Health inequalities in the Regional Prevention Plans: an analysis of 702 projects developed by Italian Regions

Background The attention on the prevention of health inequalities has been growing in the last years. In Italy there are 21 different regional prevention Regional Prevention Plans (RPPs). The aim of the study was to analyze the factors associated with the planning in the prevention of health inequalities in the different regions. Methods Several multiple logistic regression models were built to analyze factors associated with the regional prevention planning on inequalities. The following predictive variables were initially tested in the model: quality, geographic area, area of intervention, regional percentage of migrants, income inequality (Gini index) and Gross domestic product. Project’s quality was assessed through a specific tool developed within a Ministry of Health project to conduct an evidence-based analysis of RPPs. Results A total of 702 projects were analyzed. A significant association between inequalities prevention projects with regions with the higher part of migrants (OR:2.06, 95%CI: 1.03-4.10), with the area of the interventions related to specific part of the population (2.93, 95%CI:1.65-5.19) and with the quality of the projects (1.97, 95%CI: 1.06-3.64) was found. Conclusions Regions with higher percentage of migrants resulted likely to have inequalities projects in their prevention planning while no association was showed with income inequality, geographic area and Gross domestic group. A higher quality of the planning and the interventions on specific part of the population are associated too. Key messages Regions with a greater part of migrants are more likely to plan on the prevention of inequalities. Moreover, inequalities prevention planning among regions is related to quality of the regional health programming.