Health Action Zones in Sicily: a model to identify social and health inequalities
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University of Palermo, Doctor resident in hygiene and preventive medicine at University of Palermo, via g bonanno 19, Italy
DASOE Sicily, Italy
University of Palermo, Italy
ex DASOE Sicily, Italy
Servizio sovrazonale di Epidemiologia - ASL TO3, Piedmont Region, Italy
Publication date: 2023-04-26
Popul. Med. 2023;5(Supplement):A795
Background & Objective:
The Health Action Zones (HAZs) represent geographical aggregates that allow to divide larger territories into smaller areas. They were developed by the English National Health Service (NHS) in the 2000s to identify deprived areas and, ultimately, target, tackle and reduce health inequalities over the whole territory. Since Piedmont was the first Italian region to develop the HAZs, a collaboration with Sicily was signed to implement the system over the insular territory as well. The framework of the HAZs system for the Sicilian region is proposed below.

Material and method:
In each HAZ social and health inequalities would be evaluated based on two indicators: their socio-economical condition and their overall health status. INDICATOR OF SOCIAL DISADVANTAGE:Subjects with low education: percentage of individuals (between 15-60) having stopped their education at completion of primary school or before.Inactive subjects: percentage of individuals (between 15-64) students, homemakers, unable to work or retired.NEET: percentage of individuals (between 15-30) not being engaged in employment research, education, and professional training.Percentage of subjects in crowded households: overcrowding would be established if the residence size is less than 30, 50, 65, 80, 110, and 125 m^2 when the cohabitants are respectively 1, 2, …, 6. INDICATOR OF HEALTH. Based on an epidemiologic study conducted in Sicily, these items have been selected by D’Anna et-al as the most critical:Crude mortality rate associated with diabetes.Crude mortality rate associated with cardiovascular disease.Infant mortality rate.Percentage of women (between 50-69 years) who undergo breast cancer screening.Road accidents per capita.

231 HAZs were identified (111 between provincial capitals and 120 in inner areas) with an average population of 22,000 inhabitants.

This tool can contribute to the Evidence-Based-Policy-Making process, promoting health-service development and improving effectiveness of Sicilian Health System in reducing inequalities.