Socioeconomic differentials in premature mortality in Rome: changes from 1990 to 2001

Giulia Cesaroni,Carla Ancona,Carlo A Perucci,Nera Agabiti,Francesco Forastiere

doi:10.1186/1471-2458-6-270

Abstract

BackgroundWhile socioeconomic inequalities in mortality have widened in many countries, evidence of social differentials is scarce in Southern Europe. We studied temporal changes in premature mortality across socioeconomic groups in Rome between 1990 and 2001.MethodsWe analysed all 126,511 death certificates of residents of Rome aged 0–74 years registered between 1990–2001. A 4-level census block index based on the 1991 census was used as an indicator of socioeconomic position (SEP). Using routine mortality data, standardised mortality rates (per 100,000 inhabitants) were calculated by SEP and gender for four time periods. Rate ratios were used to compare mortality by gender and age.ResultsOverall premature mortality decreased in both genders and in all socioeconomic groups; the change was greater in the highest socio-economic group. In both men and women, inequalities in mortality strengthened during the 1990s and appeared to stabilise at the end of the 20th century. However, for 60–74 year old women the gap continued to widen.ConclusionSocioeconomic inequalities in health in Rome are still present at the beginning of the 21st century. Strategies to monitor the impact of SEP on mortality over time in different populations should be implemented to direct health policies.

Highlights

While socioeconomic inequalities in mortality have widened in many countries, evidence of social differentials is scarce in Southern Europe
In this study we evaluated the temporal changes of premature mortality across socioeconomic groups in Rome over a period of 12 years, from 1990 to 2001
We used rate ratios (RRs) with 95% confidence intervals (95%CI) to compare inequalities in mortality by gender and age

Summary

Introduction

While socioeconomic inequalities in mortality have widened in many countries, evidence of social differentials is scarce in Southern Europe. We studied temporal changes in premature mortality across socioeconomic groups in Rome between 1990 and 2001. The role of National Health Services (NHSs) and universal health care coverage in contrasting inequalities in health has been repeatedly advocated [9,10]. Data on these disparities in Southern Europe, e.g. in Italy, in the second half of the 90s are rare[1,5,6]. In this study we evaluated the temporal changes of premature mortality (under 75 years of age) across socioeconomic groups in Rome over a period of 12 years, from 1990 to 2001

Methods

Results

Discussion

Conclusion