Causes of mortality across different immigrant groups in Northeastern Italy.

Ugo Fedeli,Eliana Ferroni,Francesco Avossa,Mario Saugo,Mara Pigato

doi:10.7717/peerj.975

Abstract

Background. Despite massive immigration towards Southern Europe in the last two decades, data on mortality by cause among immigrants in Italy are scarce. The aim of this study was to investigate mortality from all and from specific causes of death among immigrants residing in the Veneto Region (Northeastern Italy).Methods. Mortality records for the period 2008–2013 were extracted from the regional archive of causes of death, whereas population data were obtained from the 2011 Italian census. Immigrants were grouped by area of provenience based on the information on country of citizenship available both in mortality and census data. Standardized Mortality Ratios (SMR) with 95% Confidence Intervals (CI) were computed for the period 2008–2013 in subjects aged 20–59 years, with rates of Italian citizens as a reference.Results. Overall mortality was reduced both in male (SMR 0.86, CI [0.80–0.92]) and female immigrants (SMR 0.72, CI [0.65–0.78]), although an increased risk was observed for subjects from Sub-Saharan Africa. Significantly raised SMR for circulatory diseases were found among Sub-Saharan Africans and Southern Asians in both genders. Sub-Saharan Africans experienced a higher risk of death, especially from cerebrovascular diseases: SMR 4.78 (CI [2.67–7.89]) and SMR 6.09 (CI [1.96–14.2]) in males and females, respectively. Among Southern Asians, the increase in mortality from ischemic heart diseases reached statistical significance in males (SMR 2.53, CI [1.42–4.18]). In spite of a lower risk of death for all neoplasms combined, mortality from cancer of cervix uteri was increased among immigrants (SMR 2.61, CI [1.35–4.56]), as well as for other cancer sites in selected immigrant groups. A raised mortality was found for infectious diseases in Sub-Saharan Africans (both genders), and for transport accidents among females from Eastern Europe.Conclusion. Our study showed great variations in mortality by cause and area of provenience among immigrants resident in the Veneto Region and highlighted specific health issues that should be addressed through tailored efforts in chronic diseases prevention.

Highlights

Many studies have revealed the existence of mortality differences between the native and the immigrant population, with the latter usually showing lower rates due to many factors, mainly the “healthy migrant effect,” observed both in North America and in European countries (Singh & Hiatt, 2006; Spallek et al, 2012; Boulogne et al, 2012; Scott & Timaeus, 2013; Omariba, Ng & Vissandjee, 2014; Moncho et al, 2014)
The largest immigrant group is constituted by subjects from Eastern Europe, and African countries and Asian countries are well represented
The present study demonstrates a great variation in mortality risk among immigrants in Italy by age, gender, area of provenience and specific cause of death

Summary

Introduction

Many studies have revealed the existence of mortality differences between the native and the immigrant population, with the latter usually showing lower rates due to many factors, mainly the “healthy migrant effect,” observed both in North America and in European countries (Singh & Hiatt, 2006; Spallek et al, 2012; Boulogne et al, 2012; Scott & Timaeus, 2013; Omariba, Ng & Vissandjee, 2014; Moncho et al, 2014). In some countries higher mortality rates in immigrants were observed, in specific ethnic groups and for specific causes of death, with large variations observed by age and gender (Rostila & Fritzell, 2014; Bos et al, 2007). Overall mortality was reduced both in male (SMR 0.86, CI [0.80–0.92]) and female immigrants (SMR 0.72, CI [0.65–0.78]), an increased risk was observed for subjects from Sub-Saharan Africa. A raised mortality was found for infectious diseases in Sub-Saharan Africans (both genders), and for transport accidents among females from Eastern Europe. Our study showed great variations in mortality by cause and area of provenience among immigrants resident in the Veneto Region and highlighted specific health issues that should be addressed through tailored efforts in chronic diseases prevention

Objectives

Methods

Results

Discussion

Conclusion