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Objectives: 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., Design: 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., Setting and Participants: 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., Main Outcomes Measures: all-cause mortality, type-2 diabetes mellitus, hypertension, neoplasms, respiratory diseases, metabolic syndrome, antidepressants use, polypharmacy, and multimorbidity., Results: 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., Conclusions: 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.

This article examines the relationship between the financial crisis of 2008 and the health of Italians using aggregate and individual health indicators in correlation with the socioeconomic changes which have occurred in the Italian population. First, the study contextualises the changes referring to some important health indicators (life expectancy, death and suicide rates). Then, the main hypothesis on the relation between worsened individual health conditions and socioeconomic deterioration is tested. For this purpose, individual data from 2005 to 2013 stemming from Health Condition and Use of Health Services surveys (Italian National Institute of Statistics) are analysed. The results show that the social categories most severely affected by the crisis, in both employment and economic terms, were basically the same as those that experienced a worsening of their physical and psychological health conditions. These categories of people have a low level of educational attainment, live in southern and insular regions and are most often men. [ABSTRACT FROM AUTHOR]

Backgrounds: The empirical evidence shows discordant results regarding the role of local contexts on individual health. This article considers the role of the municipal socio-economic contexts on self-rated health in Italy, taking into account some individual variables.Methods: Multilevel model software (MlwiN) is used to fit multilevel linear regression models of perceived health. Individual data are from the Italian surveys on "Aspects of Daily Life" 2010, 2011 and 2012, collected by the Italian National Institute of Statistics (Istat). In addition, municipality-level social, demographic and economic characteristics are from the 2011 Census and the database "Atlas of Italian Municipalities" (Istat).Results: The main findings of this study confirm that, controlling for age and gender at the individual level, poor health is influenced by socio-economic positions: lower education, not working or looking for employment and disadvantaged family social class predict higher perceived health. The individual level explains the 70.1% heterogeneity in self-assessed health, the family level 25.6% and the municipality level only 4.3%. The additional influence of the socio-economic context is, conversely, of little substantive importance.Conclusions: Finally, by showing that variability in health relates mainly to individual characteristics, this study suggests that intervention to mitigate social inequalities in health should focus on structural factors, such as education and the labour market. [ABSTRACT FROM AUTHOR]

In recent years, Italian citizens have increasingly been asked to share pharmaceutical costs, but at the same time, households' medicines expenditure has decreased. Cost-sharing policies have to be assessed not just in terms of limitation of moral hazard and revenue to the state, but also for equal opportunities for citizen users accessing health services. The aim of this article is to analyze how Italian co-payment policies ('ticket') on medicines may affect pharmaceutical expenditure of households, considering territorial and social groups variation. We reviewed the per capita private spending on medicines of Italian regions, separating pharmaceutical outlay and 'ticket.' Across the period 2001-2010 we found that the overall per capita private spending on medicines remained substantially stable, although medicine expenditure decreases while the 'ticket' increases. When cost sharing rises, out-of-pocket spending on medicines by poorer families seems to remain unchanged; however, poorer families seem to reduce their pharmaceutical expenditure. Our analysis suggests that applying co-payment in Italy is partly successful, in terms of greater revenue to the health system, but in the last few years, cost-sharing increases would seem to have rebounded negatively on more vulnerable families, due to the economic crisis. [ABSTRACT FROM AUTHOR]