Donatella Lanari

International migration and health inequalities in later life

ABSTRACT The aim of this paper is to ascertain the existence of differences in self-perceived health and depression between immigrants and native-born populations aged 50 years and older living in Western and Northern European countries. We examine the effect of country of origin, length of time in the host country and citizenship on the health of adults, using data from the Survey on Health, Ageing and Retirement in Europe (SHARE). As the logistic regressions reveal, some immigrant groups are more likely to perceive worse self-rated health and to suffer from depression than native-born groups, even when demographic and socio-economic variables are taken into account. In particular, people born in Eastern Europe living in Germany, France and Sweden have the highest odds ratio of poor health with respect to natives. Nativity status, duration and citizenship clearly contribute towards explaining health differences which are shown to vary significantly across countries. Furthermore, the perception of poor health rises as the length of stay increases, although a non-linear pattern was found. Results indicate that greater efforts by policy makers are needed in order to improve the health of specific middle-aged and older groups of immigrants in Europe.

Food prices and overweight patterns in Italy

In this paper, we examine the role of relative food prices in determining the recent increase in body weight in Italy. Cross-price elasticities of unhealthy and healthy foods estimated by a demand system provide a consistent framework to evaluate substitution effects, when a close association is assumed between unhealthy (healthy) foods and more (less) energy-dense foods. We used a dataset constructed from a series of cross-sections of the Italian Household Budget Survey (1997–2005) to obtain the variables of the demand system, which accounts for regional price variability. The relative increase in healthy food prices was found to produce nontrivial elasticities of substitution towards higher relative consumption of unhealthy foods, with effects on weight outcomes. In addition, these changes were unevenly distributed among individuals and were particularly significant for those who were poorer and had less education.

New model to predict the timing of olive (Olea europaea) flowering: A case study in central Italy

Abstract The aim of this study was to analyse the statistical relationships among climatic variables and flowering dates for olive species (Olea europaea). Data were collected over 21 years (1982–2002) from the study area located in the province of Perugia, central Italy. Flowering was studied through the aerobiological method and daily pollen concentrations (expressed as pollen grains/ m3) were recorded. A new flowering forecasting indicator (modified chilling unit, CUm) is proposed to identify the beginning and the central phase of anthesis (maximum pollen concentration) in olive groves. Correlation and regression analyses were carried out regarding two different flowering stages and meteorological variables expressed as thermal amounts. A mean temperature variable was introduced to consider the current conditions during flowering (from the first pollen concentrations to the maximum). The best fitting model was obtained considering the maximum pollen concentration date and the modified chilling unit formula with a cut‐off temperature of 12°C. The validity of this model was tested using data from 1999 to 2002 (not included in the model parameterisation). The results showed that this new climatic indicator is able to accurately forecast the timine of fiowerina for olive trees.

Socio-demographic determinants and access to prenatal care in Italy

BackgroundMany governments have made commitments to examine inequalities in healthcare access based on studies assessing the association between several socio-demographic factors and late initiation or fewer prenatal examinations. This study addressed the question of whether socio-demographic determinants were significant in explaining differences in prenatal care in one administrative region of Italy, Umbria.MethodsData were obtained from the administrative source of the regional Standard Certificate of Live Births between 2005 and 2010, and were merged with Census data to include a socio-economic deprivation index. Standard and multilevel logistic regression models were used to analyze the magnitude of various individual-level maternal characteristics and socio-demographic indicators, such as nationality, employment status, education with respect to late access to the first examination, and low number of medical visits.ResultsThe study involved approximately 37,000 women. The heterogeneous effects of socio-demographic variables were documented on the prenatal care indicators analyzed. A multivariate model showed that women born outside Italy had a higher probability of making their first visit later than the 12th week of pregnancy and low numbers of prenatal medical visits; the estimated odds ratio for the analyzed indicators range from 2.25 to 3.05. Inadequate prenatal healthcare use was also observed in younger and pluriparous women and those with low education; in addition, having a job improved the use of services, possibly through transmission of information of negative consequences due to delayed or few prenatal visits. Interestingly, this study found a substantial reduction in the number of pregnant women who do not use prenatal healthcare services properly.ConclusionsThe aim of this research is to provide more accurate knowledge about the inadequate use of prenatal healthcare in Italy. Results highlight the existence of differences in healthcare use during pregnancy, especially for women from less advantaged social classes (i.e., unemployed or poorly educated). Such inequalities should be examined in all areas of public policy and public services, to ensure equal opportunity for their use.

Height Convergence and Internal Migration in Mid-Twentieth-Century Italy

Height convergence across Italian regions during the second half of the twentieth century is a widely recognized fact. However, it has been suggested that this process was partly affected by the massive migratory flow of people from southern to northern Italy in the 1950s and 1960s, which greatly slowed the height growth rate in the receiving regions, since immigrants were on average shorter than the receiving northern population. The main aims of this study were to estimate the speed of height convergence of Italian military conscripts in the second half of the twentieth century, and to estimate the contribution of internal migration from the south to the north of Italy to height convergence. We hypothesized that migrants from southern Italy reduced height levels among northerners relative to what they would have been without considering migration. We used cohort data on Italian conscripts born in 1951 and 1980. Results indicate that internal migration may explain from 24 to 32.7 percent of height convergence, meaning that ignoring migration flows yields an overestimation of the height changes for conscripts living in the south of Italy.

Health and income inequalities in Europe: What is the role of circumstances?

&NA; Equality of opportunity theories distinguish between inequalities due to individual effort and those due to external circumstances. Recent research has shown that half of the variability in income of World population was determined by country of birth and income distribution. Since health and income are generally strictly related, the aim of this paper is to estimate how much variability in income and health is determined by external circumstances. We use data from the Survey of Health, Ageing and Retirement (SHARE) and the English Longitudinal Survey on Ageing (ELSA), two comparable multidisciplinary surveys that provide micro‐level data on health and financial resources among the elderly for a large number of European countries. Our baseline estimation shows that about 20% of the variability in income is explained by current country‐specific circumstances, while health outcomes range from 12% using BMI to 19% using self‐rated health. By including early‐life circumstances, the explained variability increases almost 20 percentage points for income and for self‐rated health but less for other health outcomes. Finally, by controlling for endogeneity issues linked with effort, our estimates indicate that circumstances better explain variability in health outcomes. Results are robust to some tests, and the implications of these findings are discussed.

Estimating the Smoking Ban Effects on Smoking Prevalence, Quitting and Cigarette Consumption in a Population Study of Apprentices in Italy.

Objectives: We evaluated the effects of the Italian 2005 smoking ban in public places on the prevalence of smoking, quitting and cigarette consumption of young workers. Data and Methods: The dataset was obtained from non-computerized registers of medical examinations for a population of workers with apprenticeship contracts residing in the province of Viterbo, Italy, in the period 1996–2007. To estimate the effects of the ban, a segmented regression approach was used, exploiting the discontinuity introduced by the application of the law on apprentices’ smoking behavior. Results: It is estimated that the Italian smoking ban generally had no effect on smoking prevalence, quitting ratio, or cigarette consumption of apprentices. However, when the estimates were applied to subpopulations, significant effects were found: −1% in smoking prevalence, +2% in quitting, and −3% in smoking intensity of apprentices with at least a diploma.

The Effects of Immigrant Status and Age at Migration on Changes in Older Europeans’ Health:

The purpose of this study was to determine the differences between natives and immigrants in regard to transition probabilities among health states in self-rated health (SRH), depression, and activities of daily living for middle-aged and older adults in Europe. The Survey of Health, Aging, and Retirement allows us to investigate how successfully the immigrants have aged from 2004 to 2011 compared to natives, according to country of origin and age at migration. We showed that some groups, such as Eastern European immigrants, have higher probabilities of health deterioration in terms of SRH. Moreover, those immigrants who arrived in the host country during adulthood experienced relatively fast health decline.

Immigrant mothers and access to prenatal care: evidence from a regional population study in Italy

Objectives We addressed the question of whether use of adequate prenatal care differs between foreign-born and Italian mothers and estimated the extent to which unobservable characteristics bias results. Setting This study is on primary care and especially on adequate access to prenatal healthcare services by immigrant mothers. Participants Approximately 37 000 mothers of both Italian and foreign nationality were studied. Data were obtained from the Standard Certificate of Live Birth between 2005 and 2010 in Umbria. Results Estimates from the bivariate probit model indicate that immigrant mothers are three times more likely to make fewer than four prenatal visits (OR=3.35) and 1.66 times more likely to make a late first visit (OR=1.66). The effect is found to be strongest for Asian women. Conclusions Standard probit models lead to underestimation of the probability of inadequate use of prenatal care services by immigrant women, whereas bivariate probit models, which allow us to consider immigrant status as an endogenous variable, estimated ORs to be three times larger than those obtained with univariate models.

HEALTH AND BODY MASS INDEX CHANGES AMONG ITALIAN CONSCRIPTS BORN IN 1951 AND 1980

This paper investigates changes in BMI in the second half of the twentieth century, focusing on two cohorts of Italian conscripts born in 1951 and 1980, and examines how the correlates of high and low BMI have changed over time. Data from conscript cohorts taken from the archives of Italian military districts show that younger conscripts exposed to the rising prevalence of immune-allergological and psychological diseases and metabolic dysfunctions underwent substantial increases in weight. These results are evidenced by quantile regression models, the largest BMI gains being found in diabetic conscripts at the 75th and 90th percentiles.