As a result, the population of Campania has been suffering from persistent and widespread socio-economic deprivation (Barba et al., 2011 Marfe and Di Stefano, 2016), while the gap with the Centre and the North of Italy has been increasing progressively over the last 50 years (Daniele and Malanima, 2011).

National and European measures tackling these structural problems have proved to be inadequate (Crescenzi et al., 2017 Cerciello et al., 2019). High unemployment rates, lack of social services, poor infrastructural endowments, low institutional quality and a significant presence of criminal organisations are all structural problems that constrain the economic performance of the region (Greyl et al., 2013 Pinotti, 2015). Pinpointing these municipalities could allow policymakers to design targeted and effective policy measures aimed at reducing cancer mortality.Ĭampania is the third poorest region of Italy in terms of GDP per capita (ISTAT, 2020a). In this work, we aim to identify the municipalities where confounding factors act as driving forces in the determination of high CMRs through an original multi-step analysis based on frequentist and Bayesian analysis. These figures, in contrast to common sentiment and previous studies, need to be investigated thoroughly in order to assess the exact role of the confounding factors.

Interesting information may be drawn from the observation of municipal data: in spite of previous claims, some municipalities featuring high environmental quality and low socio-economic deprivation also display high CMRs, while other Campanian municipalities facing disastrous environmental and socio-economic conditions are characterised by low CMRs. While some studies managed to identify links between these two confounding factors and cancer mortality, the evidence is overall mixed. A vast strand of the scientific literature has tried to verify whether poor environmental quality and widespread socio-economic deprivation might explain the high cancer mortality rates (CMRs) observed, especially in the municipalities – infamously labelled as the ‘Land of Fires’ – that were hit most severely by the crisis. The region of Campania in Southern Italy features high levels of socio-economic deprivation and low levels of environmental quality.

Istat 2013