Health in Italy

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Olive oil and vegetables are central to the Mediterranean diet. Oil-1383546 1920.jpg
Olive oil and vegetables are central to the Mediterranean diet.

Italy is known for its generally very good health system, and the life expectancy is 80 for males and 85 for females, placing the country 5th in the world for life expectancy, [2] and low infant mortality. In comparison to other Western countries, Italy has a relatively low rate of adult obesity (below 10% [3] ), as there are several health benefits of the Mediterranean diet. [4] The proportion of daily smokers was 22% in 2012, down from 24.4% in 2000 but still slightly above the OECD average. [5] Smoking in public places including bars, restaurants, night clubs and offices has been restricted to specially ventilated rooms since 2005. [6]

Contents

In 2013, UNESCO added the Mediterranean diet to the Representative List of the Intangible Cultural Heritage of Humanity of Italy (promoter), Morocco, Spain, Portugal, Greece, Cyprus and Croatia. [7] [8] As with any developed country, Italy has adequate and sufficient water and food distribution, and levels of nutrition and sanitation are high. In Italy, medical care is provided for free under a universal healthcare system, which operates on the assumption that healthcare is a human right and should be accessible to everyone regardless of their ability to pay. [9]

Water and Food

Italy has a good and sufficient water supply, yet, especially due to droughts, common in the summer (notably in Southern Italy), water shortages can frequently occur. [10] Italians consume a very high amount of mineral water, the highest compared to equivalent neighbours: in 1992, the average person in Italy drank 116 litres, compared to 105 in Belgium, 93 in Germany and 80 in France. According to studies, 18 million people in Italy annually are confronted with at least one slight water shortage, and 18% of Italian families have been recorded as having irregular distribution patterns. [10] Some water distribution is also uneven, and can be explained by economic factors; for example, people in Lombardy, Italy's richest region, drink nine times more bottled water than Campania, one of the country's poorest. [10]

A problem which often presents itself regarding drinking water is water pollution and the presence of harmful purifying chemicals and/or herbicides, which can cause several health problems. [10] According to a decree issued by the state, the maximum presence of herbicides or similar materials in Italy drinking water is 0.5 μg per litre. [10]

Italy's nutritious and generally healthy cuisine ensures that Italians are well-nourished and eat good food. The relatively recent addition of several drugs to meats has meant that controls have increased from 4,000 in 1988 to 56,831 in 1991. [10]

Radiation

Being a relatively warm and sunny country, Italians are often exposed to direct radiation from the sun (ultraviolet radiation), which, if not protected from sun cream or block, can create carcinogenic skin diseases, such as skin cancer. Despite this, the greatest risk from exposure to radiation is found indoors. [10]

Life expectancy and mortality

Life expectancy at birth in Italy Life expectancy by WBG -Italy.png
Life expectancy at birth in Italy

Italy has one of the highest life expectancies in the world. Italy's high average varies greatly by regions. In the more affluent north, the life expectancy at birth in 1990 for a man was lower than in Italy's south (73.3 compared to 74.2). For a woman, the average is higher in the north than in the south (80.6 compared to 79.8). [10] Central Italy has the highest average, with 74.7 for men and 81.0 for women. [10]

In 2003, the average national life expectancy at birth for a woman was 78~84, and for a man 71~77. [11] By 2009, this average had increased to 77.26 for men, and 83.33 for women. [12] As of 2019, Italian women life expectancy is 85/86 years, whereas for Italian men is 81 years. [13]

Italy also has a very low rate of infant mortality, that of 5.51 out of 1000 people, the 185th lowest in the world. [12] From 1970 to 1989, the death rate went down dramatically, from 11 and 10.3 for men and women, to 8.3 and 6.7. [10]

In 2015 Liguria had the highest cancer mortality of any region in Europe, at 377 per 100,000 population. [14]

Vaccination

The Italian vaccination system is complex because services and decisions are delivered by 21 separate regional authorities creates many variations. There is a National committee on immunizations that updates the national recommended immunization schedule, with input from the ministry of health representatives, regional health authorities, national institute of health, and other scientific societies. [15] Regions may add more scheduled vaccinations, but cannot exempt citizens from nationally mandated or recommended ones. [15] A nationwide plan for eliminating measles and rubella began in 2001. [15]

Childhood vaccinations included in national schedules are free for all Italian children and foreign children who live in the country. [15] Estimated coverage for the required three doses of HBV-Hib-IPV vaccines is at least 95% of 2 year olds. Influenza is the only nationally necessary vaccine for adults, and is administered by general practitioners. [15] Italy has a national vaccine injury compensation program. [16] One evaluation of vaccine coverage in 2010, which covered the 2008 birth cohort, showed a slight decline in immunization insurance coverage rates of diphtheria, hepatitis B, polio, and tetanus after those specific vaccinations had been made mandatory. [17] However, vaccination levels continued to pass the Italian government's goal of 95% outreach. [17]

Aiming to integrate immunization strategies across the country and equitize access to disease prevention, the Italian Ministry of Health issued the National Immunization Prevention Plan (Piano Nazionale Prevenzione Vaccinale) in 2012 which proposed an institutional "lifecourse" approach to vaccination. [18] HPV vaccine coverage increased, and pneumococcal vaccine and meningococcal C vaccines had a positive public reception. However, both infant vaccine coverage rates and influenza immunization in the elderly have been decreasing. [18] A 2015 government plan in Italy aimed to boost vaccination rates and introduce a series of new vaccines, and triggered protests among public health professionals. [19] Partially in response to the statistic that less than 86% of Italian children receive the measles shot, the National Vaccination Plan for 2016–18 (PNPV) increased vaccination requirements. [19] Chickenpox shots would be required for newborns. [19] Under this plan, government spending on vaccines would double to €620 million annually, and children could be barred from attending school without proving vaccination. [19] Although these implementations would make Italy a European frontrunner in vaccination, some experts questioned the need for several of the vaccines, and some physicians worried about the potential punishment they may face if they do not comply with the proposed regulations. [19]

There were 5,000 cases of measles in 2017, up from 870 in 2016, 29% of all those in the European Union. The law compelling children to have 10 vaccinations in order to enroll at state schools came into effect in March 2018 but in August 2018 the Five Star Movement pushed legislation through the Italian Senate abolishing it. It has not yet passed the Chamber of Deputies but parents do not now have to provide schools with a doctor's note to show their children have been vaccinated. [20]

Smoking

Smoking in Italy has decreased greatly in the past decades for men, yet women have had a less definitive pattern. From a country where in 1966 a 68.5% average of the male population smoked, this had gone down to a ~37% average in 1991. For women, it increased from ~15% for women in 1966, to ~16.5%, notably in the centre, where it has gone up from 15% to 20.1%. [10]

Climate change

This section is an excerpt from Climate change in Italy § Health impacts.[ edit ]

Indeed, increases in temperature, ozone concentration or fine dust, particularly in urban areas, would increase deaths from ischaemic heart disease, stroke, metabolic disorders [21] and nephropathy, due to heat stress. [22] This impact is most likely to affect vulnerable people such as the elderly, children, pregnant women and people with chronic diseases, and widens the inequality gap in health care. [23]

Rising temperatures and heat waves are one of the causes of death every year in Italy, which has prompted Italy to create the Heat Wave Forecasting and Warning System bulletins. The Ministry of Health set up Heat Wave Warning and Forecasting System (HHWWS) bulletins, some time before the 2022 European heat wave. [24]

Climate change has caused many impacts, and this can be shown through the Climate Risk Index 2020 ranking which reports events between 1999 and 2018. The studies rank the impacts of climate change in terms of economic losses, GDP losses and deaths. [24]

In the ranking that records the highest number of deaths related to extreme weather events, Italy is the 6th country in the world and the first in Europe with almost 20,000 people dying due to floods and heat waves. [25]

See also

Related Research Articles

<span class="mw-page-title-main">Vaccination</span> Administration of a vaccine to protect against disease

Vaccination is the administration of a vaccine to help the immune system develop immunity from a disease. Vaccines contain a microorganism or virus in a weakened, live or killed state, or proteins or toxins from the organism. In stimulating the body's adaptive immunity, they help prevent sickness from an infectious disease. When a sufficiently large percentage of a population has been vaccinated, herd immunity results. Herd immunity protects those who may be immunocompromised and cannot get a vaccine because even a weakened version would harm them. The effectiveness of vaccination has been widely studied and verified. Vaccination is the most effective method of preventing infectious diseases; widespread immunity due to vaccination is largely responsible for the worldwide eradication of smallpox and the elimination of diseases such as polio and tetanus from much of the world. However, some diseases, such as measles outbreaks in America, have seen rising cases due to relatively low vaccination rates in the 2010s – attributed, in part, to vaccine hesitancy. According to the World Health Organization, vaccination prevents 3.5–5 million deaths per year.

<span class="mw-page-title-main">Measles</span> Viral disease affecting humans

Measles is a highly contagious, vaccine-preventable infectious disease caused by measles virus. Symptoms usually develop 10–12 days after exposure to an infected person and last 7–10 days. Initial symptoms typically include fever, often greater than 40 °C (104 °F), cough, runny nose, and inflamed eyes. Small white spots known as Koplik's spots may form inside the mouth two or three days after the start of symptoms. A red, flat rash which usually starts on the face and then spreads to the rest of the body typically begins three to five days after the start of symptoms. Common complications include diarrhea, middle ear infection (7%), and pneumonia (6%). These occur in part due to measles-induced immunosuppression. Less commonly seizures, blindness, or inflammation of the brain may occur. Other names include morbilli, rubeola, red measles, and English measles. Both rubella, also known as German measles, and roseola are different diseases caused by unrelated viruses.

<span class="mw-page-title-main">MMR vaccine</span> Any of several combined vaccines against measles, mumps, and rubella

The MMR vaccine is a vaccine against measles, mumps, and rubella, abbreviated as MMR. The first dose is generally given to children around 9 months to 15 months of age, with a second dose at 15 months to 6 years of age, with at least four weeks between the doses. After two doses, 97% of people are protected against measles, 88% against mumps, and at least 97% against rubella. The vaccine is also recommended for those who do not have evidence of immunity, those with well-controlled HIV/AIDS, and within 72 hours of exposure to measles among those who are incompletely immunized. It is given by injection.

<span class="mw-page-title-main">Vaccine hesitancy</span> Reluctance or refusal to be vaccinated or have ones children vaccinated

Vaccine hesitancy is a delay in acceptance, or refusal, of vaccines despite the availability of vaccine services and supporting evidence. The term covers refusals to vaccinate, delaying vaccines, accepting vaccines but remaining uncertain about their use, or using certain vaccines but not others. The scientific consensus that vaccines are generally safe and effective is overwhelming. Vaccine hesitancy often results in disease outbreaks and deaths from vaccine-preventable diseases. Therefore, the World Health Organization characterizes vaccine hesitancy as one of the top ten global health threats.

<span class="mw-page-title-main">Vaccination schedule</span> Series of vaccinations

A vaccination schedule is a series of vaccinations, including the timing of all doses, which may be either recommended or compulsory, depending on the country of residence. A vaccine is an antigenic preparation used to produce active immunity to a disease, in order to prevent or reduce the effects of infection by any natural or "wild" pathogen. Vaccines go through multiple phases of trials to ensure safety and effectiveness.

A vaccination policy is a health policy adopted in order to prevent the spread of infectious disease. These policies are generally put into place by state or local governments, but may also be set by private facilities, such as workplaces or schools. Many policies have been developed and implemented since vaccines were first made widely available.

<span class="mw-page-title-main">Health in the United States</span> Overall health of the population of the United States

Health may refer to "a state of complete physical, mental and social well-being and not merely the absence of disease and infirmity.", according to the World Health Organization (WHO). 78.7 was the average life expectancy for individuals at birth in 2017. The highest cause of death for United States citizens is heart disease. Sexually transmitted infections impact the health of approximately 19 million yearly. The two most commonly reported infections include chlamydia and gonorrhea. The United States is currently challenged by the COVID-19 pandemic, and is 19th in the world in COVID-19 vaccination rates. All 50 states in the U.S. require immunizations for children in order to enroll in public school, but various exemptions are available by state. Immunizations are often compulsory for military enlistment in the United States.

Health in the United Kingdom refers to the overall health of the population of the United Kingdom. This includes overall trends such as life expectancy and mortality rates, mental health of the population and the suicide rate, smoking rates, alcohol consumption, prevalence of diseases within the population and obesity in the United Kingdom. Three of these – smoking rates, alcohol consumption and obesity – were above the OECD average in 2015.

<span class="mw-page-title-main">Health in Pakistan</span> Overview of health in Pakistan

Pakistan is the fifth most populous country in the world with population approaching 225 million. It is a developing country struggling in many domains due to which the health system has suffered a lot. As a result of that, Pakistan is ranked 122nd out of 190 countries in the World Health Organization performance report.

The Expanded Program on Immunization is a World Health Organization program with the goal to make vaccines available to all children.

Vaccination Week In The Americas (VWA) is an annual public health campaign by the member states of the Pan American Health Organization (PAHO) to promote equity and access to immunization. It is marked each year during the last week of April.

<span class="mw-page-title-main">Health in Spain</span> Overview of health in Spain

In 2012, life expectancy at birth in Spain reached 82.5 years, one of the highest among OECD countries and more than two years higher than the OECD average. Only Japan, Iceland and Switzerland had a higher life expectancy than Spain in 2012. The top three causes of death since 1970 have been cardiovascular diseases, cancer and respiratory diseases.

European Immunization Week (EIW) is an annual regional initiative, coordinated by the World Health Organization Regional Office for Europe (WHO/Europe), to promote immunization against vaccine-preventable diseases since its launch in 2008. EIW activities are carried out by participating WHO/Europe member states. In the past these have included: disseminating informational materials about immunization, organizing immunization campaigns, organizing training sessions for health care workers, arranging workshops or conferences with political decision makers to discuss immunization, and holding press conferences about immunization-related issues.

<span class="mw-page-title-main">Vaccines for Children Program</span>

The Vaccines for Children Program (VFC) is a federally funded program in the United States providing no-cost vaccines to children who lack health insurance or who otherwise cannot afford the cost of the vaccination. The VFC program was created by the Omnibus Budget Reconciliation Act of 1993 and is required to be a new entitlement of each state's Medicaid plan under section 1928 of the Social Security Act. The program was officially implemented in October 1994 and serves eligible children in all U.S. states, as well as the Commonwealth of Puerto Rico, the U.S. Virgin Islands, American Samoa, Guam, and the Commonwealth of the Northern Mariana Islands.

<span class="mw-page-title-main">Health in France</span> Overview of health in France

Life expectancy in France at birth was 81 years in 2008. A new measure of expected human capital calculated for 195 countries from 1990 to 2016 and defined for each birth cohort as the expected years lived from age 20 to 64 years and adjusted for educational attainment, learning or education quality, and functional health status was published by the Lancet in September 2018. France had the ninth highest level of expected human capital with 25 health, education, and learning-adjusted expected years lived between age 20 and 64 years.

<span class="mw-page-title-main">Health in Germany</span> Overview of health in Germany

Germany ranked 20th in the world in life expectancy in 2014 with 76.5 years for men and 82.1 years for women. It had a very low infant mortality rate, and it was eighth place in the number of practicing physicians, at 3.3 per 1,000 people.

<span class="mw-page-title-main">Health in Norway</span> Overview of health in Norway

Health in Norway, with its early history of poverty and infectious diseases along with famines and epidemics, was poor for most of the population at least into the 1800s. The country eventually changed from a peasant society to an industrial one and established a public health system in 1860. Due to the high life expectancy at birth, the low under five mortality rate and the fertility rate in Norway, it is fair to say that the overall health status in the country is generally good.

<span class="mw-page-title-main">Mission Indradhanush</span> Health mission of the government of India

Mission Indradhanush is a health mission of the Government of India. It was launched by Union Health Minister J. P. Nadda on 25 December 2014. The scheme this seeks to drive towards 90% full immunisation coverage of India and sustain the same by year 2022. Vaccination is being provided against eight vaccine-preventable diseases nationally, i.e. Diphtheria, Whooping Cough, Tetanus, Polio, Measles, severe form of Childhood Tuberculosis and Hepatitis B and meningitis & pneumonia caused by Haemophilus influenza type B; and against Rotavirus Diarrhea and Japanese Encephalitis in selected states and districts respectively.

Within the Pacific, Tonga is recognised to have some of the highest overall health standards, implementing a combination of preventative and immediate strategies to curb rates of communicable disease, child mortality and overall life expectancy. The Tongan government aims to continue such levels of health through achieving their Millennium Development Goals (MDG) detailing their focus on improving their healthcare system within the areas of maternal and infant health as well as improve access to immunisation, safe water and sanitation.

<span class="mw-page-title-main">2019 measles outbreak in the Philippines</span> Disease outbreak in the Philippines

The 2019 Philippines measles outbreak began in early 2019. An outbreak of measles was officially declared in February 2019 in select administrative regions in Luzon and Visayas including Metro Manila by the Philippine government. The outbreak is attributed to lower vaccination rates, from a high of 88% 10 to 15 years previous to 74% at the time of the outbreak, allegedly caused by the Dengvaxia controversy.

References

  1. ↑ Duarte, A., Fernandes, J., Bernardes, J. & Miguel, G. (2016). "Citrus as a Component of the Mediterranean Diet". Journal of Spatial and Organizational Dynamics. 4: 289–304.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  2. ↑ "World Health Statistics 2016: Monitoring health for the SDGs Annex B: tables of health statistics by country, WHO region and globally". World Health Organization. 2016. Archived from the original on 23 June 2016. Retrieved 27 June 2016.
  3. ↑ "Global Prevalence of Adult Obesity" (PDF). International Obesity Taskforce. Archived from the original (PDF) on 27 March 2009. Retrieved 29 January 2008.
  4. ↑ Dinu, M; Pagliai, G; Casini, A; Sofi, F (10 May 2017). "Mediterranean diet and multiple health outcomes: an umbrella review of meta-analyses of observational studies and randomised trials". European Journal of Clinical Nutrition. 72 (1): 30–43. doi:10.1038/ejcn.2017.58. hdl: 2158/1081996 . PMID   28488692. S2CID   7702206.
  5. ↑ "OECD Health Statistics 2014 How Does Italy Compare?" (PDF). OECD. 2014. Archived from the original (PDF) on 24 September 2015.
  6. ↑ "Smoking Ban Begins in Italy | Europe | DW.COM | 10 January 2005". Deutsche Welle . Archived from the original on 21 June 2015. Retrieved 1 August 2010.
  7. ↑ "UNESCO Culture Sector, Eighth Session of the Intergovernmental Committee (8.COM) – from 2 to 7 December 2013". Archived from the original on 20 December 2013. Retrieved 3 April 2014.
  8. ↑ "UNESCO – Culture – Intangible Heritage – Lists & Register – Inscribed Elements – Mediterranean Diet". Archived from the original on 15 April 2014. Retrieved 3 April 2014.
  9. ↑ Butticè, Claudio (2019). Universal health care. Health and medical issues today. Santa Barbara, California: Greenwood. ISBN   978-1-4408-6844-3.{{cite book}}: CS1 maint: date and year (link)
  10. 1 2 3 4 5 6 7 8 9 10 11 "Archived copy" (PDF). Archived from the original (PDF) on 2010-03-03. Retrieved 2010-04-07.{{cite web}}: CS1 maint: archived copy as title (link)
  11. ↑ "WHO - Italy". who.int.
  12. 1 2 "The World Factbook". cia.gov.
  13. ↑ Statista. "Life expectancy at birth in Italy from 2002 to 2020, by gender". Statista.
  14. ↑ Ballas, Dimitris; Dorling, Danny; Hennig, Benjamin (2017). The Human Atlas of Europe. Bristol: Policy Press. p. 66. ISBN   9781447313540.
  15. 1 2 3 4 5 "Ministero Della Salute". Italian Ministry of Health. Retrieved 2016-03-10.
  16. ↑ "Indennizzi per i danneggiati in modo irreversibile da vaccinazioni, trasfusioni e somministrazione di emoderivati infetti (Legge 210/92)" (in Italian). Retrieved 10 June 2022.
  17. 1 2 Haverkate, D’Ancona, Giambi, Johansen, Lopalco, Cozza, and Appelgren (2012). "Mandatory And Recommended Vaccination In The EU, Iceland And Norway: Results Of The Venice 2010 Survey On The Ways Of Implementing National Vaccination Programmes". Euro Surveillance. 17 (22). doi: 10.2807/ese.17.22.20183-en . PMID   22687916 . Retrieved 10 Mar 2016.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  18. 1 2 Bonanni P, Ferro A, Guerra R, Iannazzo S, Odone A, Pompa MG, Rizzuto E, Signorelli C (July 2013). "Vaccine coverage in Italy and assessment of the 2012-2014 National Immunization Prevention Plan". Epidemiologia e Prevenzione. 39 (4 Suppl 1): 146–58. PMID   26499433.
  19. 1 2 3 4 5 Margottini L. "New Vaccination Strategy Stirs Controversy in Italy". Science Insider. American Association for the Advancement of Science. Retrieved 2016-03-10.
  20. ↑ "Italy Senate overturns mandatory vaccination law". Financial Times. 6 August 2018. Retrieved 17 September 2018.
  21. ↑ Al-Kindi, Sadeer G.; Brook, Robert D.; Biswal, Shyam; Rajagopalan, Sanjay (October 2020). "Environmental determinants of cardiovascular disease: lessons learned from air pollution". Nature Reviews Cardiology. 17 (10): 656–672. doi:10.1038/s41569-020-0371-2. PMC   7492399 . PMID   32382149.
  22. ↑ Glaser, Jason; Lemery, Jay; Rajagopalan, Balaji; Diaz, Henry F.; García-Trabanino, Ramón; Taduri, Gangadhar; Madero, Magdalena; Amarasinghe, Mala; Abraham, Georgi; Anutrakulchai, Sirirat; Jha, Vivekanand; Stenvinkel, Peter; Roncal-Jimenez, Carlos; Lanaspa, Miguel A.; Correa-Rotter, Ricardo; Sheikh-Hamad, David; Burdmann, Emmanuel A.; Andres-Hernando, Ana; Milagres, Tamara; Weiss, Ilana; Kanbay, Mehmet; Wesseling, Catharina; Sánchez-Lozada, Laura Gabriela; Johnson, Richard J. (8 August 2016). "Climate Change and the Emergent Epidemic of CKD from Heat Stress in Rural Communities: The Case for Heat Stress Nephropathy". Clinical Journal of the American Society of Nephrology. 11 (8): 1472–1483. doi:10.2215/CJN.13841215. PMC   4974898 . PMID   27151892.
  23. ↑ "Climate change 2014, impacts, adaptation and vulnerability" (PDF). IPCC.
  24. 1 2 "Ondata di calore estesa in tutta Italia". Ministero della Salute.
  25. ↑ "GLOBAL CLIMATE RISK INDEX 2020" (PDF). Germanwatch.
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