According to the Centers for Disease Control and Prevention “the social determinants of health are the circumstances in which people are born, grow up, live, work, and age, as well as the systems put in place to deal with illness” (CDC 2015). The main conditions that contribute to “shaping” the set of “forces” are economics, social policies, and politics. In the activity PDF 6.3 about the solid facts of social determinates of health inequalities the introduction recognizes that in “even the most affluent countries, people who are less well off have substantially shorter life expectancies and more illnesses than the rich.” Italy can be seen as an example for this situation. Although Italy is an affluent first world country some areas are seen as low social class.
Through this semester I’ve been observing gender equity and low fertility rates in Italy for the more “ideal” social class level. For this week’s topic I am looking at those at a lower social class level with health care inequalities (if healthcare is even provided). The infant mortality rate is higher for those in a lower social class and I have been writing about the concern of a major drop in the population. Lowering the infant mortality rate in the lower classes could help bring up Italy’s total fertility rate.
Of all European countries, Italy is seen as one of the countries where regional health disparities has a big impact to socioeconomic health disparities and even now is increasing (Franzini and Giannoni 2010). Roberto De Vogli et al. takes recognition to the social and psychological pathway of the social determinates of health and argues that income inequality affects health through “individual perceptions of place in the social hierarchy” (De Vogli et al. 2005). This can produce negative emotions such as “stress, shame, and distrust” which can create poorer health habits such as smoking and overeating.
The infant mortality rate is a “key indicator” of child and population health (Dallolio, Lenzi, and Pia Fantini 2013). The De Vogli et al. researchers found results showing that “wealthy countries corroborate previous evidence showing a significant correlation between income inequality and life expectancy” (De Vogli et al. 2005). A graph showed that income inequality was negatively correlated to life expectancy at birth. Northern regions including Marches, Umbria, and Tuscany are “more equitable” when it comes to income distribution and show higher life expectancy at birth. Southern regions including Sicily and Campania have greater inequalities with income distribution showing lower life expectancy at birth. The study performed by Dallolio et al. showed the excess mortality rate comparing Southern Italy to Northern is 27% (Dallolio, Lenzi, and Pia Fantini 2013)!
Some improvements are slowly being made. Dallolio et al.’s study showed a great decrease in neonatal mortality and infant mortality rates when comparing Southern Italy to Northern from the early 1990s to the late 2000s (although sadly showed a 15% increase in post-neonatal mortality) (Dallolio, Lenzi, and Pia Fantini 2013). It’s important that public policy and public health initiatives are taken to take away these and other inequalities at the population level (De Vogli et al. 2005).
Dallolio, Laura. Lenzi, Jacopo. Pia Fantini, Maria. “Temporal and geographical trends in infant, neonatal and post-neonatal mortality in Italy between 1991 and 2009.” Italian Journal of Pediatrics 39.19 (2013) : n. pag. Web. 12 Aug. 2015.
De Vogli, Roberto. Mistry, Ritesh. Gnesotto, Roberto. Cornia, Giovanni Andrea. “Has the relation between income inequality and life expectancy disappeared? Evidence from Italy and top industrialised countries.” Journal of Epidemiology & Community Health 59.2 (2005) : 158-162. Web. 12 Aug. 2015.
Franzini, Luisa. Giannoni, Margherita. “Determinates of health disparities between Italian regions.” BMC Public Health 10.296 (2010) : 1-10. Web 12 Aug. 2015.
“Social Determinates of Health.” CDC. CDC, 6 Feb. 2015. Web. 11 Aug. 2015.