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This paper investigates the association between work trajectories and frailty in later life in four ageing contexts (AAI index): Czech Republic, Denmark, Italy and Poland. Data of the Survey of Health, Ageing and Retirement in Europe (SHARE) is used to create the frailty index and linear regression models are applied to assess the association between frailty condition and work trajectories of 6187 women and men, aged between 50 and 74 years old. The findings underline that women experience worse frailty than men in all countries. Having precarious work trajectories is detrimental to individuals' health everywhere, but it becomes even worse for Danish men and Polish men and women. The ageing context (AAI index) is not associated with health inequalities in older people. We suggest that further research should explore more in detail the mechanisms linking job insecurity to psycho-social risks as possible determinants of frailty, taking into account differences at the national level. [ABSTRACT FROM AUTHOR]

Population aging is particularly pronounced in Italy. Recently, home-care services emerged as one of the desirable strategy when dealing with such situations of fragility. In this framework, we present the evaluation of a home-care service which was experimentally implemented by Fondazione Sacra Famiglia and Casa di Cura Ambrosiana in the 2017–2018 biennium. The service consisted of a twice-weekly nursing visit intended to monitor patient health conditions and to gather data constantly supervised by a geriatrician. The eligible population consisted of the users of San Carlo Hospital Emergency Department (91 individuals). Twenty of these individuals had access to the experimental home-care service. The results show the smaller probability of mortality for the treatment group compared to the control group, but similar probabilities in admissions to ER and in hospitalizations. These findings suggest that health home-care policies could reduce mortality by lessening the negative effects of relational isolation. [ABSTRACT FROM AUTHOR]

Background: In February 2021, the spread of a new variant of SARS-CoV-2 in the Lombardy Region, Italy caused concerns about school-aged children as a source of contagion, leading local authorities to adopt an extraordinary school closure measure. This generated a debate about the usefulness of such an intervention in light of the trade-off between its related benefits and costs (e.g. delays in educational attainment, impact on children and families' psycho-physical well-being). This article analyses the epidemiological impact of the school closure intervention in the Milan metropolitan area. Methods: Data from the Agency for Health Protection of the Metropolitan City of Milan allowed analysing the trend of contagion in different age classes before and after the intervention, adopting an interrupted times series design, providing a quasi-experimental counterfactual scenario. Segmented Poisson regression models of daily incident cases were performed separately for the 3–11-year-old, the 12–19-year-old, and the 20+-year-old age groups, examining the change in the contagion curves after the intervention, adjusting for time-varying confounders. Kaplan-Meier survival curves and Cox regression were used to assess the equality of survival curves in the three age groups before and after the intervention. Results: Net of time-varying confounders, the intervention produced a daily reduction of the risk of contagion by 4% in those aged 3–11 and 12–19 (IRR = 0·96) and by 3% in those aged 20 or more (IRR = 0·97). More importantly, there were differences in the temporal order of contagion decrease between the age groups, with the epidemic curve lowering first in the school-aged children directly affected by the intervention, and only subsequently in the adult population, which presumably indirectly benefitted from the reduction of contagion among children. Conclusion: Though it was not possible to completely discern the effect of school closures from concurrent policy measures, a substantial decrease in the contagion curves was clearly detected after the intervention. The extent to which the slowdown of infections counterbalanced the social costs of the policy remains unclear. [ABSTRACT FROM AUTHOR]

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]

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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]

There is widespread concern that episodes of unemployment and unstable working conditions adversely affect health. We add to the debate by focusing on the relationship between work trajectory and the self-reported health of Italian men and women during the present economic downturn. Relying on Italian data in the EU-SILC project (from 2007 to 2010), our sample includes all individuals aged 30 to 60 in 2010, and uses multivariate binomial regression models for preliminary analyses and the Structural Equations modelling (SEM) to observe the cumulative effects of health status according to different job trajectories. Our main findings show similar pictures for men and women. Individuals who are unemployed, ejected or in precarious occupational positions have a higher risk of worsening their health status during these years. [ABSTRACT FROM AUTHOR]

In the last few years, much sociological debate hasfocusedon individualisation theory, especially on Beck's risk society version. According to this theory, contemporary social change can be interpreted as the progressive weakening of the influence of social structures on individual behaviour. Individualisation theory has been adopted in many fields of study (voting behaviour, consumption behaviour, etc.). Although much of the debate has a theoretical character, there have been some attempts to empirically assess individualisation theory. As far as poverty is concerned, scholars supporting individualisation theory, as well as scholars opposing it, have adopted one of the following methodological strategies: highlighting the role played by individual variables (especially by life course variables) rather than structural variables; controlling for individual rather than structural variables. Both these approaches focus on short observation windows; however, it is necessary to consider long periods in order to assess the core of individualisation theory, i.e. the decreasing influence of social structures. Our approach assesses the change (rather than the stability) of the individual-level relationship between structures (occupational classes, education, etc.) and poverty over a long time period. This changing-parameter model is implemented through multilevel modelling with families at level one and years at level two. The analysisfocuseson the Italian case and it is based on data from the Family Expenditure Survey (Indagine sui Consumi delle Famiglie) that was collected by the Italian Statistical Institute (ISTAT). It covers the period from 1985 to 2011. The results seem to indicate that there is stability in the relationship between structures and poverty. [ABSTRACT FROM PUBLISHER]

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]

Our study investigates changes occurred in the Italian social stratification in the last twenty years. It is based on stratification studies that consider individual occupations as the main aspect of the immaterial and material resource allocation and, more precisely, the studies that order occupations along a continuum by their social desiderability. At this aim we compare the de Lillo-Schizzerotto Scale (1985) with a new edition of the same scale, realized in 2005 by an inter-university research equipe; doing this, we focused on scores and ranking of the occupational categories in the two scales. Metric and ordinal association measures between the two Scales do not show significant changes in the structure of perceived desiderability of occupations in the Italian labour market. Therefore, in this point of view, twenty years later results confirm the stability of the social inequality system in our country. [ABSTRACT FROM AUTHOR]

Health inequalities, rather than representing a secondary or a partial aspect of social inequalities, constitute their most emblematic expression. Making use of the Istat Multiscopo dataset on health conditions (2000), it was possible to describe the main relationships between social conditions and health status in Italy. The study was devoted to reconstruct a «health space» in order to synthesize the health profiles of social clusters identified on the basis of occupational position, educational attainment and economic sector of activity. The results of the analyses suggest that there is a cumulative disadvantage combining the effects of structural socio-economic inequalities related to the scarcity of material resources, the usure du travail and the symbolic resources. It appears that a sort of «cultural contagion» of risky behaviours takes place within socially homogeneous groups. [ABSTRACT FROM AUTHOR]

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.