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Objectives: to describe hospitalisation, access to emergency care, and mortality of people living in marginalized urban areas which include public housing buildings in the North-West suburb of Rome, and to compare the results with those observed among people living in the neighbouring area., Design: cross sectional study., Setting and Participants: resident population in the XIII and XIV Municipality of Rome, subdivided into five urban areas, in 2011-2018., Main Outcome Measures: hospitalisation, access to emergency care, and mortality rates and rates ratios based on hospital discharges and emergency department visits derived from the Health Information Systems and from the Mortality Registry of Lazio Region (Central Italy), stratified by urban areas., Results: the results show a higher use of hospital assistance and emergency care services as well a higher mortality among residents of urban areas characterized by marginalization and social disadvantage in the North-West suburb in Rome, compared to the surrounding area. The association is stronger for the residents of ex-Bastogi, a compound particularly marginalised and socially disadvantaged, where excesses in hospitalisation, emergency care admission, and mortality of +60%, +150%, and +140%, respectively, occurred., Conclusions: the excesses of hospital use, emergency care visits, and mortality observed among the residents of marginalized urban areas suggest the need to reorganize the preventive and primary care services considering the socioeconomic disadvantage in such housing contexts. The use of both qualitative and quantitative approaches allows to understand the complexity of such contexts.

In Italy, immigrants represent a "fuzzy" set, to which it is difficult to apply dichotomous categories as a classification (i.e., regular/irregular, economic/forced, etcetera). These categories lose its meaning when used to study health phenomena. Rather, the epidemiological profile of such a heterogeneous population depends on the varying influence of health determinants in the life-course of migration. This article builds on those assumptions, and analyses the health of irregularly- staying immigrants by adopting a global approach to the migration phenomenon. The article aims at identifying cross-sectional elements of continuity and epidemiological dynamics in the different categories. Different factors, strictly interacting with each other, strongly influence the resulting picture. Specific push-factors primarily influence the starting phases ("healthy migrant effect") and the final stages of the migration process ("salmon effect"). These factors determine good health in these groups, but are also interwined with other dynamics, connected both with the social integration process ("exhausted migrant effect") and the relation with health services, which depends on the regional and local contexts of reference. Such dynamics have been thoroughly examined for "economic migrants" arriving on the Italian coasts. However, nowadays there is important evidence that the "healthy migrant effect" can be also applied to incoming international protection seekers, as demonstrated, for example, by the low prevalence of imported infectious diseases (including tuberculosis). Mental health deserves special attention and a particular final focus, for it is a topic still not adequately addressed, in spite of the high incidence of psychic problems, caused by violence endured either before or during the journey. In the framework of migration phenomena, health issues of irregularly staying immigrants stands hence as most vulnerable, due to the overlapping effects of departure and travel conditions, and of marginalization experienced by a wide group of them in the host Country. It is, therefore, essential to pursue a balanced management of this phenomenon - rich both in implications and in opportunities - by developing highly inclusive and evidence-based public policies.