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The UN Sustainable Development Goals have set clear targets on global poverty, hunger and malnutrition to be achieved by 2030, which have prompted academics and policymakers to identify useful strategies and drivers. Moreover, the COVID19 pandemic has exacerbated inequalities at national and sub-national levels thus hampering the achievement of these goals. On considering the multifaceted nature of poverty, a recent research strand focuses on food poverty and insecurity issues in terms of economic access to food and healthy diet consumption, with moderate and extreme food insecurity affecting almost 9% of the population in Europe and North America. This paper aims to analyse food poverty and insecurity at regional level in Italy. Using micro-data from the Italian Household Budget Survey carried out by ISTAT, an analytical approach was proposed to define and measure the different degree of food poverty and insecurity. Moreover, to obtain insights into whether food poverty and insecurity can afford population healthy nutrition, inequality of the distributions of food expenditure categories are estimated. The results provided us with information on other important aspects of the poverty. Indeed, in Italy individuals who are at-risk-of-food-poverty or food insecure amount to 22.3% of the entire population. Furthermore, the at-risk-of-food-poverty-rate varies at regional level from 14.6% (Umbria) to 29.6% (Abruzzo), with high levels of food consumption inequalities observed above all for vegetables, meat and fish. All these issues could help policy makers to define economic intervention policies aimed at reducing social exclusion and achieving more equitable and sustainable living conditions for the entire population. [ABSTRACT FROM AUTHOR]

Background: With over 1 million HIV-related deaths annually, quality end-of-life care remains a priority. Given strong public preference for home death, place of death is an important consideration for quality care. This 11 country study aimed to i) describe the number, proportion of all deaths, and demographics of HIV-related deaths; ii) identify place of death; iii) compare place of death to cancer patients iv), determine patient/health system factors associated with place of HIV-related death.Methods: In this retrospective analysis of death certification, data were extracted for the full population (ICD-10 codes B20-B24) for 1-year period: deceased's demographic characteristics, place of death, healthcare supply.Results: i) 19,739 deaths were attributed to HIV. The highest proportion (per 1000 deaths) was for Mexico (9.8‰), and the lowest Sweden (0.2‰). The majority of deaths were among men (75%), and those aged <50 (69.1%). ii) Hospital was most common place of death in all countries: from 56.6% in the Netherlands to 90.9% in South Korea. The least common places were hospice facility (3.3%-5.7%), nursing home (0%-17.6%) and home (5.9%-26.3%).iii) Age-standardised relative risks found those with HIV less likely to die at home and more likely to die in hospital compared with cancer patients, and in most countries more likely to die in a nursing home. iv) Multivariate analysis found that men were more likely to die at home in UK, Canada, USA and Mexico; a greater number of hospital beds reduced the likelihood of dying at home in Italy and Mexico; a higher number of GPs was associated with home death in Italy and Mexico.Conclusions: With increasing comorbidity among people ageing with HIV, it is essential that end-of-life preferences are established and met. Differences in place of death according to country and diagnosis demonstrate the importance of ensuring a "good death" for people with HIV, alongside efforts to optimise treatment. [ABSTRACT FROM AUTHOR]

Household consumption expenditure represents a crucial measure to be used for assessing individuals' material living conditions and well-being. Indeed, the analysis of household conditions can provide policy makers with a clear picture of the economic and social situation of the area in which they are operating. However, official sample surveys which are generally used for this purpose, such as the Household Budget Survey in Italy carried out by the National Institute of Statistics, do not allow for reliable disaggregated estimates thus hindering appropriate and effective planning and evaluation of political interventions at local level. By referring to the 2012 Italian Household Budget Survey, this paper aims at obtaining reliable provincial estimates of household consumption expenditure in Italy. We use Small Area Estimation methods and we adjust the estimates for spatial differences in price levels by computing and using sub-national Purchasing Power Parities, thus obtaining 'real' estimates of consumption expenditure to be used for intra-national comparisons. [ABSTRACT FROM AUTHOR]

Italy was severely hit by COVID-19 during 2020 and great concern about the possible increase of suicide rates in the population has arisen since early pandemic phases. Analyses limited to March–April have shown a drop in suicides in both sexes. This study aims to analyze suicide mortality in Italy during the whole 2020 making comparisons with the pre-pandemic period 2015–19, by sex, age and geographic area. Official cause-of-death data with national coverage were used to analyze suicide mortality by sex, month, age class and geographic area in the population aged ≥10 years (54,595,179). The monthly number of suicide deaths in 2020 was compared to the average number in 2015–19. Age-specific and age-adjusted suicide rates in 2020 and in 2015–19 were compared using rate-ratios with 95 % confidence intervals. Compared to 2015–19 a non-significant reduction of the overall suicide rate was observed during 2020, both in males (−3 %) and females (−7 %). Suicide rates non-significantly decreased in most age groups; an increase, although not statistically significant, was found among males aged ≥75 years and females aged ≥85 years. Suicide deaths reduced mainly in Central-Southern areas and the Islands, while they slightly increased in the North especially among males. Study limitations include accuracy of death certification and the relatively brief observation period. The study contributes to the analysis of early effects of the COVID-19 pandemic on suicide mortality in the whole population highlighting sex, age and territorial differences and suggesting to monitor possible increases in a longer observation period. • In Italy, compared to 2015-19 a non-significant reduction of the overall suicide rate was observed in 2020, in both sexes • An increase in suicide rates, although non-significant, was found among males aged ≥75 years and females aged ≥85 years • The variation in the number of suicide deaths during 2020 is not uniform across the country [ABSTRACT FROM AUTHOR]

Objectives: This study aimed at investigating gender differences in the relationship between sociodemographic factors and suicide mortality, as well as in the method used for suicide and the presence of comorbidities in an older population in Italy.Methods/design: We conducted a historical cohort study based on individual record linkage across the 15th Italian Population Census, the Italian Population Register, and the National Register of Causes of Death. Suicides among people aged 75 years or older from 2012 to 2017 were analyzed. Crude mortality rates were computed, and cause-specific mortality rate ratios were estimated using negative binomial regression models. Chi-square tests were used to evaluate significant gender differences in suicide methods and comorbidities associated with suicide.Results: The study included 9,686,698 individuals (41% men, 59% women). Compared to living alone, living with children or partners reduced suicide mortality, especially among men. Having high or medium educational levels was associated with lower mortality than low educational levels among men. Foreign citizens had lower mortality among men, but not among women. Living in urban areas was associated with lower suicide rates in men and higher rates in women. Methods of suicide significantly differed by gender: leading methods were hanging, strangulation, and suffocation in men, and falling from height in women. Mental comorbidity was significantly more frequent among women, especially at ages 75-84 years.Conclusions: We believe that our findings might help to promote public health strategies taking gender differences in old age into account to improve social support and quality of life of older men and women. [ABSTRACT FROM AUTHOR]

Suicide is a leading cause of death among adolescents and is recognized as a serious public health problem. This study aimed to investigate the relationship between family characteristics and the risk of suicide among adolescents in Italy using nationwide official data. We carried out a cohort study based on the record linkage between the 15th Italian Population Census, the Italian Population Register, and the National Register of Causes of Death. Suicides in adolescents aged 10–19 years from 2012 to 2016 were analyzed. Hazard ratios of mortality from suicide were estimated through a multivariable Cox regression model using time-on-study as the time scale. We included 8,284,359 children and adolescents (51% males, 49% females). Over the 5-year follow-up, we registered 330 deaths from suicides (74% males), mostly occurred in the age class 15–19 years (86%). The suicide rate was 1.71 per 100,000 person-years among males and 0.65 among females. We found some familial characteristics associated with a higher risk of dying by suicide, including: living in single-parent or reconstructed families (among boys), a 40-year or more age gap between mother and child (among girls), having highly educated parents, an age difference between parents greater than 5 years. Furthermore, the study showed a lower risk for boys living in urban areas and for both boys and girls living in South Italy. Our results could help in identifying adolescents at high risk of suicide who could benefit from the planning of targeted intervention strategies. [ABSTRACT FROM AUTHOR]

• In the winter seasons from 2013/14 to 2016/17, an estimated average of 5,290,000 ILI cases occurred in Italy, corresponding to an incidence of 9%. • More than 68,000 deaths attributable to flu epidemics were estimated in the study period. • Italy showed a higher influenza attributable excess mortality compared to other European countries. especially in the elderly. In recent years, Italy has been registering peaks in death rates, particularly among the elderly during the winter season. Influenza epidemics have been indicated as one of the potential determinants of such an excess. The objective of our study was to estimate the influenza-attributable contribution to excess mortality during the influenza seasons from 2013/14 to 2016/17 in Italy. We used the EuroMomo and the FluMomo methods to estimate the annual trend of influenza-attributable excess death rate by age group. Population data were provided by the National Institute of Statistics, data on influenza like illness and confirmed influenza cases were provided by the National Institutes of Health. As an indicator of weekly influenza activity (IA) we adopted the Goldstein index, which is the product of the percentage of patients seen with influenza-like illness (ILI) and percentage of influenza-positive specimens, in a given week. We estimated excess deaths of 7,027, 20,259, 15,801 and 24,981 attributable to influenza epidemics in the 2013/14, 2014/15, 2015/16 and 2016/17, respectively, using the Goldstein index. The average annual mortality excess rate per 100,000 ranged from 11.6 to 41.2 with most of the influenza-associated deaths per year registered among the elderly. However children less than 5 years old also reported a relevant influenza attributable excess death rate in the 2014/15 and 2016/17 seasons (1.05/100,000 and 1.54/100,000 respectively). Over 68,000 deaths were attributable to influenza epidemics in the study period. The observed excess of deaths is not completely unexpected, given the high number of fragile very old subjects living in Italy. In conclusion, the unpredictability of the influenza virus continues to present a major challenge to health professionals and policy makers. Nonetheless, vaccination remains the most effective means for reducing the burden of influenza, and efforts to increase vaccine coverage and the introduction of new vaccine strategies (such as vaccinating healthy children) should be considered to reduce the influenza attributable excess mortality experienced in Italy and in Europe in the last seasons. [ABSTRACT FROM AUTHOR]

Background: Most people prefer to receive end-of-life care in familiar surroundings rather than in hospital. This study examines variation in place of death for people dying from Parkinson's disease (PD) across 11 European and non-European countries. Methods: Using death certificate data of 2008 for Belgium, France, Italy, Hungary, Czech Republic, New Zealand, USA, Canada, Mexico, South Korea and Spain for all deaths with PD as an underlying cause (ICD-10 code: G20) cross-national differences in place of death were examined. Associations between place of death and patient socio-demographic and regional characteristics were evaluated using multivariable binary logistic regression analyses. Results: The proportion of deaths in hospital ranged from 17% in the USA to 75% in South Korea. Hospital was the most prevalent place of death in France (40%), Hungary (60%) and South Korea; nursing home in New Zealand (71%), Belgium (52%), USA (50%), Canada (48%) and Czech Republic (44%); home in Mexico (73%), Italy (51%) and Spain (46%). The chances of dying in hospital were consistently higher for men (Belgium, France, Italy, USA, Canada), those younger than 80 years (Belgium, France, Italy, USA, Mexico), and those living in areas with a higher provision of hospital beds (Italy, USA). Conclusions: In several countries a substantial proportion of deaths from PD occurs in hospitals, although this may not be the most optimal place of terminal care and death. The wide variation between countries in the proportion of deaths from PD occurring in hospital indicates a potential for many countries to reduce these proportions. [ABSTRACT FROM AUTHOR]