Mortality differences between migrants and Italians residing in Rome before, during, and in the aftermath of the great recession. A longitudinal cohort study from 2001 to 2015

Abstract

Background In Europe, one of the most consistent findings is that of migrant mortality advantage in high-income countries. Furthermore, the literature shows that economic shocks, which bring worse health outcomes, can severely affect the most disadvantaged individuals. We analyse differences and changes in all-cause mortality between Italians and migrants residing in Rome before, during, and in the aftermath of the Great Recession (2001–2015) by birth-cohort. Methods The analysis is a longitudinal open cohort study. Mortality data come from the Register of the Causes of Death (58,637 deaths) and the population denominator (n = 2,454,410) comes from the Municipal Register of Rome. By comparing three time-periods (2001–2005, 2006–2010, and 2011–2015), we analyse all-cause mortality of Rome residents born, respectively, in the intervals 1937–1976, 1942–1981, 1947–1986 (aged 25–64 years at entry into observation). Computing birth-cohort-specific death rates and applying parametric survival models with age as the time-scale, we compare mortality differences between migrants and Italians by gender, area of origin, and time-period. Results Overall, we find a lower risk of dying for migrants than Italians regardless of gender (Women: HR = 0.61, 95% CI 0.56–0.66; Men: HR = 0.49, 95% CI 0.45–0.53), and a lower death risk over time for the total population. Nevertheless, such a pattern changes according to gender and migrants’ area of origin. Conclusion Given the relevance of international migrations in Europe, studying migrants’ health has proved increasingly important. The deterioration in migrant health and the gradual weakening of migrants’ mortality advantage is likely to become a public health issue with important consequences for the healthcare system of all European countries.

In-between centers and suburbs? Increasing differentials in recent demographic dynamics of Italian metropolitan cities

“…Internal migration was likely the most powerful factor discriminating growing from declining cities (e.g., Gavalas et al, 2014). At the same time, the lower elasticity of the natural component to external shocks and the slowing down of international migrations during COVID-19 pandemics may have consolidated such divides (Trappolini et al, 2001). These results document the urgent need to strengthen the self-restraining capacity of Southern Italian territories, by increasing their attractiveness (and permeability) to international migration flows.…”

“…Examples can be found for Rome and Naples (Benassi et al, 2019b), Palermo (Busetta et al, 2016), Milan (Rimoldi & Terzera, 2017) and Catania (Mazza & Punzo, 2016) and for some of the main Italian urban contexts (Bitonti et al, 2023). Crisci (2010), Salvati and Carlucci (2014) and Trappolini et al (2021) provided specific contributions about demography, urban transformations, and differential mortality between foreigners and Italians in Rome. Strozza et al (2014b) focused on the demography and reproductive behaviors characteristic of Naples' neighborhoods.…”

Case Identification and Characterization of Migrants with Dementia in the Lazio Region Using Health Administrative Data

“…Migrants were operationally defined as people living in Italy but born abroad and were further classified according to their country of birth as follows: 1) migrants from High Migratory Pressure Countries (HMPCs: Central-Eastern Europe, Africa, Asia -except for Israel and Japan-, and Latin America); and 2) migrants from Highly Developed Countries (HDCs: North America, Europe— except for Central and Eastern Europe, Oceania, Israel, and Japan) [ 21, 22 ].…”

“…An increase in the number of migrants with cognitive disturbances referred to dedicated healthcare facilities (e.g., memory clinics) has been documented in some European countries [8][9][10]. However, recent surveys have shown that these services are still only partially prepared to manage dementia in patients with a history of migration and that several gaps and 2) migrants from Highly Developed Countries (HDCs: North America, Europe-except for Central and Eastern Europe, Oceania, Israel, and Japan) [21,22].…”