Public Health Section, Department of Medicine and Surgery, University of Perugia, 06129 Perugia, Italy.
Department of Infectious Diseases, Istituto Superiore di Sanità, 00162 Rome, Italy.
Int J Environ Res Public Health. 2023 Aug 4;20(15):6521. doi: 10.3390/ijerph20156521.
There is evidence that non-Italians presented higher incidence of infection and worse health outcomes if compared to native populations in the COVID-19 pandemic. The aim of the study was to compare Italian- and non-Italian-born health outcomes, accounting for socio-economic levels.
We analyzed data relative to 906,463 people in Umbria (Italy) from 21 February 2020 to 31 May 2021. We considered the National Deprivation Index, the Urban-Rural Municipalities Index and the Human Development Index (HDI) of the country of birth. We used a multilevel logistic regression model to explore the influence of these factors on SARS-CoV-2 infection and hospitalization rates. Diagnosis in the 48 h preceding admission was an indicator of late diagnosis among hospitalized cases.
Overall, 54,448 persons tested positive (6%), and 9.7% of them were hospitalized. The risk of hospital admission was higher among non-Italians and was inversely related to the HDI of the country of birth. A diagnosis within 48 h before hospitalization was more frequent among non-Italians and correlated to the HDI level.
COVID-19 had unequal health outcomes among the population in Umbria. Reduced access to primary care services in the non-Italian group could explain our findings. Policies on immigrants' access to primary healthcare need to be improved.
有证据表明，在 COVID-19 大流行期间，与本地人群相比，非意大利人感染的发生率更高，健康状况更差。本研究的目的是比较意大利出生和非意大利出生人群的健康结果，并考虑社会经济水平。
我们分析了 2020 年 2 月 21 日至 2021 年 5 月 31 日期间翁布里亚（意大利）906463 人的数据。我们考虑了国家贫困指数、城乡市政指数和出生国的人类发展指数（HDI）。我们使用多水平逻辑回归模型来探讨这些因素对 SARS-CoV-2 感染和住院率的影响。入院前 48 小时内的诊断是住院病例中晚期诊断的指标。
总体而言，54448 人检测呈阳性（6%），其中 9.7%住院。非意大利人的住院风险更高，且与出生国的 HDI 呈负相关。入院前 48 小时内的诊断在非意大利人中更为常见，且与 HDI 水平相关。
COVID-19 在翁布里亚的人群中产生了不平等的健康结果。非意大利人群获得初级保健服务的机会减少可能解释了我们的发现。需要改善移民获得初级医疗保健的政策。
