The health status of the Italian population is among the best in Europe, but only where prevention is in force, or better, in the north. The situation in the south is the exact opposite. Every year the National Observatory on Health (Osservasalute) puts perspective on this. Here is the Osservasalute Report 2017.
Osservasalute 2017: Problems in the South
According to the health report, where health services have been the most effective, “the state of health of the Italian population has improved with less deaths due to cancer and chronic diseases such as diabetes and hypertension (mortality rates due to these causes have gone down by 20% in the last 12 years)”. Furthermore, in Italy, “premature death rates (cfr. mainly caused by chronic disease) have gone down by almost 20% in the last 12 years, from approximately 290 people in every 10,000 to 230″.
The last ten years have also confirmed what has been known for some time now. There is a profound gap between the north and the south both in performance, with regards to the issues analysed, and the quality of regional services, especially those involving the health system. Several parameters were analyzed in each region in order to determine the overall performance of Regional Health Services from 2008 to 2015. Based on performance, the regions were then grouped into one of four categories: low performance (Campania, Sardinia, Sicily, Calabria and Puglia), middle performance (Basilicata, Molise, Abruzzo and Lazio), good and often high performance (Valle d’Aosta, Trentino-Alto Adige, Piedmont and Liguria) and high performance (Umbria, Marche, Lombardy, Emilia-Romagna, Toscana, Veneto and Friuli Venezia Giulia).
The gap in the fight against cancer and chronic disease
Statistics show that death rates have gone down mostly in the North while they have actually gone up in the south. Death rates due to cancer and chronic disease (the main cause of death in the world) has even surpassed 25%. “The situation is the worst in Campania”, states Alessandro Solipaca, scientific director of the National Observatory on Health in the Italian Regions, “where death rates due to these diseases are +28% while the national average is only 2.3%. In Sicily death rates are +10%, in Sardinia +7% and in Calabria +4.7%. Puglia is the exception with death rates comparable to the national average”.
An increase in private expenditure
According to Osservasalute 2017, a significant increase in private expenditure was noticed in the ten-year period from 2005-2015 (+23.2%, from €477.30 euro per capita to €588.10), especially in Northern regions that have high levels of public expenditures, good essential levels of care and low percentages of people that refuse therapy.
“These statistics can be interpreted”, states Alessandro Solipaca, as the result of individual choices made by citizens who, having the economic possibility, prefer private health care that offers quicker or higher quality healthcare services. On the other hand, we must not forget that often co-payments in the public sector are comparable to the price of the same service in the private sector”.
The region with the highest per capita of private expenditure is Lombardy (€608), followed by other regions in the North, while Sicily brings up the rear (€245). In the south, out-of-pocket spending is low and the percentage of people who declare they do not have enough money to pay for treatments is a high 20%, four times higher than percentages observed in the north.
Priority to prevention
Walter Ricciardi, director of the National Observatory on Health in the Italian Regions (Università Cattolica of Rome) and president of the National Institute of Health (Iss), says “we hope that something is done as soon as possible, beginning with the National Health Fund, which needs to redress real health needs and not just theoretical needs derived from the demographic structure of the Regions. Likewise, as emphasized in the new Osservasalute Report, we need to regain the quality of the management and operations of the health systems that suffer deficits like in regions of southern Italy”. Priority must go to prevention, “because statistics clearly indicate the obvious results of areas that have effectively carried out prevention, such as in lower rates of different types of cancer”. Prevention also includes lifestyle modification, given that the report also shows that in Italy there has been:
- An increase in obesity and no decline in tobacco consumption
- An increase in alcohol consumption
- A slight increase, but not enough, in the percentage of people who practice sports or physical activity
This phrase may seem obvious, but it can never be said enough- prevention is better than cure.
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