目标:记录米兰市(伦巴第大区,意大利北部),检查地区社会经济劣势与健康结果之间的关系,目的是建议采取政策行动来解决这些问题。
方法:分析使用了生态框架;分析中考虑了多个健康指标;通过诸如低教育,失业,移民身份,住房拥挤。对于每个市政统计区域,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。
方法:米兰市的居民年龄在30至75岁之间,自2019年1月1日起居住在米兰,分为88个统计区域。
方法: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,抗抑郁药的使用,多药,和多重性。
结果: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。肿瘤显示出相反的社会梯度,而与抗抑郁药使用的关系各不相同。
结论:这些发现为米兰健康不平等的分布提供了有价值的见解,并有助于现有的有关健康社会决定因素的文献。该研究强调需要有针对性的干预措施来解决差距并促进公平的健康结果。研究结果可为制定旨在减少城市健康不平等的有效公共卫生战略和政策提供信息。
OBJECTIVE: 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.
METHODS: 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.
METHODS: 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.
METHODS: 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.