The Socio-Economic Health Deprivation Index and association with mortality and attitudes towards influenza vaccination among the elderly population in Palermo, Sicily

Abstract Introduction Inequality levels are associated with vaccination coverage among the older and at risk population hypothesizing socio-economic status (SES) as a determinant of health status. The aim of the study was to evaluate the trend of health outcome and socio-health-economic-status deprivation index (IDPA) among elderly people in Palermo city, Italy . Methods The Palermo Unit of 2015 CCM project deal with collection of data useful to validate IDPA using the Italian census data from 2009 to 2015 on overall mortality and cause of death. The preventive outcome used to validate the IDPA index was vaccination coverage from 2009-2010 to 2014-2015 influenza season among Palermo elderly population. Results Among the elderly IDPA had a significantly decreasing trend in overall mortality (p <0.05) and a significant increasing trend of mortality due to influenza or pneumonia (p <0.05) with higher deprivation index. Comparing vaccination coverage with deprivation levels, a linear trend between coverage rates increase and deprivation index decrease (p <0.05) was observed, with an overall 27% vaccination coverage among the older people. Elderly population of Palermo living in a census context with more regular migrant, divorced and single-parent families were more hesitant to the execution of influenza vaccination. Conclusions This study allowed to identify the elderly population groups with lower influenza vaccination adherence to which could be addressed health promotion interventions in order to facilitate the "healthy aging".