ObjectiveThe aim of this paper is to describe the results obtained from the application of a specific local deprivation index, calculated on the basis of 2011 Census sections, to general and cause-specific mortality and influenza vaccination coverage among elderly people of the municipality of Florence.MethodsGeneral and cause-specific mortality data (2009-2013) and influenza vaccination coverage data (2015/16 and 2016/17) have been collected for subjects aged ≥65 years residing in the municipality of Florence (Tuscany), at the 2011 Census section level. Socio-Economic and Health Deprivation Index (SEHDI) has been constructed and validated by using socio-economic indicators and mortality ratios.ResultsHalf the Florence population belongs to the medium deprivation group; about 25% belongs to the two most deprived groups, and the remaining 25% is wealthy. Elderly people mostly belong to the high deprivation group. All-cause mortality and cause-specific mortality (cancer and respiratory diseases) reach the highest values in the high deprivation group.Influenza vaccination coverage (VC) is 54.7% for the seasons 2015/16 and 2016/17, combined. VC shows a growing linear trend as deprivation increases. VC appears to be correlated with different factors in the different deprivation groups.ConclusionsSocio-economic deprivation plays an important role in health choices, so the application of SEHDI allows to identify the characteristics of the main sub-groups of the population with a low adherence to influenza vaccination. Results of the present study should be spread to General Practitioners in order to help them to promote influenza vaccination to their patients