BACKGROUND: since January 2017, a multidisciplinary research group, involving the Local Health Authority, the Municipality, and the University of Bologna, carried out a city-wide action-research project on health inequalities consistin of an ecological study over the years 2011-2015 based on indicators that are routinely available within health and social services. OBJECTIVES: to document existing geographical inequalities in health outcomes and use of healthcare services in the city of Bologna (Emilia-Romagna Region, Northern Italy), with the aim to suggest policy action to tackle them. DESIGN: the results of the first phase of the above-mentioned project were reported: five related to the social determinants of health (exposure) and five related to the social determinants of ill-health (outcomes). For each municipal statistical area, the distribution of the exposures as well as rates and Bayesian Relative Risks of the outcomes 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 Bologna aged 18 years in the period 2011-2015, grouped into 90 statistical areas. RESULTS: a North-South divide was apparent for most of the socioeconomic and ill-health indicators, with a high concentration of adverse outcomes in the North-Western part of the city. Adherence to cancer screening represented an exception, being greater in the areas with higher proportion of unfavourable health outcomes. An inverse association between education level and health outcomes was found. Low family income was weakly to moderately correlated with health outcomes. Proportion of residents in council houses and of the teenage foreign population showed a moderate to strong association with all outcomes, but mortality and screening adherence. CONCLUSIONS: an ecological analysis based on data that are routinely collected by local health and social institutions can be effective in revealing the geographical patterns of health inequalities. When accompanied by strategic choices aimed at bridging knowledge and action, this approach may facilitate the direct engagement of local actors towards health equity.

An ecological study on health inequalities in the city of Bologna (Emilia-Romagna Region, Northern Italy): bridging knowledge and action = Uno studio ecologico sulle disuguaglianze in salute a Bologna: unire conoscenza e azione / Valeria Gentilini, Chiara Bodini, Chiara Di Girolamo, Ilaria Camplone, Gabriele Cavazza, Paolo Marzaroli, Muriel Musti, Vincenza Perlangeli, Paolo Pandolfi, Lorenzo Pizzi, Martina Riccio. - In: EPIDEMIOLOGIA E PREVENZIONE. - ISSN 1120-9763. - ELETTRONICO. - 44:5-6 (Suppl. 1)(2020), pp. 45-53. [10.19191/EP20.5-6.S1.P045.073]

An ecological study on health inequalities in the city of Bologna (Emilia-Romagna Region, Northern Italy): bridging knowledge and action = Uno studio ecologico sulle disuguaglianze in salute a Bologna: unire conoscenza e azione

Valeria Gentilini
;
Chiara Bodini;Chiara Di Girolamo;Ilaria Camplone;Paolo Pandolfi;Lorenzo Pizzi;Martina Riccio
2020

Abstract

BACKGROUND: since January 2017, a multidisciplinary research group, involving the Local Health Authority, the Municipality, and the University of Bologna, carried out a city-wide action-research project on health inequalities consistin of an ecological study over the years 2011-2015 based on indicators that are routinely available within health and social services. OBJECTIVES: to document existing geographical inequalities in health outcomes and use of healthcare services in the city of Bologna (Emilia-Romagna Region, Northern Italy), with the aim to suggest policy action to tackle them. DESIGN: the results of the first phase of the above-mentioned project were reported: five related to the social determinants of health (exposure) and five related to the social determinants of ill-health (outcomes). For each municipal statistical area, the distribution of the exposures as well as rates and Bayesian Relative Risks of the outcomes 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 Bologna aged 18 years in the period 2011-2015, grouped into 90 statistical areas. RESULTS: a North-South divide was apparent for most of the socioeconomic and ill-health indicators, with a high concentration of adverse outcomes in the North-Western part of the city. Adherence to cancer screening represented an exception, being greater in the areas with higher proportion of unfavourable health outcomes. An inverse association between education level and health outcomes was found. Low family income was weakly to moderately correlated with health outcomes. Proportion of residents in council houses and of the teenage foreign population showed a moderate to strong association with all outcomes, but mortality and screening adherence. CONCLUSIONS: an ecological analysis based on data that are routinely collected by local health and social institutions can be effective in revealing the geographical patterns of health inequalities. When accompanied by strategic choices aimed at bridging knowledge and action, this approach may facilitate the direct engagement of local actors towards health equity.
2020
An ecological study on health inequalities in the city of Bologna (Emilia-Romagna Region, Northern Italy): bridging knowledge and action = Uno studio ecologico sulle disuguaglianze in salute a Bologna: unire conoscenza e azione / Valeria Gentilini, Chiara Bodini, Chiara Di Girolamo, Ilaria Camplone, Gabriele Cavazza, Paolo Marzaroli, Muriel Musti, Vincenza Perlangeli, Paolo Pandolfi, Lorenzo Pizzi, Martina Riccio. - In: EPIDEMIOLOGIA E PREVENZIONE. - ISSN 1120-9763. - ELETTRONICO. - 44:5-6 (Suppl. 1)(2020), pp. 45-53. [10.19191/EP20.5-6.S1.P045.073]
Valeria Gentilini, Chiara Bodini, Chiara Di Girolamo, Ilaria Camplone, Gabriele Cavazza, Paolo Marzaroli, Muriel Musti, Vincenza Perlangeli, Paolo Pandolfi, Lorenzo Pizzi, Martina Riccio
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11585/780575
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