The two behavioural risk factor surveillances on the adult and elderly populations as information systems for leveraging data on health-related sustainable development goals in Italy

When does morbidity start? An analysis of changes in morbidity between 2013 and 2019 in Italy

Morbidity is one of the key aspects for assessing populations' well-being. In particular, chronic diseases negatively affect the quality of life in the old age and the risk that more years added to lives are years of disability and illness. Novel analysis, interventions and policies are required to understand and potentially mitigate this issue. In this article, we focus on investigating whether in Italy the compression of morbidity is in act in the recent years, parallely to an increase of life expectancy. Our analysis rely on large repeated cross-sectional data from the national surveillance system passi, providing deep insights on the evolution of morbidity together with other socio-demographical variables. In addition, we investigate differences in morbidity across subgroups, focusing on disparities by gender, level of education and economic difficulties, and assessing the evolution of these differences across the period 2013-2019.

Data from the PASSI d'Argento Surveillance System on Difficulties Met by Older Adults in Accessing Health Services in Italy as Major Risk Factor to Health Outcomes

(1) Age-friendly health systems ensure access to quality healthcare services to all people, especially older adults. (2) We used data on elderly population collected from 2016 to 2019 by the Italian ongoing surveillance system PASSI d'Argento to analyze the prevalence and associations between accessing health services and modifiable risk factors included in the 25 × 25 strategy for the burden of noncommunicable diseases with health outcomes. (3) Chronic diseases and hospitalization as descriptors of health status showed that the elderly perceived as having poor access to care and prevention incurred a higher risk of hospitalization. The association between difficulties in accessing health services and hospitalization was always the highest in terms of the adjusted prevalence ratio (aPR), regardless of the other behavioral risk factors considered, controlling each model with sociodemographic conditions. Elderly hospitalized at least once for two days or more in the last 12 months had greater risk to have problems in accessing health services, whereas the model included health conditions such as obesity (aPR = 1.95 95% CI 1.75-2.17), smoking (aPR = 1.95 95% CI 1.76-2.16), alcohol use (aPR = 1.93 95% CI 1.73-2.14), hypertension (aPR = 1.92 95% CI 1.73-2.13) and diabetes (aPR = 1.91 95% CI 1.73-2.12). (4) Health policies should encompass socio-economic and living environment barriers which prevent access to care among older adults.

Urban Health at a Glance in Italy by PASSI and PASSI d’Argento Surveillance Systems Data

(1) The percentage of the world’s urban population is 56% and is expected to reach 68% by 2050. In this study, we have investigated the dimensions of individual health by relating them to the type of residing municipality. (2) We also analyzed the health status, prevention, lifestyle, and elderly conditions in illustrated from PASSI and PASSI d’Argento (PdA) surveillance systems data by estimating the prevalence rates and adjusted odds ratios (ORs) for different municipal residences. (3) Urban areas negatively influence some health outcomes, such as respiratory system diseases (OR = 1.24; 95% CI 1.18–1.30). With regards to the spontaneous participation in screening programs from female adults residing in urban areas, we observed ORs of 1.24 (1.13–1.37) and 1.30 (1.12–1.39) for breast and uterine cervix cancers, respectively. Urban contexts seem to promote healthy lifestyles, as there is a lower consumption of alcohol in both adult (0.92; 0.88–0.95) and elderly populations (0.85; 0.77–0.94), although sedentary life is more widespread. Compared to elderly residents living in rural settings, urban individuals find their neighborhood less safe and are less considered as a “resource”. (4) Urban areas promote some unhealthy conditions but can also be a valuable source of services and perspectives. According to the increasing urban population, public health policies towards implementing sustainable development should be established.

Healthy lifestyle and recommendations in health care among hypertensive and diabetic patients in Brazil, 2019

OBJECTIVE

To estimate prevalence of healthy behaviors among individuals aged 30 years or more, diagnosed with arterial hypertension and diabetes mellitus, using information from the National Health Survey, 2019.

METHODS

Cross-sectional study with cluster sampling and simple random sampling in three stages. Individuals were aggregated according the following conditions: having arterial hypertension; arterial hypertension only; diabetes mellitus; diabetes mellitus only; arterial hypertension and diabetes mellitus only; without chronic non-communicable diseases. Poisson regression models and crude and adjusted prevalence ratios for sex, age group, and schooling were used. The proportion of recommendations received by patients with arterial hypertension and diabetes mellitus was estimated by type of care (public/private).

RESULTS

A total of 69,285 individuals aged 30 years or more was analyzed. Compared to individuals without non-communicable diseases, prevalence of consumption of fruits and vegetables ≥5 days a week was significantly higher among individuals with arterial hypertension (39.9% - 95%CI 38.8-41.0) and those with diabetes mellitus (42.8% - 95%CI 40.7-44.9). However, estimates of not having consumed ultra-processed food were low, 19.7% (95%CI 18.9-20.6) and 21.9% (95%CI 20,3-23.5), respectively. Prevalence of not smoking reached values close to 90% and significant prevalence ratios, whereas the practice of physical activity had levels below 30% and non-significant prevalence ratios. The proportion of healthy eating recommendations reached 90%, but it was close to 70% for not smoking.

CONCLUSIONS

It is necessary to encourage the practice of healthy lifestyles and provide information about the benefits of physical activity and the harmful effects of unhealthy eating for well-being and aging with quality.