Spatial inequalities in life expectancy related to educational level in the urban context of Rome: Livia Maria Salvatori

Introduction The Statistic Bureau of the City of Rome, in 2009, demonstrated differences in life expectancy (LE) among areas of Rome that differed for socioeconomic status of their inhabitants. The aim of our study was to investigate the association between LE and study titles (STs) in different areas of Rome. Methods Rome is divided in 155 socioeconomically homogeneous administrative urban zones (UZs). Percentages of population with specific STs (e.g. “primary school diploma”); distribution of age among three classes (0-29; 30-54; 55-99); total population were extracted from the 2011 National Census for each UZ. Data about LE were collected from the Statistic Bureau of Rome, which grouped the UZs in 7 areas according to homogeneous socioeconomic profiles. Two multiple linear regression models were built to calculate the association between STs and LE both in male and female population. Results As reported, the LEs for the various Areas for females and males were: 81.4 years and 78 years in Area 1; 81.9 years and 78.7 years in Area 2; 81.3 years and 77.4 years in Area 3; 81.7 years and 78.3 years in Area 4; 81.2 years and 76.3 years in Area 5; 80.8 years and 76.7 years in Area 6; 81.1 years and 77.2 years in Area 7. Multiple linear regression showed that for both males and females LE was directly associated with the percentage of “Degree or higher title” (β: 0.017, 95% CI: 0.001-0.035; β: 0.021, 95% CI: 0.007 - 0.035; respectively) and inversely correlated with the percentage of “Lower secondary school diploma or lower title” (β: -0.028, 95% CI: -0.044 - -0.012, β: 0.012, 95% CI: -0.023 - -0.001; respectively). Conclusions These results showed that part of the differences in LE between different areas in Rome is due to the education level, enhancing our comprehension of health inequities dynamics in local contexts. Key messages: The differences in study titles, used as a proxy of education level, explain part of the differences in life expectancy between the Rome areas showed by the analysis of the Statistic Bureau of Rome. There is a need to investigate more deeply the association between social determinants and health outcomes, to better understand the mechanisms underlying health inequalities in local contexts.