Territorial clusters of mortality and role of social and environmental factors: the case of ULSS 6 Euganea (Italy)

To protect the social well-being of the population, the health profile of residents in the province of Padua assisted by ULSS 6 Euganea(1) in the three-year period between 2017 and 2019 has been studied. In particular, the mortality profile is assessed to verify the presence of territorial areas in which excess of mortality is present. To achieve this goal, it is necessary to implement methods that are capable to detect individual areas in which deaths are significantly higher than in the whole territory, and then construct territorial clusters of several areas with an excess of mortality. We adopt the Besag-York-Molli ' e model with INLA (Integrated Nested Laplace Approximation) to calculate the standardized mortality rates (SMR) adjusting for the spatial structure and for the socio-economic characteristics of the population. This allows us to find areas with excess of mortality. Furthermore, we discovered clusters of areas with significantly higher mortality through the model-based clustering method DClusterm initialized with different criteria. In particular, the study reveals the presence of a mortality cluster in the south-west area of the territory of ULSS 6 and others near the municipality of Padua, depending on gender and cause of death. These results allow us to assess the principal reasons for the death excess in the province and to plan targeted interventions for improving life quality in specific areas.