Socioeconomic conditions, social inequalities and violent mortality in Turin, Italy 2001-2008
Background: This study assessed the contributions of individual and characteristics of area of residence-level to socio-economic inequalities in violent mortality in a metropolitan Italian region.
Setting: Turin, Italy.
Methods: Study population was extracted from the Turin Longitudinal Study including all residents aged 20 years or more, who were censused in Turin in 2001. A mortality follow up was carried out from November 2001 to December 2008, taken into account all deaths for homicide (ICD IX 800-949), suicide (ICD IX 950-959), AIDS and overdose (ICD IX 960-979) and alcohol related causes (ICD IX 980-989). Two multilevel Poisson regression models were fitted to assess the effects of individual socioeconomic conditions (controlling for educational level, occupational status, and housing conditions) and the independent contribution of contextual-level socioeconomic conditions (Gini income concentration index and neighbourhood deprivation index) on mortality risk for the total number of violent-deaths.
Results: the analysis suggest that risks to suffer any violent death for causes observed regularly increasing with lower education and is 50% higher in the lower educated individuals, compared with people with high education, to be employed showed significantly lower mortality than all the other categories. A significantly two-fold risk among those living in disadvantaged house and significantly higher among people living in small rented houses. After include in the second model area indicators-level neither the socio-economic characteristics of the neighborhood nor the relative distribution of income seem to be associated with an increase of risk of mortality from the analyzed causes.
Conclusions: The socio-economic characteristics are the main determinants of individual variability in risk of mortality from violent causes and discomfort, while the characteristics of the social context does not seem to play a significant role in a large Italian metropolitan city, independently on the influence of individual socioeconomic status. The policy implications suggest that reducing socioeconomic inequalities in violence mortality may require continuing along the model developed by the environmental organization, and other cities to invest selectively on new environmental features that may moderate further the risk of violent death among people most deprived.