Investigating Disparities in Cause-Specific Mortality Based on Education in Italy

Marilena Pappagallo, Istat (Italian National Institute of Statistics)
Alessandro Feraldi, Sapienza University of Rome
Cristina Giudici, Sapienza University of Rome
Luisa Frova, Istituto Nazionale di Statistica (ISTAT)

Reducing socioeconomic disparities in mortality is a critical public health concern. Acknowledging the importance of socioeconomic health disparities is crucial to establishing effective systems for monitoring health inequalities. Educational level is the most widely recognized proxy for socioeconomic status. We used the Mortality Inequality Database 2019–2020. The database combines the National Register of Causes of Death, covering all deaths in 2019 and 2020, and the National Base Register, which includes demographic data (i.e., place of residence and education level). We estimated Age-Standardized Mortality Rate Ratios between education levels, by sex, age group, cause of death, and region, and used quantile regression models to analyze regional mortality disparities in Italy, accounting for these variables. The link between education and mortality varies by cause of death, sex, and age. Across the Italian regions, individuals with lower education levels face mortality rates 1.5 to more than 3 times higher than those with higher education. Males experience more pronounced inequalities in most of the regions, though for some causes (e.g., diabetes and COVID-19), females report higher inequalities. The implementation of policies that support education is crucial for the promotion of health equity and for the protection of the most vulnerable.

Keywords: Inequality, Disadvantage and Discrimination, Mortality and Longevity

See extended abstract.