Italy Global Health project

Welcome!

This page will allow you to explore the health-care system and how it is delivered in Italy, along with a vulnerable population and a health causing problem. You will also be able to see similarities, differences, and statistics comparisons of Italy and the United States. What can the United States learn from Italy? Scroll down to find out!

Alaina Caruso, Breanna Heifet, & Dana McCormick

World Health Rankings

The Italian health-care system is ranked 2nd in the world where as the United States health-care system is ranked 37th in the world. Italian is the primary spoken language in Italy. Italy has a population of 60 million people, and the United States has a population of 308 million people (World Health Organization).

Health Related Index Factors

Italy / United States Health Related Index for all Factors

Health Statistics compared between Italy and the United States

Health Statistics Comparisons in Italy and the United States

Life Expectancy

The life expectancy in Italy is 82.7 years old. The life expectancy in the United States is 78.9 years old.

Contributing factors:

  • Mediterranean diet
  • Wine reduces risk of heart disease
  • Shift from poverty to growing affluence (Walsh, 2013)

Smoking

In Italy, 16.6% of the population smokes. In the United States, 10.7% of the population smokes.

Contributing Factors:

  • Lower socioeconomic class
  • Older population more susceptible to smoking ages 45-54
  • Males ages 34-45 (Semyovov, 2012)

Motor Vehicle Accident Deaths in Italy

In Italy, 8/100,000 deaths occur from motor vehicle accidents. In the United States, 11.9/100,000 deaths occur from motor vehicle accidents.

Contributing factors:

  • Country roads are more narrow with no guardrails
  • Speed limits vary
  • Traffic in emergency lanes
  • Pile ups occur at toll booths (Nomads, W)

Child Obesity

In Italy, 39.2% of children are overweight/obese. In the United States, 21.1% of children 2-4 are overweight/obese.

Contributing Factors:

  • Not enough physical activity
  • Not enough prevention programs
  • Junk food consumption (Binkin, et al. 2009)

Italian Health-care System

The Servizio Sanitario Nazionale (SSN) is the National Health Service that is regionally organized in Italy. The SSN provides universal coverage free of charge at the point of delivery. The National Health Service is funded through national and regional taxes supplemented by co- payments for pharmaceuticals and outpatient care. Public sources made up 78.2% of total health-care spending, with private spending/out of pocket payments making up 17.8% (Ferre, et al, 2014).

Delivery of Care

  • The Healthcare in Italy is delivered by public providers.
  • The Ministry of Health is the main institution responsible for public health at a national level.
  • Primary care services are provided by health districts.
  • Inpatient care is provided through a network of public and private hospitals (Ferre, et al, 2014).

United States Health-care System

Multiple systems that operate independently or in collaboration make up the United States health-care system. Public sources make up 48% of health-care expenditures in the United States. Private third party payer account for 40%. 12% is paid by individuals out of pocket. 30% of the United States population is covered by the public financing system. Medicare provides coverage for seniors and the disabled. Medicaid covers health-care services for some of the poor and near-poor. 54% of Americans receive private health insurance coverage through an employer (Ferre et. al, 2014).

Delivery of Care

  • Care is delivered through a primary care provider to those who are insured, though with some kinds of insurance (e.g. PPO) individuals may go directly to a specialist.
  • Those who are uninsured visit community centers and emergency rooms for health care.
  • Retail clinics available in pharmacies
  • Urgent Care
  • There are eight federal public health agencies in the United States. Some federal public health agencies include: The Centers for Disease Control and Prevention, The food and Drug Administration, and the National Institutes of Health. "Federal, state and local public health services have been underfunded, and tend to be driven by immediate concerns; for example, as concerns rose over terrorist attacks in the United States, much of the public health funding and services switched to terrorism preparedness, leaving holes in other areas of public health (Ferre, et al, 2014)."

Health Asset

Everyone is entitled to receive free medical care in Italy regardless of if they are legal, illegal, employed, and unemployed. Citizens are able to visit a doctor and hospital without paying any fees. Non-citizens can also go to the hospital, free-of-charge. Italy spends way less money per capita when compared to the United States, yet still has a higher ranked healthcare system. Just because Italians are receiving free health care does not mean that the care is worse compared to the United States. Italy pays their health care providers way less compared to the United States. Another huge difference is that Italy charges patients for their prescriptions based on their income and the necessity of the drug. There is no cap on prescriptions in the United States so Americans are paying way more for the same drug. The same goes for specialist procedures. The procedures in the United States can cost almost ten times more than in Italy for the exact same thing (Bezzone, 2015).

Health Threat

Citizens in Italy pay upwards of 50% of their paychecks to income taxes. Income tax is calculated on citizens' income. Although they are only paying taxes on what they can afford, the cost of taxes in the country is among the highest in all of Europe. Obviously, the people of Italy are not the only ones putting much of their money towards taxes, but the problem is that recently, there has been a reduction in the quality of the services provided to their citizens. This is especially so when it comes to their healthcare. The hospitals are likely to be understaffed, and the waiting lists can be extremely long, depending on if the condition is life threatening or not. "Patients are treated based on the severity of their condition, with waiting times range from 10 days, up to a year." This is not the case if it is an emergency (Bezzone, 2015).

What Can We Learn?

Overall, we can learn a lot from the Italian healthcare system. Healthcare is a right in Italy, where in the United States, some may say it is the most profitable business in an industrialized nation. Free health care allows the people of Italy to know they are protected at all times. The United States healthcare providers need to cut unnecessary spending on things like excess testing, because they know private insurance companies cover the cost. Doctors are paid way more, and medications are more expensive, along with specialist procedures. It can cost an American about 30,000 dollars to give birth, while it costs nothing for a person to give birth in Italy. Maybe the people of the United States could decide if an increase in taxes and longer wait times for appointments could be more beneficial if it means free healthcare as our right (Trump, 2009).

Vulnerable population

Migrants of low socioeconomic and minority status are the vulnerable population in Italy. "Behavioral changes in culture and diet are associated with migration: the abandonment of a balanced traditional diet and the Westernization of dietary habits can lead immigrants to obesity and related diseases such as diabetes, hypertension and cardiovascular diseases (Bracele, et al.)"

Health Harming Problem

Childhood obesity is a health harming problem in Italy. Italy can boast about their low adult obesity, coming in at about 10% of the population, but the obesity in children is sadly high at about 36% for boys and 34% for girls. In turn, the WHO predicts that as the prevalence of childhood obesity rises, by 2030 disease rates may double. In the southern part of Italy, childhood obesity is most prominent...Two times more prominent to be precise. This is interesting considering that the diet in the southern area is Mediterranean. It is thought that obesity is an issue due to junk food consumption and cultural components (European Association for the Study of Obesity, 2013). Also, data from numerous sources suggest that parental factors in the South are risk factors for childhood obesity. For example, not having had breastfed their children or being obese themselves. Lastly, in the south, television watching, sedentary lifestyle and skipping breakfast are very high in comparison to the north. Although all of these factors are risk factors for childhood obesity in Italy, especially in the southern parts, the risk factors are not limited to the ones previously mentioned (Binkin & et al. , 2009).

What is being done to address childhood obesity in Italy?

The SIO (Società Italiana dell'Obesità), also known as Italian Society of Obesity, has no cure for obesity. However, the seriousness of childhood obesity is strongly acknowledged by the president, Dr. Sbraccia, of the SIO. It is evident that diet alone is not a long term treatment for everyone and everyone needs a different treatment plan based on their individual needs. The SIO is currently trying to make networks that are specialized centers that can work with policy makers to examine and improve existing treatment protocols for obesity. Dr. Sbraccia, hopes to be able to provide specialized treatment for patients' individual needs (European Association for the Study of Obesity, 2013).

Additional Solutions For Childhood Obesity in Italy

Awareness of physical fitness and food nutrition to fuel the body is important. Not only is awareness important but implementation is also key. Involvement of parents to implement physical activity and healthy foods is taking this issue another step further. If there were more posters and television commercials promoting family involvement in physical activity and meal time nutrition, families may be more encouraged to get involved together as a team.

There needs to be further investigation of the physical activity, social and food habits in Italy. A survey from this community, maybe given to the schools for the children to fill out and also for the parents to fill out about their kids, will help to determine what hinders the health of the children (Bracale & et al., 2013).

What do you think?

Do you think the maternal mortality rate in the United States would decline if the United States had free universal health coverage like Italy?

References

Bezzone, F. (2015, June 12). Italian healthcare system vs. the US healthcare system. Retrieved from Life in Italy website: http://www.lifeinitaly.com/life/medical-system

Binkin, N., & et al. . (2009). A national survey of the prevalence of childhood overweight and obesity in Italy. Obesity Reviews, 2-10. doi:10.1111/j.1467-789X.2009.00650.x

Bracale, R., Milani, L., Ferrara, E., Balzaretti, C., Valerio, A., Russo, V., . . . Carruba, M. O. (2013). Childhood obesity, overweight and underweight: a study in primary schools in Milan. Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity, 18(2), 183-191. doi:10.1007/s40519-013-0036-9

European Association for the Study of Obesity. (2013). Obesity in Italy. Retrieved from EASO: http://easo.org/media-portal/country-spotlight/obesity-in-italy/

Ferré , F., Guilio de Belvis, A., Valerio, L., Longhi, S., Fattore, G., Ricciardi, W., & Maresso, A. (2014). Italy Health System Review. Health Systems in Transition , 15(4).

Health-related SDGs. (n.d.). Retrieved April 09, 2017, from http://vizhub.healthdata.org/sdg/

Nomads, W. (n.d.). 4 Things Travelers Should Know Before Driving in Italy. Retrieved April 10, 2017, from https://www.worldnomads.com/travel-safety/europe/italy/driving-in-italy

Semyonov, L., Iarocci, G., Boccia, A., & Torre, G. L. (2012). Socioeconomic Differences in Tobacco Smoking in Italy: Is There an Interaction between Variables? Retrieved April 10, 2017, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3317588/

Steeves, A. (2013, February). Health costs and healtcare in the US and Italy. Retrieved from University of New Hampshire website: https://www.unh.edu/healthyunh/blog/2013/02/health-costs-and-healthcare-us-and-italy

Trump, J. (2009, October 30). Health care expert compares Italian health care system with U.S. Retrieved from Wake Forest University website: http://news.law.wfu.edu/2009/10/health-care-expert-compares-italian-health-care-system-with-u-s-2/

Walsh, F. (2013, March 07). Why do the Italians live longer than us? Retrieved April 10, 2017, from http://www.bbc.com/news/health-21690003

World Health Organization. (n.d.). Retrieved April 10, 2017, from http://www.who.int/en/

Credits:

Created with images by trishhartmann - "Venice Sunny Day [explore 9-4-13]" • nathanh100 - "Map of Italy, Undated" • DarkoStojanovic - "doctor medical medicine" • Daria-Yakovleva - "cheese cheese plate wine" • markusspiske - "cigarette smoking smoke" • Pexels - "architecture buildings cars" • USDAgov - "A girl eating her lunch with other kids in background" • robertsharp - "Italian Flag" • Unsplash - "american flag usa" • Wokandapix - "learn word scrabble" • fdecomite - "travel" • mdiaz9 - "candy apple sweet" • krossbow - "026-365" • diapicard - "fruit basket grapes apples" • tasha - "pregnant tummies heart"

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