The National Observatory on Health in the Italian Regions of the Catholic University has recently highlighted the problem of health inequalities, determined by factors linked "to the context" in which citizens live and "to the individuals" themselves and capable of generating significant gaps in the Italian population, also in terms of access to health services.
MAIN FACTORS
According to the Observatory, inequalities are determined by the resources placed at the disposal of the National Health Service, by its organization, by the degree of urbanization and by the social capital of the territory of residence. These factors, indicated as context-related factors, overlap with individual factors, both of a biological nature (e.g. genetic heritage, gender, age), and of a socio-economic nature (e.g. income, educational qualification, profession).
HEALTH INEQUALITIES
Life expectancy, premature mortality, presence of chronic conditions represent the combined effect of the factors previously indicated and allow us to have a general picture of the national territory. The 2017 data reported by the Observatory indicate that, while in Campania men and women live an average of 78,9 and 83,3 years, in the Autonomous Province of Trento men reach 81,6 years while women 86,3. In general terms, the North-East records a higher survival (life expectancy of men and women equal to 81,2 and 85,6 years) compared to the South (life expectancy of men and women equal to 79,8 and 84,1 years). Florence is the longest-lived Province (84,1 years in life expectancy; 1,3 years more than the national average) while Caserta and Naples have a life expectancy of more than 2 years lower than the national average (2016 data). Campania, Sicily, Sardinia, Lazio, Piedmont and Friuli also represent the Regions with high values of premature mortality, having recorded numerous avoidable deaths between 2004 and 2013.
THE SOCIAL GAP
An Italian man can hope to live to 77 years if he has a low level of education and 82 years if he has a degree, while Italian women can aim for 83 and 86 years respectively (2012 data). The prevalence of people with at least one serious chronic disease in the 25-44 age group is 5,8% among those with low educational qualifications and 3,2% among university graduates. This gap would seem to increase with age, between 45-64 years the percentages reach 23,2% and 11,5%. Among the other data reported by the Observatory we also find that obesity affects 14,5% of people with low educational qualifications, while the percentage drops to 6% among the most educated. Parents with degrees also contribute to influencing the health of their children: 20% of the children of female graduates are overweight but this percentage rises to 30% when the mother has a low educational qualification.
INEQUALITIES IN ACCESS TO SERVICES
In our country, citizens often give up treatment or health services due to the impossibility of paying the ticket for the service: a circumstance that negatively affects the possibility of preventing a disease or diagnosing it promptly. The Observatory highlights, also in this case, the weight due to the social gap, reporting that "in the 45-64 age group, the renunciation of at least one health service is equal to 12% among those who have completed compulsory schooling and 7% among graduates. Withdrawal for economic reasons among people with a low level of education is equal to 69%, while among graduates this quota stops at 34%.”
PROJECTED IMPACT
Our National Health Service, of a universalist nature, has to face a large demand for health characterized by chronicity and polymorbidity, taking into account limited economic resources. The fight against inequalities therefore remains an objective to be pursued through initiatives aimed at improving cultural empowerment in terms of health and lifestyles and improving access to care by making the system more sustainable, for example by networking hospital and territorial structures and verifying the appropriateness of the services offered, thus improving a health system which, having registered a 6,6 percentage point difference between the less and the more educated in terms of inequalities, remains second only to Sweden.
Source: i-com.it
