Beyond the underlying cause of death: an algorithm to study multi-morbidity at death.

Background: In countries with high life expectancy, a growing share of the population is living with several diseases, a situation referred to as multi-morbidity. In addition to health data, cause-of-death data, based on the information reported on death certificates, can help monitor and characterize this situation. This requires going beyond the underlying cause of death and accounting for all causes on the death certificates which may have played various roles in the morbid process, depending on how they relate to each other.

Socioeconomic inequalities in avoidable mortality in Italy: results from a nationwide longitudinal cohort.

Background: Disparities in avoidable mortality have never been evaluated in Italy at the national level. The present study aimed to assess the association between socioeconomic status and avoidable mortality.

Methods: The nationwide closed cohort of the 2011 Census of Population and Housing was followed up for 2012-2019 mortality.

Frailty at death: An examination of multiple causes of death in four low mortality countries in 2017.

Background: The increasing prevalence of frailty in aging populations represents a major social and public health challenge which warrants a better understanding of the contribution of frailty to the morbid process.

Objective: To examine frailty-related mortality as reported on the death certificate in France, Italy, Spain and the United States in 2017.

Methods: We identify frailty at death for the population aged 50 years and over in France, Italy, Spain and the United States.

Epidemiologic transition of lung cancer mortality in Italy by sex, province of residence and birth cohort (1920-1929 to 1960-1969).

Space-time analysis of mortality risk is useful to evaluate the epidemiologic transitions at the subnational level. In our study, we analysed the death certificate records for lung cancer in Italy in 1995-2016, obtained from the Italian National Institute of Statistics. Our objective was to investigate the spatial-temporal evolution of lung cancer mortality by sex and province of residence (n = 107) using the birth cohort as relevant time axis.

Increased kidney disease mortality among people with AIDS versus the general population: a population-based cohort study in Italy, 2006-2018.

Objectives: This study aimed to assess whether an excess mortality related to kidney and other urinary tract diseases exists among Italian people with AIDS (PWA), as compared with the general population without AIDS (non-PWA).

Design: Population-based, retrospective cohort study.

Setting And Participants: We conducted a nationwide study including 9481 Italian PWA, aged 15-74 years, reported to the National AIDS Registry between 2006 and 2018.

Male and Female Differences in Homicide Mortality: Results of an Italian Longitudinal Study, 2012-2018.

Introduction: Italy has one of the lowest homicide rates in Europe. However, while it is decreasing overall, the proportion of murdered women is increasing. This study aimed to analyze the demographic and socioeconomic characteristics associated with homicide mortality in Italy, focusing specifically on male and female differences.

[Effects of the COVID-19 pandemic on the inequalities in total mortality by country of birth].

Objectives: to evaluate the impact on total mortality of the COVID-19 pandemic in Italy, by country of birth.

Design: historic cohort study based on administrative databases.

Setting And Participants: the study is based on subjects included in the Base Register of Individuals of the Italian National Institute of Statistics on 01.

Nationwide longitudinal population-based study on mortality in Italy by immigrant status.

A systematic analysis of the mortality of immigrant residents throughout Italy has never been carried out. The present study aimed to evaluate differences in mortality by immigrant status. A longitudinal study of the Italian resident population (native and immigrants) recorded in the 2011 National Institute of Statistics Census was conducted.

Mortality of people with AIDS in Italy: comparison of AIDS surveillance and multiple cause-of-death registries.

Aims: To assess whether the use of multiple cause-of-death data could improve reporting of AIDS mortality in Italy.

Method: Population-based, record-linkage study, on 3,975,431 deaths recorded in the National Registry of Causes of Death (RCoD) and 4,530 deaths recorded in the National AIDS Registry (RAIDS), during 2006-2012.

Results: The record-linkage identified 3,646 AIDS-related deaths present in both registries, 884 deaths in the RAIDS without mention of HIV/AIDS in the RCoD, and 3,796 deaths in the RCoD with mention of HIV/AIDS that were not present in the RAIDS.

Variation in Cause-Specific Mortality Rates in Italy during the First Wave of the COVID-19 Pandemic: A Study Based on Nationwide Data.

Italy was a country severely hit by the first coronavirus disease 2019 (COVID-19) pandemic wave in early 2020. Mortality studies have focused on the overall excess mortality observed during the pandemic. This paper investigates the cause-specific mortality in Italy from March 2020 to April 2020 and the variation in mortality rates compared with those in 2015-2019 regarding sex, age, and epidemic area.

Education inequalities in overall mortality during the first wave of the COVID-19 pandemic in Italy.

Background: there is increasing concern that the COVID-19 pandemic has disproportionately affected the most vulnerable individuals.

Objectives: to determine whether education inequalities have widened during the first wave of the COVID-19 pandemic in Italy. DESIGN: historic cohort study based on administrative databases.

Acute Effects of Particulate Matter on All-Cause Mortality in Urban, Rural, and Suburban Areas, Italy.

Background: Short-term exposure to particulate matter (PM) has been related to mortality worldwide. Most evidence comes from studies conducted in major cities, while little is known on the effects of low concentrations of PM and in less urbanized areas. We aim to investigate the relationship between PM and all-cause mortality at national level in Italy.

A long-term nationwide study on chronic kidney disease-related mortality in Italy: trends and associated comorbidity.

Background: Chronic kidney diseases (CKDs) represent a major public health concern worldwide with increasing incidence and prevalence. However, the epidemiological dimension of CKD in Italy is still under evaluation. By analyzing all the conditions reported on death certificates (multiple causes of death), we aimed to investigate the real burden of CKD mortality in Italy over 15 years and identify the main conditions contributing to death in association with CKD.

Salmon bias effect as hypothesis of the lower mortality rates among immigrants in Italy.

Compared with natives, immigrants have lower all-cause mortality rates, despite their lower socioeconomic status, an epidemiological paradox generally explained by the healthy migrant effect. Another hypothesis is the so-called salmon bias effect: "statistically immortal" subjects return to their country of origin when they expect to die shortly, but their deaths are not registered in the statistics of the country of residence. This underestimation of deaths determines an artificially low immigrant mortality rate.

Evolution of Pathology Patterns in Persons Who Died From COVID-19 in Italy: A National Study Based on Death Certificates.

In Italy, during the first epidemic wave of 2020, the peak of coronavirus disease 2019 (COVID-19) mortality was reached at the end of March. Afterward, a progressive reduction was observed until much lower figures were reached during the summer, resulting from the contained circulation of SARS-CoV-2. This study aimed to determine if and how the pathological patterns of the individuals deceased from COVID-19 changed during the phases of epidemic waves in terms of: (i) main cause of death, (ii) comorbidities, and (iii) complications related to death.

The Role of COVID-19 in the Death of SARS-CoV-2-Positive Patients: A Study Based on Death Certificates.

Death certificates are considered the most reliable source of information to compare cause-specific mortality across countries. The aim of the present study was to examine death certificates of persons who tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) to (a) quantify the number of deaths directly caused by coronavirus 2019 (COVID-19); (b) estimate the most common complications leading to death; and (c) identify the most common comorbidities. Death certificates of persons who tested positive for SARS-CoV-2 provided to the National Surveillance system were coded according to the 10th edition of the International Classification of Diseases.

Multi-morbidity and frailty at death: A new classification of death records for an ageing world.

Mortality statistics based on underlying cause of death are challenged by increased life expectancy and the growing share of population reaching ages associated with frequent multi-morbidity (with death likely resulting from interactions between multiple diseases). We provide a novel way of analysing causes of death: accounting for all causes mentioned on death certificates and summarizing this information along two dimensions emblematic of ageing populations-multi-morbidity and frailty. We implement this classification for all deaths at ages 50+ in Italy in 2014.

Excess liver-related mortality among people with AIDS compared to the general population: an Italian nationwide cohort study using multiple causes of death.

Objectives: Liver diseases have become a leading cause of death among people with AIDS (PWA). This study aimed to investigate whether PWA experienced excess mortality related to liver diseases as compared to the general population (non-PWA), using a multiple cause of death (MCoD; i.e.

Parental education and cancer mortality in children, adolescents, and young adults: A case-cohort study within the 2011 Italian census cohort.

Background: Progress in the treatment of juvenile cancers has led to remarkable improvements in survival. However, not all families have the resources to cope with the burden that such diseases require. This study was aimed at evaluating the association between parental education and cancer mortality in children, adolescents, and young adults.