Epidemiologia & Prevenzione最新文献

The course "Climactions-URBAN HEALTH", dedicated to all professions related to the national health service, aimed to raise awareness among healthcare professionals about the risks to human health associated with climate change through an online tool. The course was created to promote training as a means of implementing adaptation and mitigation strategies for climate change. It is an online Continuing Medical Education (CME) course developed on the e-learning platform of the Italian National Health Institute (Istituto Superiore di Sanità - ISS). This course was directed and scientifically coordinated by the Ecosystem and Health Unit (ISS), in collaboration with the Department of Epidemiology of the Latium Region, and technically coordinated by the Training Office (ISS).The course attracted 25,000 participants, reaching the maximum limit available on the platform.The high number of participants who completed the course, their positive feedback on the course, the different professional categories to which they belong, and their diverse origins across the country serve as indicators of the effectiveness of distance learning, demonstrating it as a valid tool for promoting climate change adaptation and mitigation strategies for professionals within the Italian National Health Service and the Italian National Health System for Prevention.

Objectives: to identify environmental, socioeconomic, and territorial characteristics in five urban areas (Turin, Bologna, Rome, Bari, Palermo) and to identify areas characterized by high environmental and socioeconomic vulnerability.

Design: geographical study.

Setting and participants: study domain on five Italian cities, each city was characterized at the urban-area level.

Main outcome measures: for each urban area or neighbourhood, multiple spatial indicators were constructed concerning the main environmental (air pollution, urbanisation, temperature, altitude and presence of rivers and watercourses, greenery, road and rail networks), and socioeconomic (deprivation index) aspects. These characteristics have been synthesised into a composite indicator with a geographically weighted principal component analysis in order to characterise environmental and socioeconomic vulnerability in a single measure that can be more easily interpreted compared to a set of individual indicators.

Results: the involved cities have numerous databases suitable for mapping the main environmental and socioeconomic characteristics. Turin is the most populous of these cities and the one which has the highest average daily PM10 value (29.7±1.4 µg/m3). Together with Palermo, it is the city with the highest density of local roads. Data on residential land cover show a South-North gradient, from 50% in Palermo and Bari to 24,5% in Rome. Low-density residential areas prevail in all cities. The synthetic value of the indicator captures the spatial variability of the territory, highlighting the areas of greatest urban vulnerability in each city under study. Bologna and Roma are the cities with the highest percentage of residents in the high environmental, climate, and socioeconomic vulnerability level, respectively 38% and 29%, while Bari and Palermo show the highest fraction of population living in low vulnerability areas.

Conclusions: in this study, five Italian cities were characterised from an environmental, socioeconomic, and spatial perspective. Furthermore, through the use of a synthetic indicator of socioeconomic environmental exposure, the most vulnerable areas were identified. This indicator provides immediate and effective information to support policies to protect health and combat environmental and social risk factors in the area.

Background: Lombardy Region (RL) is organized into 8 Health Protection Agencies (ATS) and 86 Districts, which are responsible for organizing and coordinating territorial health care for reference population ranging between 80,000 and 120,000 inhabitants. RL has implemented the Health Profiles Portal, an advanced system that integrates health care, socio-health, and social data to provide a clear and comparable view of the population's needs at different territorial levels. To develop the portal, it was necessary to construct denominators that would ensure the accuracy and comparability of the healthcare indicators.

Objectives: to compare three different methods for constructing population denominators: two based on Regional Registries (NAR) and one on the Italian National Institute of Statistics (Istat) data.

Methods: the first denominator (NAR_portale) used for the portal was constructed from all monthly extractions of NAR in 2023 collected by the ATSs; the second denominator (NAR_202401) was based on the assisted population as of January 2024, including those who died in 2023; the third denominator (ISTAT_202401) was based on Istat population data as of 01.01.2024. Comparisons, expressed as percentage variations (VP) relative to NAR_portale, were carried out at both the ATS and District levels, with separate analyses by gender, age, nationality, and residence in nursing homes (RSA).  Results: overall, NAR_portale identified a population of 10,111,769 residents, NAR_202401 recorded 10,106,191 subjects (VP 0.05%), and ISTAT_202401 recoded 10,012,054 (VP 0.99%). Greater variability was observed at the ATS level, whereas districts within the same ATS exhibited more homogeneous trends. The largest VPs were observed in the extreme age groups (0-1 and 85+ years), among foreign citizens, and among RSA residents.

Conclusions: the differences between denominators highlight the complexity of constructing reference populations for health monitoring. NAR_portale provides greater dynamism and completeness, but efforts are needed to standardise and ensure comparability with other sources. In the future, the integration of different data sources and the use of advanced methodologies could improve monitoring quality and support more effective healthcare planning.

Background: urban areas face growing challenges from climate change, especially in the form of extreme heat events that disproportionately affect vulnerable populations. Turin, a large city in Northern Italy, in past years has developed a policy framework integrating health equity into urban planning through the "Health in All Policies" approach.

Objectives: to assess climate-related health risks in Turin by identifying spatial patterns of social vulnerability associated with Urban Heat Islands (UHIs), with the goal of guiding targeted adaptation and mitigation strategies.

Design: cross-sectional ecological risk assessment using the IPCC framework, integrating data on hazard, exposure, and vulnerability.

Setting and participants: the analysis focused on the municipality of Turin (847,237 residents), with a specific emphasis on individuals aged over 65 years. The spatial unit of analysis was the census tract (N. 3,852).

Main outcome measures: an index of climate risk was developed for each census tract by aggregating normalized indicators for climatic hazard (UHI intensity), exposure (elderly population), and vulnerability (socioeconomic, demographic, health, and environmental indicators).

Results: the analysis revealed significant spatial disparities in climate risk across the city. Northern and peripheral neighbourhoods showed the highest levels of social vulnerability and climate risk, while green and less densely populated areas displayed lower risk. The approach enabled the identification of high-priority areas for urban health interventions.

Conclusions: the study demonstrates the feasibility and policy relevance of applying a structured climate health risk assessment framework at the urban level. The methodology supports evidence-based planning for climate adaptation, helping local authorities target actions to protect vulnerable populations and reduce health inequalities. The results contribute to ongoing efforts in Turin to integrate climate resilience into citywide health and social policy agendas.

Objectives: to quantify the impact of heat on mortality, in terms of heat attributable deaths in 6 Italian cities included in the CCM Climactions project (Turin, Genoa, Bologna, Rome, Bari, Palermo) and to estimate the potential health co-benefits by considering temperature reduction scenarios in urban areas proposed in the project case studies in terms of urban nature-based solutions measures and albedo variation of impervious surfaces.

Design: city-specific time series models and impact assessment.

Setting and participants: daily mortality counts and average temperature data in six Italian cities (Turin, Genoa, Bologna, Rome, Bari, Palermo) included in the CCM CLIMACTIONS project Main outcome measures: overall mortality. Non-linear distributed lag models were used to estimate risk and attributable deaths for increments between the 75th and the 99th percentiles of the mean temperature distribution (lag 0-3) over the period 2006-2015. To estimate the benefits of the intervention scenarios proposed in Climactions to reduce temperatures in urban areas, the deaths attributable to heat with and without this reduction were calculated and the difference between the two estimates corresponds to the potential change in the impact due to scenario measures introduced.

Results: the study reports a reduction in heat attributable deaths between 25% and 35% and between 40% and 60% in all cities, respectively, for the two scenarios of average temperature mitigation equal to 1.3°C and 2°C.

Conclusions: although only referring to simulation scenarios, the study provides further evidence of how urban nature-based solutions and the variation in the albedo of surfaces can be beneficial at an urban level both for the environment and populations health, supporting the implementation of climate change adaptation measures.