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Differential impact of Covid-19 by citizenship and degree of urbanisation in five Italian regions from February 2020 to July 2021: results of a collaborative study (supported by Ministry of health)
1
Local Health Authority Parma Public Health Department, Local Health Authority Parma Italy
2
Emilia-Romagna Region / University of Turin Regional Health and Social Care Agency, Emilia-Romagna Region / University of Turin Italy
3
ASL TO3 Piedmont Region Epidemiology Unit, ASL TO3 Piedmont Region Italy
4
Regional health agency of Tuscany Italy
5
Regional health agency of Tuscany Regional health agency of Tuscany, epidemiology observatory, Florence, Italy Italy
6
Sicily Region / Health Authority, Trapani Province Department of Health Services and Epidemiological Observatory, Health Authority, Sicily Region / Complex Unit of Clinical Pathology, Department of Radiological Sciences and Services, Sant’Antonio Abate Hospital, Health Authority, Trapani Province Italy
7
Sicily Region Department of Health Services and Epidemiological Observatory, Health Authority, Sicily Region Italy
8
Ministry of health - Italy Office 05 - Prevention of the Communicable Diseases and International Prophylaxis Directorate-General for Health Prevention - Ministry of Health, Italy Italy
9
National Institute for Health, Migration and Poverty National Institute for Health, Migration and Poverty (INMP) Italy
10
Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia Epidemiology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia Italy
Publication date: 2023-04-26
Popul. Med. 2023;5(Supplement):A1378
ABSTRACT
Background and objective:
The Covid-19 pandemic produced greater negative effects on vulnerable populations, potentially more exposed to contagion and severe outcomes. This cross-sectional study aimed to compare the impact of the pandemic between Italian and immigrant residents in five Italian regions (Piedmont, Emilia-Romagna, Tuscany, Latium, and Sicily), taking into account the degree of urbanisation.
Methods:
Age-standardised monthly rates (smR) of positivity, hospitalisations and 30-day mortality ─ stratified by sex and citizenship ─ were calculated pooling the data of the 5 regions for all levels of urbanisation and restricting to urban areas only (DEGURBA-EUROSTAT=1); residents were observed until July 2021.
Results:
Among the 23,098,881 residents as of 31/12/2020, 9.4% had non-Italian citizenship. Positivity rates were slightly lower among immigrants than Italians at the start of the pandemic (-46.7% and -30.4% smR differences among males and females, respectively, in March 2020) and during the peaks of November 2020 (-17.9% and -19.1%) and March 2021 (-15.0% and -8.4%). Conversely, from July to September 2020, positivity rates (+177.7% and +176.3%), hospitalisation (+88.3 and +53.3) and mortality rates (+253.9% and +260.2%) became higher in the immigrant population, and then tended to be the same as in Italians until early 2021. Since February and during the spring of 2021, the mortality rates among immigrants exceeded that of Italians (+32.5% and +31.0% in April 2022). Differences by citizenship were more pronounced in urban areas, particularly among males for hospitalisations (+296% in September 2020) and mortality (+103% in April 2021).
Conclusions:
In the five analysed regions, immigrant residents showed higher rates of hospitalisation and mortality due to Covid-19 in summer 2020 and from February 2021, with greater excesses in urban areas ─ among men ─ and in the last months of the study period, when the impact of vaccination campaign became important in the control of the pandemic. Nicola Caranci Emilia-Romagna Region Regional Health and Social Care Agency, Emilia-Romagna Region via A. Moro 21, 40127 Bologna. Italy Italy Letizia Bartolini Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia Epidemiology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia Italy
The Covid-19 pandemic produced greater negative effects on vulnerable populations, potentially more exposed to contagion and severe outcomes. This cross-sectional study aimed to compare the impact of the pandemic between Italian and immigrant residents in five Italian regions (Piedmont, Emilia-Romagna, Tuscany, Latium, and Sicily), taking into account the degree of urbanisation.
Methods:
Age-standardised monthly rates (smR) of positivity, hospitalisations and 30-day mortality ─ stratified by sex and citizenship ─ were calculated pooling the data of the 5 regions for all levels of urbanisation and restricting to urban areas only (DEGURBA-EUROSTAT=1); residents were observed until July 2021.
Results:
Among the 23,098,881 residents as of 31/12/2020, 9.4% had non-Italian citizenship. Positivity rates were slightly lower among immigrants than Italians at the start of the pandemic (-46.7% and -30.4% smR differences among males and females, respectively, in March 2020) and during the peaks of November 2020 (-17.9% and -19.1%) and March 2021 (-15.0% and -8.4%). Conversely, from July to September 2020, positivity rates (+177.7% and +176.3%), hospitalisation (+88.3 and +53.3) and mortality rates (+253.9% and +260.2%) became higher in the immigrant population, and then tended to be the same as in Italians until early 2021. Since February and during the spring of 2021, the mortality rates among immigrants exceeded that of Italians (+32.5% and +31.0% in April 2022). Differences by citizenship were more pronounced in urban areas, particularly among males for hospitalisations (+296% in September 2020) and mortality (+103% in April 2021).
Conclusions:
In the five analysed regions, immigrant residents showed higher rates of hospitalisation and mortality due to Covid-19 in summer 2020 and from February 2021, with greater excesses in urban areas ─ among men ─ and in the last months of the study period, when the impact of vaccination campaign became important in the control of the pandemic. Nicola Caranci Emilia-Romagna Region Regional Health and Social Care Agency, Emilia-Romagna Region via A. Moro 21, 40127 Bologna. Italy Italy Letizia Bartolini Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia Epidemiology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia Italy
| ISSN: | 2654-1459 |
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