-specific mortality across neighbourhoods of European cities is scarce. This study presents maps of avoidable mortality in European cities and analyses differences in avoidable mortality between neighbourhoods with different levels of deprivation.MethodsWe determined the level of mortality from 14 avoidable causes of death for each neighbourhood of 15 large cities in different European regions. To address the problems associated with Standardised Mortality Ratios for small areas we smooth them using the Bayesian model proposed by Besag, York and Mollié. Ecological regression analysis was used to assess the association between social deprivation and mortality.ResultsMortality from avoidable causes of death is higher in deprived neighbourhoods and mortality rate ratios between areas with different levels of deprivation differ between gender and cities. In most cases rate ratios are lower among women. While Eastern and Southern European cities show higher levels of avoidable mortality, the association of mortality with social deprivation tends to be higher in Northern and lower in Southern Europe.ConclusionsThere are marked differences in the level of avoidable mortality between neighbourhoods of European cities and the level of avoidable mortality is associated with social deprivation. There is no systematic difference in the magnitude of this association between European cities or regions. Spatial patterns of avoidable mortality across small city areas can point to possible local problems and specific strategies to reduce health inequality which is important for the development of urban areas and the well-being of their inhabitants.

to evaluate the effects of a pre-existing condition of diabetes and of the use of antidiabetic drugs in the Sicilian population on different outcomes of the COVID-19 disease. a retrospective observational study based was used. Data deriving from the COVID-19 epidemic surveillance and from the collection of information on drugs consume by Sicilian residents. due to the data availability, the study was calibrated on the Region and included all population distinguishing by gender and age groups. the risks of cumulative incidence for COVID-19 were investigated in people who had diabetes comorbidities to incur a hospitalization for COVID-19, to be treated within an intensive care unit, and lethality. The role of previous antidiabetic drug treatments with respect to each study outcome was also investigated. in Sicily, from 01.03.2020 to 26.06.2020, a number of 172 cases of COVID-19 disease with diabetes comorbidity were diagnosed. The data did not show any difference in the cumulative incidence for COVID-19 between diabetics (64.2/100,000 inhabitants) and non-diabetics (56.9/100,000 inhabitants) patients. Diabetes increases the risk of hospitalization in the under 80 in both men and women (men: OR 2.62; women OR 4.31), for treatment in intensive care (men: OR 4,41; women: OR 7.74), and for death (men: OR 5.21; women OR 5.92). The analysis of drug using showed risks effect of insulin (OR 2.13) on hospitalization, sulfonylureas/glinides (OR 2.58) on intensive care and protective of metformin on death both in single component (OR 0.44) and in multicomponent (OR 0.43). data availability made it possible to monitor the occurrence and explore some of the characteristics of the cases with COVID-19 in Sicily. Diabetes does not seem to represent a risk factor for SARS-CoV-2 infection in Sicily, while previous diabetes condition seems to determine greater risk of hospitalization, treatment in intensive care, and lethality among over 80. There are also gender differences with almost double risks in women for hospitalization and intensive care only. Among the antidiabetic drugs investigated, there was a risk for hospitalization and intensive care while protective for deaths. This study represents an important tool for the activation of intervention programmes in the area aimed at populations with greater health risk deriving from the effects of this new pandemic.

Objectives: Increasing the understanding of the variety of data sources around health equity that are available and how to use these data to drive public health and health care practice is critical to address inequities and improve health outcomes. The social determinants of health (SDOH), factors related to where people live, work, play, and age, are strongly tied to health outcomes. Primary and secondary SDOH can be used to understand the context of the issues faced at the individual and community levels and can help inform appropriate interventions and support the connection to available resources. Methods: The Heath Equity Profile, available from the public facing Florida Community Health Assessment Resource Toolset (FLHealthCHARTS) website, contains over 150 indicators at the county-level related to demographics, income and employment, housing, education, risk behaviors, access to care, access to food, and various health outcomes, including prevalence, incidence, morbidity, and mortality. The indicators contained in the Health Equity Profile were used to identify counties with the largest SDOH disparities and largest burden of poor health outcomes for several initiatives focused on increasing community-clinical linkages and leveraging cross-sector partnerships to address health outcomes. Findings: Public health initiatives focused on hypertension, diabetes, and heart disease have leveraged the data contained in the Health Equity Profile to select geographic areas for implementation. Using these data, interventions were able to be deployed in areas with the greatest need and opportunity to benefit. Understanding the conditions under which individuals live is critical to the successful implementation of both public health and health care improvement efforts. Various data sources are widely available that can provide additional context and guidance for the development of tailored interventions to improve individual and population health.

Home gardens have been an integral part of the recent food‐based interventions aimed at stimulating changes in dietary patterns and improving nutrition. However, evidence of their effects on food security, dietary quality, child anthropometry and incomes is limited, particularly among vulnerable populations groups. Using panel data from a sample of approximately 1900 households from vulnerable population groups in Odisha, India, difference‐in‐differences and other econometric techniques, we analyse the effects of home gardens on food security, dietary quality, child anthropometry and income. On average, home gardens contribute to better household food security, higher dietary quality of men and women but do not contribute to higher children's dietary quality and anthropometry. Also, home gardens increase monthly per adult equivalent incomes by 37% and reduce the prevalence of poverty by 11.7 percentage points. Quantile regression results suggest that home gardens enhance food security and incomes in all quantiles, but richer farmers benefit more than poorer farmers. Overall, home gardens can enhance household food security, dietary quality of men and women, and income gains among vulnerable farming population groups, but they may not suffice to improve child dietary quality and anthropometry.

Tooth retention has been one of the main aims of oral care which in turn could have contributed to the social oral health divide. To investigate this issue further, data collected for a group audit was used to study the reasons for tooth extraction for patients attending for routine treatment at four dental practices. The practices served populations in areas with different levels of deprivation in South Wales. In 558 teeth extracted over 417 visits, the reasons for extractions were: caries 59%, periodontal disease 29.1%, pre-prosthetic 1%, wisdom teeth 4.6%, orthodontic 5.5%, trauma 1.2%, patient request 2.4% and 6.2% other reason. The number of extraction visits per day within the group of dental surgeons varied with three practitioners performing more than three extraction visits per day while one practitioner had only 0.51. These reasons did not significantly depend on levels of deprivation. However, significantly more teeth were extracted for caries in the most deprived group in comparison to the least deprived. Therefore, could there be a case for appropriate extractions in the quest for equitable care?

Gauza jakina da gizarte-faktore desberdinek zenbait gaixotasunen intzidentzia eta eboluzioa baldintzatzen dutela, mundu-mailan zein EAEn. Lan honen helburu nagusia Gipuzkoan 2010-2017 denboraldian maila sozioekonomikoaren eta betidanik pobreziarekin erlazionatutako gaitz baten arteko lotura aztertzea izan da; alegia, gabezia-mailaren eta tuberkulosiaren arteko harremana ikertzea. Bigarren helburua 2003-2017 urteetan zehar gaixotasun horren eboluzioa deskribatzea izan da. Maila sozioekonomikoa analizatzeko, paziente bakoitzari modu ekologikoan esleitutako gabezia-indizea erabili da, diagnostiko aldian bizi ziren errolda-sekzioko informazioaz baliatuta. Intzidentzien kalkulurako, 2011ko erroldatik lortu da biztanle kopurua, sekzio bakoitzeko eta adinaren zein sexuaren arabera, eta urte bereko EAEko populazioa erabilita estandarizazioa egin da. Biriketako lokalizazioa zuten kasuetan, maila sozioekonomikoa diagnostikoaren atzerapenarekin eta tratamendua betetzearekin elkarturik ote dagoen ere ikertu da. Horretarako hainbat analisi estatistiko erabili dira, SPSS programaz baliatuz. Lortutako emaitzei so eginez, Gipuzkoan tuberkulosiaren intzidentzia ekologikoki esleitutako gabezia-mailarekin elkarturik dagoela ondoriozta daiteke. Izan ere, maila sozioekonomiko baxuenean kokatzen diren pertsonek maila altuenean daudenek baino tuberkulosia izateko arrisku handiagoa dutela ikusi da; arriskuaren igoera estatistikoki esangarria izanik gizonetan (tasa estandarizatuaren arrazoia: 2,15, konfiantza-tartea: 1,51-3,07). Hala ere, azken 15 urteetan maila sozioekonomikoen arteko desberdintasunak murriztu direla ikus daiteke. Osasun-arretari dagokionez, ez da maila sozioekonomikoaren eta diagnostikoaren atzerapenaren arteko erlaziorik aurkitu; bai, ordea, tratamendua betetzearekin, gabezia-maila baxuetan tratamendua betetzeko probabilitatea txikiagoa izanik.

In Israel, stroke is the third most common cause of death. In 1997 stroke accounted for 2905 deaths (8.1% of total), 1390 of them among men (7.5% of total; crude mortality rate of 48.3/100 000) and 1515 among women (8.6% of total; crude rate of 51.7/100 000). This report presents trends on stroke mortality by population group and estimates of morbidity in Israel. Data on stroke mortality in Israel during 1969-1997 were obtained from the Israel Central Bureau of Statistics. Age-specific and age-adjusted mortality rates were calculated for the 2 main population groups. Data on morbidity were obtained form the 1996/1997 National Health Survey. Hospitalization rates due to stroke are based on the national hospitalization data. A monotonic decrease in stroke mortality is evident in Jews during 1969-1997 in both sexes. Age-adjusted mortality rates declined by 62.5% for Jewish men and by 73.4% for Jewish women during 1969-1997. Among Arabs, there was a general decreasing trend in the mortality for both sexes during 1973-1997. The main difference in population group mortality trends was found in the group aged >/=75 years: a statistically significant decrease in mortality rates for Jews is evident, while no decrease is apparent for Arabs. On the basis of available data for 1990, an estimated 13 000 patients with stroke were hospitalized during 1997. During the last 25 years, age-adjusted stroke mortality in Israel has declined substantially, but the decline has been much greater among Jews than Arabs. The group aged >/=75 years shows the greatest difference in trends between Jews and Arabs. This finding may be explained by differences in risk factor distribution and case fatality rates.

Grape-associated microbial community is influenced by a combination of viticultural, climatic, pedological and anthropological factors, collectively known as terroir. Therefore, grapes of the same cultivar grown in different areas can be appreciated for their distinctive biogeographic characteristics. In our previous study, we showed that the phenotypic response of Aglianico and Cabernet grapevines from Molise and Sicily regions is significantly influenced by the prevailing pedoclimatic conditions, particularly soil physical properties. However, the scale at which microbial communities differ could be important in clarifying the concept of terroir, including whether it is linked to the grape variety present in a particular vineyard. To explore this further, in the research presented here, a comparative study on the fungal communities inhabiting the berry surfaces of Cabernet and Aglianico cultivars was conducted on different vineyards located in Southern Italy (Molise, Sicily and Campania regions, the first two of which had been involved in our previous study) by using high-throughput sequencing (HTS) and multivariate data analysis. The descriptive approach through relative abundance analysis showed the most abundant phyla (Ascomycota, Basidiomycota, and Chytridiomycota), families (Cladosporiaceae, Saccotheciaceae, Pleosporaceae, Saccharomycodaceae, Sporidiobolaceae, Didymellaceae, Filobasidiaceae, Bulleribasidiaceae, and Saccharomycetaceae) and genera (Cladosporium, Aureobasidium, Alternaria, Stemphylium and Filobasidium) detected on grape berries. The multivariate data analysis performed by using different packages (phyloseq, Vegan, mixOmics, microbiomeMarker and ggplot2) highlighted that the variable “vineyard location” significantly affect the fungal community, while the variable “grape variety” has no significant effect. Thus, some taxa are found to be part of specific vineyard ecosystems rather than specific grape varieties, giving additional information on the microbial contribution to wine quality, thanks to the presence of fermentative yeasts or, conversely, to the involvement in negative or detrimental roles, due to the presence of grape-deriving fungi implied in the spoilage of wine or in grapevine pathogenesis. In this connection, the main functions of core taxa fungi, whose role in the vineyard environment is still poorly understood, are also described.

This study provides a machine learning analysis of the social and demographic features of territories, associated with different levels of deprivation, measured by the Socio-Economic Deprivation Index (SED-I). The SED-I has been developed by the Italian National Institute of Statistics (Istat) and is aimed at measuring socio-economic and educational deprivation at sub-municipal level. In this paper, we exploit the availability of socio-economic indicators and demographic context variables at Sub-Municipal Areas (SMAs) level to provide useful information for policies aimed at contrasting the economic, social, and educational deprivation as measured by the SED-I. In the context of socio-economic deprivation, territories may be characterised by a variety of interrelated variables: indicators related to the level of education in the area, employment, household structure, demographic composition referring to population density, foreign subpopulations, and age, and finally, social conditions, are employed in the analysis. Principal Component Analysis (PCA) is employed to summarise the information contained in this large number of correlated indicators. This unsupervised learning method allows us to analyse the relationships among these variables and the SED-I, pointing out the differences between two different socio-economic environments such as Trieste and Cagliari. Furthermore, a K-means cluster analysis is employed to identify population groups with similar composition in relation to deprivation and demographic features. In the K-means cluster analysis, Elbow and Silhouette methods are used to choose the optimal number of clusters. The analysis is carried out focusing on Trieste and Cagliari data, to provide a robust application on different socio-economic contests.

Prevention of congenital rubella is achieved by vaccination of susceptible women of childbearing age. In Italy, the National Plan for Measles and Congenital Rubella Elimination 2010–2015 implemented catch-up vaccination activities targeting susceptible adolescents and young adults, including women of childbearing age. The aim of this study was to assess the immunity against rubella in women of childbearing age in Tuscany (Central Italy) and Apulia (Southern Italy) and pregnant women in Apulia after the implementation of the National Plan for Measles and Congenital Rubella Elimination. Overall, anti-rubella IgG prevalence in women of childbearing age samples was 88.6% in Tuscany and 84.3% in Apulia. The lowest prevalence was observed in samples of 26–35 years old women of childbearing age in Apulia with 77.8%. Only 62.7% of samples from 26–35 years old pregnant women had IgG against rubella, and one sample out of 95 was positive to IgM. The findings of this study highlight the need for increasing awareness on the risk of contracting rubella infection during pregnancy and implement vaccination strategies to create opportunities for administration of rubella containing vaccines in young girls and women of childbearing age.