Application of socio-economic-health deprivation index, analysis of mortality and influenza vaccination coverage in the elderly population of Tuscany

Objective: The aim of this paper is to describe the results obtained from the application of a specific local deprivation index, to general and cause-specific mortality and influenza vaccination coverage among elderly people in the municipality of Florence.

Methods: General and cause-specific mortality data (2009-2013) and influenza vaccination coverage data (2015/16 and 2016/17) were collected for subjects aged ≥ 65 years residing in the municipality of Florence (Tuscany), at the 2011 Census section level. A Socio-Economic and Health Deprivation Index (SEHDI) was constructed and validated by means of socio-economic indicators and mortality ratios.

Results: Half of the population of Florence belonged to the medium deprivation group; about 25% fell into the two most deprived groups, and the remaining 25% were deemed to be wealthy. Elderly people mostly belonged to the high deprivation group. All-cause mortality and cause-specific mortality (cancer and respiratory diseases) reached their highest values in the high deprivation group. Influenza vaccination coverage (VC) was 54.7% in the 2015/16 and 2016/17 seasons, combined. VC showed a linear rising trend as deprivation increased and appeared to be correlated with different factors in the different deprivation groups.

Conclusions: As socio-economic deprivation plays an important role in health choices, application of the SEHDI enables us to identify the characteristics of the main sub-groups of the population with low adherence to influenza vaccination. The results of the present study should be communicated to General Practitioners, in order to help them to promote influenza vaccination among their patients.