Le diseguaglianze sociali nella mortalita per malattie cardiovascolari in Italia

Social inequalities in cardiovascular disease mortality are described in this paper focusing on the results of the Studio Longitudinale Torinese (SLT), an investigation that links census data with the statistical data that are currently available. The overall results confirm that cardiovascular disease mortality is higher in less-advantaged socioeconomic groups, irrespectively of the social indicator used: education, social class, housing quality, job security. Stratified data shows less important inequalities among ischemic heart disease as compared to cerebrovascular mortality. The differences are even more complex when the age groups in the two genders are analyzed, revealing cohort effects. Overall, the results agree with the previous survey carried out by ISTAT on 1981 Italian mortality, which confirmed the variations in inequalities according to geographical areas, gender and age. Differences in access to the health system are likely to be related to the differences detected for geographical areas, while differences in personal history and attitude towards health-associated behavior should explain age and gender variations in inequalities. Equity must be included in the evaluation of preventive programs and health-care models. Epidemiological and social research should be encouraged to better understand the factors that influence inequalities in cardiovascular disease mortality and in the health status of the population at large.