Neighbourhood-Level Differences in Mortality Attributable to Behavioural Risk Factors in the City of Milan, Italy

This paper investigates the impact of behavioural risk factors on non-communicable diseases mortality in Milan, focusing on their neighbourhood variation, with the scope to provide context-specific information to guide the development of effective health promotion interventions. Using administrative healthcare data, population attributable fractions were calculated based on information provided by the Global Burden of Disease project to estimate the number and proportion of deaths attributed to smoking, high body mass index, alcohol consumption, physical inactivity, and dietary risk. The findings revealed distinct territorial patterns of risk factors based on sex/gender, as territorial differences along the centre-periphery axis were observed in men but not in women. Smoking emerged as the primary risk factor for avoidable mortality, particularly in men whilst in females metabolic-related risk factors played a larger role. The proposed methodology provided valuable insights into the distribution of risky health behaviours at the neighbourhood level and underscored the need for context-specific interventions. Overall, the study emphasized the intertwined nature of territorial, socioeconomic, and gender dimensions in shaping health outcomes. It called for targeted interventions that address the specific risk profiles and challenges of each neighbourhood, promoting health equity and reducing the burden of non-communicable diseases. By understanding these complex dynamics, policymakers and public health professionals can develop effective strategies to improve population health and reduce health inequalities.