期刊论文详细信息
International Journal for Equity in Health
Socio-economic factors associated with infant mortality in Italy: an ecological study
Maria Pia Fantini2  Gianfranco Domenighetti1  Simona Calugi2  Giuseppe Franchino2  Jacopo Lenzi2  Valentina Di Gregori2  Laura Dallolio2 
[1] Institute of Public Communication and Education (ICIeF), Institute of Microeconomics and Public Economics (MECOP), University of Lugano, via Buffi 13, 6900, Lugano, Switzerland;Department of Medicine and Public Health, Alma Mater Studiorum – University of Bologna, via San Giacomo 12, 40126, Bologna, Italy
关键词: Unemployment rate;    Income inequality;    Income;    Infant mortality;   
Others  :  828345
DOI  :  10.1186/1475-9276-11-45
 received in 2012-04-06, accepted in 2012-08-05,  发布年份 2012
PDF
【 摘 要 】

Introduction

One issue that continues to attract the attention of public health researchers is the possible relationship in high-income countries between income, income inequality and infant mortality (IM). The aim of this study was to assess the associations between IM and major socio-economic determinants in Italy.

Methods

Associations between infant mortality rates in the 20 Italian regions (2006–2008) and the Gini index of income inequality, mean household income, percentage of women with at least 8 years of education, and percentage of unemployed aged 15–64 years were assessed using Pearson correlation coefficients. Univariate linear regression and multiple stepwise linear regression analyses were performed to determine the magnitude and direction of the effect of the four socio-economic variables on IM.

Results

The Gini index and the total unemployment rate showed a positive strong correlation with IM (r = 0.70; p < 0.001 and r = 0.84; p < 0.001 respectively), mean household income showed a strong negative correlation (r = −0.78; p < 0.001), while female educational attainment presented a weak negative correlation (r = −0.45; p < 0.05). Using a multiple stepwise linear regression model, only unemployment rate was independently associated with IM (b = 0.15, p < 0.001).

Conclusions

In Italy, a high-income country where health care is universally available, variations in IM were strongly associated with relative and absolute income and unemployment rate. These results suggest that in Italy IM is not only related to income distribution, as demonstrated for other developed countries, but also to economic factors such as absolute income and unemployment. In order to reduce IM and the existing inequalities, the challenge for Italian decision makers is to promote economic growth and enhance employment levels.

【 授权许可】

   
2012 Dallolio et al.; licensee BioMed Central Ltd.

【 预 览 】
附件列表
Files Size Format View
20140714001328309.pdf 223KB PDF download
Figure 1. 57KB Image download
【 图 表 】

Figure 1.

【 参考文献 】
  • [1]Gray R, Hollowell J, Brocklehurst P, Graham H, Kurinczuk JJ: Inequalities in infant mortality project briefing paper 2. Health inequalities infant mortality target: technical background. National Perinatal Epidemiology Unit, Oxford; 2009. https://www.npeu.ox.ac.uk/infant-mortality webcite
  • [2]Reidpath DD, Allotey P: Infant mortality rate as an indicator of population health. J Epidemiol Community Health 2003, 57:344-346.
  • [3]Kurinczuk JJ, Hollowell J, Brocklehurst P, Gray R: Inequalities in infant mortality project briefing paper 1. Infant mortality: overview and context. National Perinatal Epidemiology Unit, Oxford; 2009. https://www.npeu.ox.ac.uk/infant-mortality webcite
  • [4]Mosley WH, Chen L: An analytical framework for the study of child survival in developing countries. Popul Dev Rev 1984, 10(Suppl):25-45.
  • [5]Regidor E, Martínez D, Santos JM, Calle ME, Ortega P, Astasio P: New findings do not support the neomaterialist theory of the relation between income inequality and infant mortality. Social Science & Medicine 2012.
  • [6]Olson ME, Diekema D, Elliott BA, Renier CM: Impact of income and income inequality on infant health outcomes in the United States. Pediatrics 2010, 126(6):1165-1173.
  • [7]Wilkinson RG, Pickett K: The Spirit Level: Why More Equal Societies Almost Always Do Better. Penguin, United Kingdom; 2009.
  • [8]Pickett KE, Wilkinson RG: Child wellbeing and income inequality in rich societies: ecological cross sectional study. BMJ 2007, 335(7629):1080.
  • [9]Lindström C, Lindström M: Social capital, GNP per capita, relative income, and health: an ecological study of 23 countries. Int J Health Serv 2006, 36(4):679-696.
  • [10]Spencer N: The effect of income inequality and macro-level social policy on infant mortality and low birthweight in developed countries-a preliminary systematic review. Child: Care, Health & Development 2004, 30(6):699-709.
  • [11]Schell CO, Reilly M, Rosling H, Peterson S, Exstrom AM: Socioeconomic determinants of infant mortality: A worldwide study of 152 low-, middle-, and high-income countries. Scandinavian Journal of Public Health 2007, 35:288-297.
  • [12]Fantini MP, Stivanello E, Dallolio L, Loghi M, Savoia E: Persistent geographical disparities in infant mortality rates in Italy (1999–2001): comparison with France, England, Germany, and Portugal. Eur J Public Health 2006, 16(4):429-492.
  • [13]Brandolini A: Income Inequality in Italy: Facts and Measurement. http://www.sis-statistica.it/files/pdf/atti/Atti%20pubblicati%20da%20Cleup_55_77.pdf webcite
  • [14]The Italian National Institute of Statistics: ISTAT datawarehouse. http://dati.istat.it/ webcite
  • [15]ISTAT: Condizioni di vita e distribuzione del reddito in Italia Anno 2008: Life conditions and income distribution in Italy. 2008. http://www.lavoro.gov.it/NR/rdonlyres/B12DA14F-AA6B-4734-823F-3439FF53BF98/0/conddivitaistat2009.pdf webcite
  • [16]Arntzen A, Mortensen L, Schnor O, Cnattingius S, Gissler M, Andersen AM: Neonatal and postneonatal mortality by maternal education–a population-based study of trends in the Nordic countries, 1981–2000. Eur J Public Health 2008, 18(3):245-251.
  • [17]Jiménez-Rubio D: The impact of fiscal decentralization on infant mortality rates: evidence from OECD countries. Soc Sci Med 2011, 73(9):1401-1407.
  • [18]Health for All –Italia ISTAT. http://www.istat.it/it/archivio/14562 webcite
  • [19]Shaw M, Galobardes B, Lawlor DA, Lynch J, Wheeler B, Davey Smith G: The handbook of inequality and socioeconomic position. Concepts and measures. The Policy Press, Great Britain; 2007.
  • [20]Health for All –Italia ISTAT. 2008. http://www.istat.it/it/archivio/14562 webcite
  • [21]Janlert U, Hammarström A: Which theory is best? Explanatory models of the relationship between unemployment and health. BMC Publ Health 2009, 9:235. BioMed Central Full Text
  • [22]OECD: Employment Outlook 2011 – How does ITALY compare?. http://www.oecd.org/dataoecd/8/42/48683274.pdf webcite
  • [23]Costa G, Marinacci C, Caiazzo A, Spadea T: Individual and contextual determinants of inequalities in health: the Italian case. Int J Health Serv 2003, 33(4):635-667.
  • [24]Bonati M, Campi R: What can we do to improve child health in southern Italy? PLoS Med 2005, 2(9):e250.
  • [25]Baccile G, Valerio M: The 150 years anniversary of Italy: a memorandum from the South. Assist Inferm Ric 2011, 30(2):110-112.
  • [26]Ensor T, Cooper S, Davidson L, Fitzmaurice A, Graham WJ: The impact of economic recession on maternal and infant mortality: lessons from history. BMC Publ Health 2010, 10:727. BioMed Central Full Text
  文献评价指标  
  下载次数:29次 浏览次数:20次