Sixteen more years of healthy life: Bolzano beats Reggio Calabria

Sixteen more years of healthy life: Bolzano beats Reggio Calabria

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Even in health you need luck where you were born. If in the Province of Bolzano one has a greater chance of having a healthy life up to 69.3 years of age, in Calabria this expectation drops to 53.1 years, i.e. 16 years less. If in Alto Adige after the age of 65 you can hope to live without limitations for another 12.4 years, in Reggio Calabria only for 8.8.
These are the data that emerge from Bes Report – Fair and Sustainable Wellbeing of the Istat, used by the Court of Auditors in its report on the gaps in the state of health of Italians. A gap that shows how lifestyles, but also healthcare, influence not so much the general expectation (the Italian average is 82.6 years, 83 in the North and the centre, 81.7 in the South) but rather the years that we will live healthy, in the hope of an old age without the affliction of chronic or disabling pathologies.

And to think that until 30 years ago, life expectancy in good health was decidedly better in the South than in the North. “If you look at the data from the 1970s, but also those up to the end of the 1990s, the advantage for the Southern regions was clear – comments the professor Carlo La Vecchia, epidemiologist at the University of Milan -. The Mediterranean diet and lifestyle have had an important role on health and life expectancy, but this trend has completely reversed in recent years.”

The first post-pandemic data

“After the decline in life expectancy at birth due to the pandemic shock, with a decline of more than a year in 2020 compared to 2019, a slow recovery is now being observed, with a reduction in the gender gap and good levels of life expectancy health which still remain higher than the pre-pandemic figure”, he writes in the reports the researcher Emanuela Bologna. And from Istat data cross-referenced with the “report cards” of the Court of Auditors on the National Health Service, it emerges that in the regions where there is a better offer, life prospects are also better. But what is most frightening are above all the renunciations of healthcare services among young adults, due to waiting lists that are too long and due to economic problems, which will inevitably lead to elderly people who have done less prevention and are sicker.

Healthcare split in two

From the report of the Court of Auditors on Lea (Essential levels of assistance), i.e. the care that the national health system should guarantee in the same way throughout Italy, free of charge or upon payment of a ticket, once again emerges a health service that travels at very different speeds: from the data relating to 2022 almost half of the Regions has at least one insufficiency, while there where healthcare works best, i.e. in Veneto, Emilia and Tuscany followed by Lombardy, health expectations go hand in hand. The new package of free services should have come into force last January, but was postponed to April 1st and now to 2025. A postponement which for some Regions, often in the North, is not valid, given that with their own resources they have already decided to ensure them, and which further accentuates the gap and passive mobility from South to North, in search of better treatments: those who pack their bags for treatment do so above all from Campania, Calabria and Sicily towards Veneto, Lombardy and Emilia-Romagna.

The influence of lifestyles

But there are many variables that affect healthy life expectancy: there has certainly been a clear worsening of sedentary lifestyle, which in Lombardy is 25.6% while in Sicily it is 57.7% and in Calabria 58.2 %. “After a general improvement observed until 2019, starting from 2020 there are significant fluctuations for almost all indicators and, in most cases, signs of worsening emerge in the 2019-2022 comparison. In particular, the sedentary lifestyle indicatorwhich had improved with a greater spread among the population in carrying out unstructured physical activity outside of gyms and swimming pools, worsens in 2022, returning to even more critical levels compared to 2019″, notes Istat.

“It is therefore not surprising – the magistrates of the Court of Auditors underline – that in terms of excess weight the unsatisfactory national average figure of 44.5% of the adult population must be disaggregated with a peak of 54.1% in Campania, 52.8 % in Basilicata, 49.2% in Sicily”: in Piedmont and Tuscany it is 42.4%, in Bolzano 38.8%.

The habit of smoking

Sedentary lifestyle e obesity are among the main culprits of the worsening of the state of health in the South, but “we must also not forget smoking which is recording a constant negative trend in recent years”, underlines the professor The old. Which continues: this vice “spread first to the North and then to the South, where it took root” while in other regions it has drastically decreased and then started to grow again in recent years. Furthermore, “the impact of public health and hospitals on healthy life expectancy is difficult to quantify”, and this is also due to the fact that Istat data refers to “perceived health”.

Comparing the different territorial divisions, it is true that 16 years are lost from Bolzano to Calabria, but good health has improved for the South. “It reflects the socio-economic state in which we live – concludes the epidemiologist -. Healthcare is certainly changed, less so the habits of Italians who would like to continue to be treated in the hospital near their home or whichever is more convenient, when instead it has become necessary to travel, especially when it comes to tumors and an integrated treatment approach that peripheral centers are not able to able to offer”.

Reduced budget and investments

Therefore, it is useless to deny that the basis of everything is also socio-economic conditions and financial availability that influence healthy life expectancy. If peaks in heat and pollution have an impact on mortality, poverty has a direct impact on the quality of life: the economic well-being indicators updated for 2021 show an increase in the risk of poverty and great difficulties in making ends meet, with a worsening in the middle ranges which is reflected in health, from the increase in costs of fruit and vegetables to the need to turn to private healthcare for screening as well as routine or specialist tests. In this, Italy brings up the rear in Europe, with a disadvantage in the indicators of economic well-being and investments in healthcare: if in Italy public spending is 131 billion for 58.9 million inhabitants, in Germany the state spends 427 for 83.8 and France 271 for 68 million residents.

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