Cross-regional variations of Covid-19 mortality in Italy: an ecological study. (18th January 2021)

• Record Type: Journal Article
• Authors: Oliva, Cristina; Di Maddaloni, Francesco; Marcellusi, Andrea; Favato, Giampiero
• Is Part Of: Journal of public health. Volume 43:Number 2(2021)
• Page Start: 261
• Page End: 269
• Publication Date: 2021-01-18
• Subjects: infectious disease -- mortality -- socioeconomic factors; Public health -- Periodicals; Public health -- Great Britain -- Periodicals; Medical policy -- Periodicals; Medical policy -- Great Britain -- Periodicals; 362.1
• DOI: 10.1093/pubmed/fdaa248
• Languages: English
• ISSNs: 1741-3842

Abstract

ABSTRACT: Background: Disparities in cross-regional coronavirus disease 2019 (Covid-19) mortality remain poorly understood. The association between pre-epidemic health and epidemic mortality can inform a policy response to future outbreaks. Method: We conducted an ecological study of the association between the cumulative deaths attributed to Covid-19 epidemic in the 20 Italian regions and nine determinants of population health derived from a systematic review of the literature. We used a multiple least square regression to predict the cross-regional variation in mortality observed from the onset of the epidemic to 23 September 2020. Results: Four independent variables best explained the cross-regional differences in the number of deaths attributed to Covid-19: the force of infection, population density, number of elderly living in assisted facilities and the standard rate of diabetes. The semi-partial correlation coefficients suggest that the force of infection and the number of elderly residents in nursing homes were the dominant predictors of the number of deaths attributed to Covid-19. Statistical controls and validation confirmed the generalizability of the predictive model. Conclusions: Our findings indicate that a significant reduction of social contacts in main metropolitan areas and the timely isolation of elderly and diabetic residents could significantly reduce the death toll of the next wave of Covid-19 infection in Italy.