{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T15:08:32Z","timestamp":1791299312632,"version":"4.1.0"},"reference-count":18,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2017,10,24]],"date-time":"2017-10-24T00:00:00Z","timestamp":1508803200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Scand J Public Health"],"published-print":{"date-parts":[[2018,3]]},"abstract":"<jats:p>Aims: The aims of this study were to explore 2015 mortality data further and to assess excess deaths\u2019 determinants. Methods: We analysed data from a large metropolitan area in the north of Italy, the city of Bologna. We took advantage of a comprehensive local-level database and merged three different data sources to analitically explore reported 2014\u20132015 excess mortality and its determinants. Effect estimates were derived from multivariable Poisson regression analysis, according to vaccination status and frailty index. Results: We report 9.8% excess mortality in 2015 compared to 2014, with seasonal and age distribution patterns in line with national figures. All-cause mortality in the elderly population is 36% higher (risk ratio [RR]=1.36, 95% confidence interval [CI] 1.27\u20131.45) in subjects not vaccinated against seasonal flu compared to vaccinated subjects, with risk of death for influenza or pneumonia being 43% higher (RR=1.43, 95% CI 1.02\u20132.00) in unvaccinated subjects. Conclusions: Reported excess mortality\u2019s determinants in Italy should be further explored. Elderly subjects not vaccinated against the flu appear to have increased risk of all-cause and cause-specific mortality compared to vaccinated subjects after accounting for possible confounders. Our findings raise awareness of the need to promote immunisation against the flu among elder populations and offer insights to plan and implement effective public-health interventions.<\/jats:p>","DOI":"10.1177\/1403494817720102","type":"journal-article","created":{"date-parts":[[2017,10,24]],"date-time":"2017-10-24T11:01:00Z","timestamp":1508842860000},"page":"170-174","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["Excess mortality in Italy: Should we care about low influenza vaccine uptake?"],"prefix":"10.1177","volume":"46","author":[{"given":"Francia","family":"Fausto","sequence":"first","affiliation":[{"name":"Department of Public Health, Local Health Authority of Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pandolfi","family":"Paolo","sequence":"additional","affiliation":[{"name":"Department of Public Health, Local Health Authority of Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Odone","family":"Anna","sequence":"additional","affiliation":[{"name":"Department of Medicine and Surgery, University of Parma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Signorelli","family":"Carlo","sequence":"additional","affiliation":[{"name":"Department of Medicine and Surgery, University of Parma, Italy"},{"name":"School of Medicine, University Vita-Salute San Raffaele, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2017,10,24]]},"reference":[{"key":"bibr1-1403494817720102","doi-asserted-by":"publisher","DOI":"10.1177\/1403494816649833"},{"key":"bibr2-1403494817720102","doi-asserted-by":"publisher","DOI":"10.2807\/1560-7917.ES2015.20.11.21065"},{"key":"bibr3-1403494817720102","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.h116"},{"issue":"1","key":"bibr4-1403494817720102","first-page":"22","volume":"40","author":"Michelozzi P","year":"2016","journal-title":"Epidemiol Prev"},{"key":"bibr5-1403494817720102","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)62114-0"},{"key":"bibr6-1403494817720102","doi-asserted-by":"publisher","DOI":"10.1177\/1403494815585401"},{"key":"bibr7-1403494817720102","first-page":"395","volume":"40","author":"Pandolfi P","year":"2016","journal-title":"Epidemiol Prev"},{"key":"bibr8-1403494817720102","first-page":"27","author":"Pandolfi P","year":"2014","journal-title":"La fragilit\u00e0 degli anziani Bologna: Maggioli Editore"},{"key":"bibr9-1403494817720102","volume-title":"Combined predictive model. Final report and technical documentation","author":"Wennberg D","year":"2006"},{"key":"bibr10-1403494817720102","first-page":"146","volume":"39","author":"Bonanni P","year":"2015","journal-title":"Epidemiol Prev"},{"issue":"3","key":"bibr11-1403494817720102","first-page":"231","volume":"53","author":"Signorelli C","year":"2017","journal-title":"Ann Ist Super Sanita"},{"issue":"4","key":"bibr12-1403494817720102","first-page":"139","volume":"39","author":"Odone A","year":"2015","journal-title":"Epidemiol Prev"},{"key":"bibr13-1403494817720102","volume-title":"48th Conference of the Italian Society of Public Health","author":"Rizzo C"},{"key":"bibr14-1403494817720102","volume-title":"48th Conference of the Italian Society of Public Health","author":"Affanni P"},{"key":"bibr15-1403494817720102","unstructured":"Del Manso M, Rota MC, Declich S, et al. Influnet: sistema di sorveglianza sentinella delle sindromi influenzali in Italia \u2013 rapporto sulla stagione influenzale 2014\u20132015. Rapporti ISTISAN 16\/18, giugno 2016, www.iss.it\/binary\/publ\/cont\/16_18_web.pdf (accessed 18 March 2017)."},{"key":"bibr16-1403494817720102","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwt124"},{"key":"bibr17-1403494817720102","doi-asserted-by":"publisher","DOI":"10.1080\/21645515.2015.1019980"},{"key":"bibr18-1403494817720102","first-page":"88","volume":"39","author":"Ferro A","year":"2015","journal-title":"Epidemiol Prev"}],"container-title":["Scandinavian Journal of Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1403494817720102","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/1403494817720102","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1403494817720102","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T04:13:22Z","timestamp":1777695202000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/1403494817720102"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,10,24]]},"references-count":18,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2018,3]]}},"alternative-id":["10.1177\/1403494817720102"],"URL":"https:\/\/doi.org\/10.1177\/1403494817720102","relation":{},"ISSN":["1403-4948","1651-1905"],"issn-type":[{"value":"1403-4948","type":"print"},{"value":"1651-1905","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,10,24]]}}}