title: Differences in mortality by immigrant status in Italy. Results of the Italian Network of Longitudinal Metropolitan Studies.
abstract: Despite a rapid increase in immigration from low-income countries, studies on immigrants' mortality in Italy are scarce. We aimed to describe differences in all and cause-specific mortality among immigrants and Italians residing in Turin and Reggio Emilia (Northern Italy), two cities participating in the Italian Network of Longitudinal Metropolitan Studies (IN-LiMeS). We used individual data from the municipal population registers linked to the cause of death registers. All people aged 1-64 years residing between 2001 and 2010 were enrolled (open cohort) and followed up until 2013. The mortality of citizens from high migratory pressure countries (as a whole, and for each macro-area group) was compared with that of Italians; differences were estimated by Poisson regression adjusted by age and calendar year mortality rate ratios (MRRs), and by age-standardized mortality ratios for the analysis of cause-specific mortality. Compared with Italians, immigrants had lower overall mortality (MRR for men: 0.82, 95 % CI: 0.75-0.90; for women: 0.71, 95 % CI: 0.63-0.81). Sub-Saharan Africans experienced a significant higher mortality than Italians (MRR for men 1.29, 95 % CI: 1.03-1.61; for women: 1.70, 95 % CI: 1.22-2.36). Higher mortality for immigrants compared to Italians was observed for infectious diseases, congenital anomalies, some site-specific tumours and homicide mortality. Our study showed heterogeneity in mortality across the macro-areas of origin, and in particular Sub-Saharan Africans seemed to be a vulnerable population. The extension to other cohorts of IN-LiMeS will allow the health status of immigrants and vulnerable groups to be studied and monitored in more depth.
authors.affiliation: Regional Health and Social Care Agency of Emilia-Romagna, via A. Moro 21, Bologna, 40127, Italy. barbara.pacelli@regione.emilia-romagna.it.
authors.forename: Barbara
authors.identifier: 0000-0003-3250-9461
authors.initials: B
authors.lastname: Pacelli
authors.affiliation: Epidemiology Unit, ASL TO3 Piedmont Region, Grugliasco, TO, Italy.
authors.forename: Nicolás
authors.initials: N
authors.lastname: Zengarini
authors.affiliation: Epidemiology Unit, Azienda Unità Sanitaria Locale, Reggio Emilia, Italy.|Istituto di Ricovero e Cura a Carattere Scientifico-IRCCS, Arcispedale Santa Maria Nuova, Reggio Emilia, Italy.
authors.forename: Serena
authors.initials: S
authors.lastname: Broccoli
authors.affiliation: Regional Health and Social Care Agency of Emilia-Romagna, via A. Moro 21, Bologna, 40127, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Caranci
authors.affiliation: Epidemiology Unit, ASL TO3 Piedmont Region, Grugliasco, TO, Italy.
authors.forename: Teresa
authors.initials: T
authors.lastname: Spadea
authors.affiliation: Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy.|Cancer Survival Group, London School of Hygiene and Tropical Medicine, London, UK.
authors.forename: Chiara
authors.initials: C
authors.lastname: Di Girolamo
authors.affiliation: Department of Epidemiology, Lazio Regional Health Service, Rome, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Cacciani
authors.affiliation: National Institute for Health, Migration and Poverty (INMP), Rome, Italy.
authors.forename: Alessio
authors.initials: A
authors.lastname: Petrelli
authors.affiliation: Epidemiology Unit, Azienda Unità Sanitaria Locale, Reggio Emilia, Italy.|Istituto di Ricovero e Cura a Carattere Scientifico-IRCCS, Arcispedale Santa Maria Nuova, Reggio Emilia, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Ballotari
authors.affiliation: Laboratory of Public Health and Population Studies, Department of Molecular Medicine, University of Padova, Padua, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Cestari
authors.affiliation: Department of Statistics, Computer Science, Applications, University of Florence, Florence, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Grisotto
authors.affiliation: Epidemiology Unit, Azienda Unità Sanitaria Locale, Reggio Emilia, Italy.|Istituto di Ricovero e Cura a Carattere Scientifico-IRCCS, Arcispedale Santa Maria Nuova, Reggio Emilia, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Giorgi Rossi
mesh_terms: D000293:Adolescent; D000328:Adult; D002423:Cause of Death; D002648:Child; D002675:Child, Preschool; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data*; D004641:Emigration and Immigration / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007223:Infant; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000208:ethnology*; D009369:Neoplasms / Q000453:epidemiology; D012042:Registries; D014505:Urban Population; D055815:Young Adult
keywords: Cause of death; Immigrants; Italy; Mortality; Open cohort