Mortality in areas with different socioeconomic characteristics in Palermo

OBJECTIVE: To assess whether mortality rates differ among areas with different values of a socioeconomic index. DESIGN: Ecological mortality study; mortality rates were compared among four areas joining census tracts categorized by quartiles of a socioeconomic status index. This index was calculated using individual 2001 census data in a factorial analysis. SETTING: The study was conducted in Palermo (Italy) a city with 668,996 inhabitants in 2006. MAIN OUTCOMES MEASURES: Sex, age group, cause specific standardized mortality rates and rate ratios, expected life years. RESULTS: The area with the lowest value of the socioeconomic index had mortality rates higher than the area with the uppermost value. This occurred in both sexes, all age groups and for most mortality causes (with few exceptions): not all rate ratios were always statistically significant. CONCLUSION: Despite limitations due to the use of an area-based index, results suggest that the welfare system is not successful in compensating health inequalities caused by socioeconomic inequalities.