Epidemiology Unit, Agency for Health Protection of the Metropolitan City of Milan, Milan (Italy).
Department of Sociology and Social Research, University of Milano-Bicocca, Milan (Italy).
Epidemiol Prev. 2024 Jul-Oct;48(4-5):298-308. doi: 10.19191/EP24.4-5.A741.072.
to document existing geographical inequalities in health in the city of Milan (Lombardy Region, Northern Italy), examining the association between area socioeconomic disadvantage and health outcomes, with the aim to suggest policy action to tackle them.
the analysis used an ecological framework; multiple health indicators were considered in the analysis; socioeconomic disadvantage was measured through indicators such as low education, unemployment, immigration status, and housing crowding. For each municipal statistical area, Bayesian Relative Risks of the outcomes (using the Besag-Yorkand-Mollié model) were plotted on the city map. To evaluate the association between social determinants and health outcomes, Spearman correlation coefficients were estimated.
residents in the City of Milan aged between 30 and 75 years who were residing in Milan as of 01.01.2019, grouped in 88 statistical areas.
all-cause mortality, type-2 diabetes mellitus, hypertension, neoplasms, respiratory diseases, metabolic syndrome, antidepressants use, polypharmacy, and multimorbidity.
the results consistently demonstrated a significant association between socioeconomic disadvantage and various health outcomes, with low education exhibiting the strongest correlations. Neoplasms displayed an inverse social gradient, while the relationship with antidepressant use varied.
these findings provide valuable insights into the distribution of health inequalities in Milan and contribute to the existing literature on the social determinants of health. The study highlights the need for targeted interventions to address disparities and promote equitable health outcomes. The results can serve to inform the development of effective public health strategies and policies aimed at reducing health inequalities in the city.
记录意大利北部伦巴第大区米兰市现有的健康地理不平等现象，研究地区社会经济劣势与健康结果之间的关联，旨在提出解决这些问题的政策措施。
该分析采用生态框架；在分析中考虑了多个健康指标；社会经济劣势通过低教育、失业、移民身份和住房拥挤等指标来衡量。对于每个市政统计区，将结果的贝叶斯相对风险（使用 Besag-Yorkand-Mollié 模型）绘制在城市地图上。为了评估社会决定因素与健康结果之间的关联，估计了 Spearman 相关系数。
年龄在 30 至 75 岁之间、截至 2019 年 1 月 1 日居住在米兰的米兰市居民，分为 88 个统计区。
全因死亡率、2 型糖尿病、高血压、肿瘤、呼吸系统疾病、代谢综合征、抗抑郁药使用、多药治疗和多种合并症。
结果一致表明社会经济劣势与各种健康结果之间存在显著关联，低教育表现出最强的相关性。肿瘤呈现出逆社会梯度，而与抗抑郁药使用的关系则不同。
这些发现为米兰健康不平等的分布提供了有价值的见解，并为健康的社会决定因素现有文献做出了贡献。该研究强调需要采取有针对性的干预措施来解决差异问题，促进公平的健康结果。研究结果可用于为制定旨在减少该市健康不平等的有效公共卫生战略和政策提供信息。
