Monitoring All-Cause and Cause-Specific Mortality Inequalities in Italian Regions

Reducing socioeconomic disparities in mortality is a critical public health concern. Recognition of the importance of socioeconomic disparities in health is crucial to establish effective systems for monitoring health inequalities.Since 2016, Istat has been tracking social inequalities in mortality using census data. Recently Istat launched a project to develop cross-sectional mortality indicators by socioeconomic conditions. Educational level is widely considered a proxy for socioeconomic status due to its associations with employment, income, and health determinants. Istat integrated data from the National Register of Causes of Death with the level of education available from the National Base Register of Individuals. The study focuses on individuals aged 30+. Standardized mortality rates and rate ratios were calculated. Between 2019 and 2020 deaths increased by 104,314 cases, with a 15% rise in the standardized mortality rate. This increase was not uniform across the country, with higher excess mortality in the Northwest. The Covid-19 impact in 2020 was significant, accounting for 10.6% of total mortality, with gender-based variations. We observed a marked gradient in mortality by education, highlighting the negative influence of disadvantaged socioeconomic status on health. From the results emerges that among females in most of the regions the educational gradient in mortality become more important when Covid-19 in considered. Findings indicate the importance of the analyses of regional disparities, accounting for age and causes of death, in order to better understand mortality inequalities in Italy. Regional variations in healthcare access and policies may amplify or alleviate health disparities, as Italy's healthcare is regionally managed.