Internal migration in Italy in recent years: a top-down approach

Internal migration has played a key role in determining the physiognomy of Italy in the post-war period (Golini 1974; Rees et al. 1998; Golini 1999). The most intense emigration from the South (traditionally the poorest area of the peninsula) to the richest regions of the Centre-north (Baldi and Cagiano de Azevedo 1999; Pugliese 2002) took place in the twenty years between 1955 and 1975 (Bonaguidi 1987). The internal migration flows are important and necessary to properly describe the economic and political phenomena during those years (Bonifazi 2013a). In the 1970s and 1980s, there was a reduction in interregional migration flows (Di Comite 1992; Piras and Melis 2007). As a result, scholars began to focus more on international migration flows and neglected the internal ones (Pugliese 2011). However, since the nineties internal migration has regained importance (Matinotti 1993; Bonifazi 1999). Internal migration has radically changed over the years; migratory behaviour has become much more complex and less readable with the old approaches (Bubbico, Morlicchio and Rebeggiani 2011) to the point that many scholars have wondered if the traditional ones are still adequate, or have become insufficient (Raymer, Bonaguidi and Valentini 2009). Abroad, there is also a perceived need to identify new data, approaches, and analysis methods that help to grasp the ongoing changes (Caselli Vallin and Wunsch 2001; Rogers, Raymer and Little 2010). This thesis is based on these considerations and attempts to contribute to the current reflection on internal migration in Italy in recent years. The analysis will focus mainly on: the evolution over time of internal migration, age profiles, gender differences and differences between natives and immigrants. In the first three chapters, a central role will be dedicated to internal migration focusing on the place of birth. Specifically, the place of birth will not only be used to distinguish natives from immigrants, but also to identify the migratory patterns of each Italian region of birth (or Macroregions: Northwest, Northeast, Centre and South). Therefore, “place of birth” is a locution that will indicate individuals born in the 20 Italian regions (born in Piemonte, born in Valle d’Aosta, born in Lombardia, etc.) and individuals born abroad. We do not talk about “region of birth” because we include in our definition also people born abroad. The first chapter serves as an introduction to chapters two and three. It is devoted to describing the procedure utilised to allocate the region of birth to the resident population in Italy. Indeed, the resident population in Italy issued by the National Institute of Statistics (hereafter ISTAT) is also distinguished by birth region only in the census years (as well as by sex, age and region of residence). It was therefore necessary to allocate the place of birth (individuals born in the 20 Italian regions and individuals born abroad) to the resident population in Italy from 2002 to 2015 using the 2001 and 2011 censuses as starting points. The population obtained, therefore, is no longer distinguished only by sex, age and region of residence, but also by place of birth in each of the 14 years in the selected time interval (2002-2015). These estimates, on the one hand, made it possible to calculate the denominator necessary for the construction of the different migration rates by ages (necessary for the construction of the multiregional life table used in chapter 2). On the other hand, we were able to implement an application of the gravity model using as explanatory variables also the distinct population by place of birth (for a more detailed description see chapter 3). After describing the calculation procedures adopted for the allocation of the birth region to the resident population in Italy from 2002 to 2015, a description of the resulting population was made. In particular, we chose to use a lifetime migration approach (Livi Bacci 1999) based on the comparison between the place of birth and the place of residence of the populations obtained. We obtained a structural framework of migration flows and considered those who reside in a different region than the birthplace as a proxy of the migrant population. With this logic, in the first chapter, internal migration in Italy is described, starting from the national level, then the Macroregions (Northwest, Northeast, Centre and South) and finally the regional level. Before outlining each of the chapters, some clarification is needed. As well-known, there is no single definition of what internal migrations are (Livi Bacci 1999; Preston, Heuveline and Guillot 2001). Depending on the target, it may change the type of migration studied. For example, by limiting ourselves to internal migration that involves a change of residence, the definition of internal migration can be based on distance covered by a person moving. In this case, internal migrations can be defined as all changes in residence regardless of the geographical distance covered, or a minimum distance that can be established. Movements between different administrative units in the territory (Macroregions, regions and municipalities) can also identify internal migration. Sometimes, the geographic area is divided into areas that do not correspond to traditional administrative divisions (e.g., moving between urban areas and rural). In this thesis, we will always refer to the shifts between traditional administrative units (Macroregions, regions and municipalities). In each chapter, there is an analysis devoted to a different administrative level and the overall idea is, therefore, to move from a more general level (firstly, a national level and secondly, to the Macroregions), and arrive at an analysis that moves towards a more specific level (migration between municipalities). Except for chapter 1, all chapters are organised in the form of journal articles. Therefore, each of them has a very similar structure: an introduction, a literature review, a commentary on results (sometimes preceded by a section on a descriptive data analysis) and finally conclusions and literature references. For this reason, inevitably, some concepts in a chapter can be repeated in another. A second important clarification concerns the content of chapters. Chapter 1, as explained above, introduces chapters 2 and 3. Therefore, it could not be structured in the form of a journal article. In this chapter the procedure for estimating the place of birth (individuals born in the 20 Italian regions and individuals born abroad) of the resident population in Italy is explained. The models proposed in chapters 2 and 3 will be built using the results obtained in the first chapter. Given that it was not possible to also allocate the municipality of birth to the resident population, in chapter 4 (which deals in particular with migration between municipalities), the variable place of birth will only be used to distinguish the native (born in Italy) from the immigrant (born abroad). While chapter 1 is a necessary premise for subsequent chapters up to the third, chapter 4, which addresses the topic of migration between municipalities, is independent from the other chapters and uses a different source of data (European Labour Force Survey). Specifically, chapter 2 is devoted to the study of migration between Macroregions in Italy from 2002 to 2013. The time span was divided into four periods of 3 years. This choice was made to have equal ample intervals of 3 years and make sure that while distinguishing migrations, apart from gender, age, distribution of origin and destination, distinguishing them also by birthplace, where the number of migration flows was always greater than zero. The approach chosen to study such migrations was that of Rogers’ multiregional life tables (1973). However, having distinguished the resident population by birth region (through the procedure outlined in chapter 1), we were able to build tables that took into account the Macroregion of birth in our collective analysis. Therefore, we used the multiregional life table built using the place of birth dependent approaches (Ledent 1980). Using the place of birth makes the results more accurate because they can take into account the fact that a birthplace is a very important determinant of both international and internal migration (Long and Hansen 1975; Ledent 1980). Through the construction of multiregional life tables, one achieves an accurate measure of internal migration: the years of life expectancy at birth lived in the four Italian Macroregions for each birth cohort. In other words, unlike uniregional life tables, it is possible to follow the story of a cohort of 100,000 people, with regards to not only their mortality but also their internal migration, by observing the years of life expectancy at birth for each birth cohort that lives in each Macroregion. International literature has shown that this indicator is more accurate than traditional migration rates and, in our case, provides more accurate results than multiregional life tables built without taking into account the place of birth (Philipov and Rogers 1981; Halli and Rao 1992; Jozwiak 1992). An analysis of the evolution of internal migration over a period of 13 years through multiregional life tables built using the place of birth dependent approach has no precedent in Italy. What kind of results are achieved by using this model? What are the ages and sex distribution of the birth cohorts in each Macroregion? What is the time evolution that emerges from these analyses? How have migratory models changed over time for each birth cohort distinctly by sex and age? How have the migration flow destinations changed migrations between Macroregions? The use of the multiregional life table will enable us to answer these questions. Additionally in chapter 3, we deal with interregional migrations, but in this case only refer to 2014. However, the approach used tries to go deeper than the analysis in the second chapter. We used the gravity model. As well-known, the Newtonian model applied to migrations is based on direct proportionality to the masses (in our case represented by the populations) and indirect proportionality in relation to the distance between them. As in the previous two chapters, in this case, a central role will be afforded to place of birth (migrants born in the 20 Italian regions and migrants born abroad). In fact, both migration flows and populations will be distinguished by place of birth. More specifically, with reference to migration flows, a matrix will be considered in which, in addition to considering the 20 regions of origin and the 19 destination regions, the matrix will be subdivided into the 21 places of birth. The final vector will thus be 20 * 19 * 21 = 7,980 rows. In addition, in the final model proposed in the chapter, two types of populations will be used in relation to each origin and destination region: the population residents and the distinct population residents according to the place of birth (residents in the region who are born in the same region as those who migrate). A further explanatory variable is information on the gross domestic product (GDP), referring both to the region of origin and destination. The introduction of GDP will allow us to control for the role played by the richness of each Italian region. Finally, the distances will be calculated with regard to the centroids with the Vincenty method (1976). This kind of approach will allow us to ascertain how much and how the internal migration flows are determined by the size of the population residents (also distinguished by place of birth). In addition, we can investigate the role of distance in interregional migration and whether it is different depending on the place of birth. We can also study the role of the geographical location for each region. Finally, the gravity model will allow us to verify, for each region of birth, what role GPD plays in relation to the region of origin and destination. Chapter 4 is the last of the thesis. This section focuses on the analysis of migration between municipalities. The chapter represents the natural end of the path we have set ourselves, namely to proceed from the more general administrative level (migration between Macroregions) to the more particular one (migration between municipalities). Using the data for Italy provided through the European labour force survey (ILFS), the demographic characteristics (sex, age and place of birth), socio-economic characteristics (employment, income, education, area of residence) and household characteristics (type of personal relationship and parenthood) of internal migrants in Italy are analysed using multivariate analysis. In particular, we will study how these characteristics modify the propensity to migrate for the population residents in Italy (Basile and Causi 2005). We included a set of logistic models in order to control for compositional effects and to analyse the main determinants of migration. The same model has been estimated for some subgroups of women, employed, interviewees aged 25-34, born abroad and migration from the South to the Centre-north. The results obtained will enable us to verify which variables are most affected by the migration propensity and whether specific migratory patterns can be identified by demographic, socio-economic and household characteristics. Chapter 4 has already been published. The presentation will be as faithful as possible to the original publication. The only variations are: inserting colour figures (instead of black and white) and a modification of the layout to make it homogeneous with regards to the overall thesis. As already pointed out earlier, chapters 2 and 3 are in the form of journal articles. However, in this case, these are not published articles. For this reason, these sections are characterised by a greater effort to adapt the articles to the explanatory needs of the thesis. There will be references to other chapters of the thesis and in some cases the descriptions will be more detailed than required by an international journal article

Immigrants’ political engagement: gender differences in political attitudes and behaviours among immigrants in Italy

Despite the relevance of the gender dimension of immigration, political engagement of migrant women has rarely been the focus of scholarly research. This article tries to fill this gap. Using secondary data from the “Condizione e integrazione sociale dei cittadini stranieri” [Social Condition and Integration of Foreign Citizens] survey carried out by the National Institute of Statistics (ISTAT) in 2011–2012, we analysed the factors that at an individual level spur or inhibit migrants’ political engagement in Italy in terms of gender differences. We decided to use political interest and political participation separately as dependent dichotomous variables in logistic models that consider structural, situational, migratory, and group-related variables as independent factors. From our analysis, some relevant differences emerged both in terms of gender and in terms of political attitudes and behaviours. Our results confirm the existence of a gender gap in political engagement among migrants in Italy: migrant women are always less likely to be engaged in politics compared to men, both in terms of interest and participation. After controlling for some characteristics, this gap never disappears completely. Our results also suggest that there are some notable differences in the determinants of political engagement. Indeed, family workload inhibits the probability of political engagement only for migrant women. Furthermore, our results cast light on the crucial role of social capital in spurring political engagement for both women and men, thus contributing to reducing the gender gap

Economic outcomes and immigrants’ self-identification

The issue of ethnic identity is attracting a growing number of researchers from different disciplines, due to its high explanatory potential. Most of the empirical literature on the topic focuses on economic features of immigrants’ living conditions, highlighting the prominent role of the identity in affecting income, home ownership, and employment. However, such research studies have yielded heterogeneous and mixed results. Therefore, more analyses should be addressed producing more conclusive evidence on such a relevant issue. The objective of this paper is to investigate the impact of ethnic identity on the immigrants’ probability of being employed, exploiting data stemming from the multipurpose survey on “Social Condition and Integration of Foreign citizens” carried out by ISTAT in 2011-2012

La partecipazione politica delle donne immigrate in Italia: un’analisi intersezionale quantitativa

Utilizzando i dati secondari dell’indagine multiscopo “Condizione sociale e integrazione dei cittadini stranieri” condotta dall’ISTAT nel periodo 2011-2012, l’articolo analizza la partecipazione politica delle donne migranti in Italia attraverso l’utilizzo di una metodologia intersezionale quantitativa intra-categoriale e intercategoriale. Attraverso l’applicazione di modelli di regressione logistica e interazioni nella forma degli effetti marginali medi (AME) vengono esaminati i fattori che possono influenzare la partecipazione politica delle donne immigrate, guardando in particolare al ruolo intersezionale del capitale sociale. I risultati dimostrano che molti dei fattori tradizionali associati ad alti livelli di partecipazione politica contano meno per alcuni gruppi di donne migranti rispetto ad altri e che il capitale sociale svolge un ruolo chiave nel promuovere la loro partecipazione politica a livelli diversi. L’analisi contribuisce al corpo di studi empirici che utilizzano un’analisi intersezionale su dati quantitativi, mostrando come l’uso di categorie intersezionali consente di scoprire le differenze chiave all’interno dei gruppi quando si utilizzano dati secondari provenienti da un sondaggio. L’applicazione dell’approccio intersezionale all’analisi quantitativa della partecipazione politica delle donne migranti consente non solo di renderne visibili le differenze ma anche di riflettere sull’intersezionalità come metodologia della ricerca sociale applicata

La conoscenza dell'italiano e i processi di integrazione

Among the social effects of the growth of the immigrant population, what appears to be the most interesting and full of cultural and political consequences is represented by the phenomenon of multilingualism. As a result of foreign immigration, countries – such as Italy – have become countries where a variety of languages are spoken. The mastery of the language of the country of reception, however, is essential for the full integration of immigrants in different contexts of society, promoting their cultural, social and economic integration and becoming more and more often a necessary requirement for the acquisition of citizenship. In this paper we intend to identify the actual or self-perceived level of knowledge of the Italian language and the main characteristics that language learning assumes in the immigrant population present in Italy. Finally, a special focus will be dedicated to the issue of learning Italian by immigrant students or students of immigrant origin. To analyse the phenomenon of multilingualism among people of foreign origin regularly resident in Italy and their perception of the degree of learning of Italian, we referred to the survey Condizione e integrazione sociale dei cittadini stranieri, carried out by istat in 2011-12. In particular, we considered people born abroad and in Italy, still foreign or naturalized, at least 6 years old at the time of the survey. Finally, with the information available thanks to the invalsi evidence, the actual level of knowledge of the Italian language on the part of immigrant students or students of immigrant origin was verified

Guidelines for the use and interpretation of diagnostic methods in adult food allergy

Food allergy has an increasing prevalence in the general population and in Italy concerns 8 % of people with allergies. The spectrum of its clinical manifestations ranges from mild symptoms up to potentially fatal anaphylactic shock. A number of patients can be diagnosed easily by the use of first- and second-level procedures (history, skin tests and allergen specific IgE). Patients with complex presentation, such as multiple sensitizations and pollen-food syndromes, frequently require a third-level approach including molecular diagnostics, which enables the design of a component-resolved sensitization profile for each patient. The use of such techniques involves specialists' and experts' skills on the issue to appropriately meet the diagnostic and therapeutic needs of patients. Particularly, educational programs for allergists on the use and interpretation of molecular diagnostics are needed

Pediatric trauma and emergency surgery: an international cross-sectional survey among WSES members

Background: In contrast to adults, the situation for pediatric trauma care from an international point of view and the global management of severely injured children remain rather unclear. The current study investigates structural management of pediatric trauma in centers of different trauma levels as well as experiences with pediatric trauma management around the world. Methods: A web-survey had been distributed to the global mailing list of the World Society of Emergency Surgery from 10/2021-03/2022, investigating characteristics of respondents and affiliated hospitals, case-load of pediatric trauma patients, capacities and infrastructure for critical care in children, trauma team composition, clinical work-up and individual experiences with pediatric trauma management in response to patients´ age. The collaboration group was subdivided regarding sizes of affiliated hospitals to allow comparisons concerning hospital volumes. Comparable results were conducted to statistical analysis. Results: A total of 133 participants from 34 countries, i.e. 5 continents responded to the survey. They were most commonly affiliated with larger hospitals (> 500 beds in 72.9%) and with level I or II trauma centers (82.0%), respectively. 74.4% of hospitals offer unrestricted pediatric medical care, but only 63.2% and 42.9% of the participants had sufficient experiences with trauma care in children ≤ 10 and ≤ 5 years of age (p = 0.0014). This situation is aggravated in participants from smaller hospitals (p < 0.01). With regard to hospital size (≤ 500 versus > 500 in-hospital beds), larger hospitals were more likely affiliated with advanced trauma centers, more elaborated pediatric intensive care infrastructure (p < 0.0001), treated children at all ages more frequently (p = 0.0938) and have higher case-loads of severely injured children < 12 years of age (p = 0.0009). Therefore, the majority of larger hospitals reserve either pediatric surgery departments or board-certified pediatric surgeons (p < 0.0001) and in-hospital trauma management is conducted more multi-disciplinarily. However, the majority of respondents does not feel prepared for treatment of severe pediatric trauma and call for special educational and practical training courses (overall: 80.2% and 64.3%, respectively). Conclusions: Multi-professional management of pediatric trauma and individual experiences with severely injured children depend on volumes, level of trauma centers and infrastructure of the hospital. However, respondents from hospitals at all levels of trauma care complain about an alarming lack of knowledge on pediatric trauma management

Correction to: Two years later: Is the SARS-CoV-2 pandemic still having an impact on emergency surgery? An international cross-sectional survey among WSES members

Background: The SARS-CoV-2 pandemic is still ongoing and a major challenge for health care services worldwide. In the first WSES COVID-19 emergency surgery survey, a strong negative impact on emergency surgery (ES) had been described already early in the pandemic situation. However, the knowledge is limited about current effects of the pandemic on patient flow through emergency rooms, daily routine and decision making in ES as well as their changes over time during the last two pandemic years. This second WSES COVID-19 emergency surgery survey investigates the impact of the SARS-CoV-2 pandemic on ES during the course of the pandemic. Methods: A web survey had been distributed to medical specialists in ES during a four-week period from January 2022, investigating the impact of the pandemic on patients and septic diseases both requiring ES, structural problems due to the pandemic and time-to-intervention in ES routine. Results: 367 collaborators from 59 countries responded to the survey. The majority indicated that the pandemic still significantly impacts on treatment and outcome of surgical emergency patients (83.1% and 78.5%, respectively). As reasons, the collaborators reported decreased case load in ES (44.7%), but patients presenting with more prolonged and severe diseases, especially concerning perforated appendicitis (62.1%) and diverticulitis (57.5%). Otherwise, approximately 50% of the participants still observe a delay in time-to-intervention in ES compared with the situation before the pandemic. Relevant causes leading to enlarged time-to-intervention in ES during the pandemic are persistent problems with in-hospital logistics, lacks in medical staff as well as operating room and intensive care capacities during the pandemic. This leads not only to the need for triage or transferring of ES patients to other hospitals, reported by 64.0% and 48.8% of the collaborators, respectively, but also to paradigm shifts in treatment modalities to non-operative approaches reported by 67.3% of the participants, especially in uncomplicated appendicitis, cholecystitis and multiple-recurrent diverticulitis. Conclusions: The SARS-CoV-2 pandemic still significantly impacts on care and outcome of patients in ES. Well-known problems with in-hospital logistics are not sufficiently resolved by now; however, medical staff shortages and reduced capacities have been dramatically aggravated over last two pandemic years