{"id":3075,"date":"2024-06-26T18:41:29","date_gmt":"2024-06-26T16:41:29","guid":{"rendered":"https:\/\/www.rivistaeco.com\/?p=3075"},"modified":"2024-06-26T18:41:29","modified_gmt":"2024-06-26T16:41:29","slug":"tell-me-where-you-are-born-and-ill-tell-you-how-long-you-live","status":"publish","type":"post","link":"https:\/\/www.rivistaeco.com\/en\/2024\/06\/26\/tell-me-where-you-are-born-and-ill-tell-you-how-long-you-live\/","title":{"rendered":"Tell Me Where You Are Born and I\u2019ll Tell You How Long You Live"},"content":{"rendered":"

Life expectancy in Italy, like in the rest of Europe, has been steadily increasing since the 1960s. However, in some regions, it is growing more than in others. The health status of citizens is also not uniform across the country. These differences cannot be ignored and require actions to reduce them.<\/span><\/i><\/p>\n

In Europe, including Italy, life expectancy \u2013 defined as the average lifespan at birth based on current mortality rates \u2013 continues to rise, which is good news. This demographic indicator is crucial for assessing a country\u2019s development level and quality of life. However, there is also bad news: this growth is not evenly distributed across Italy, and over time, inequalities have increased, widening the North-South divide.<\/span><\/p>\n

The Good News<\/b><\/h3>\n

Let\u2019s start with the positive data. The growth in life expectancy began in the 1960s and has never stopped. According to 2023 Eurostat data, life expectancy at birth in the European Union has risen to 81.1 years. It is 1.4 years higher than it was in 2020 and 0.8 years higher than it was in 2019, the year before the pandemic. This latter figure is particularly encouraging, given the severe impact of COVID-19, which reduced life expectancy by 0.7 years during the first year of the pandemic.\u00a0<\/span><\/p>\n

The good news also applies to Italy. Italy ranks second in Europe with a life expectancy of 83.8 years, almost on par with Spain (84 years). The average growth in life expectancy from 1992 and 2023 was nearly 6 years, a growth that can certainly be attributed to advances in medical technology and more widespread prevention (see the first map). Among the provinces with above-average growth, Milan and Trento stand out with an average growth of over 7 years \u2013 far from the southern provinces of Italy where the average growth was just over 4 years.<\/span><\/p>\n

Differences Between North and South<\/b><\/h3>\n

However, not all that glitters is gold. The media\u2019s enthusiasm in celebrating Italy\u2019s good ranking for life expectancy seems excessive when we consider the stark disparities between different areas of our country. In fact, the long-term increase in life expectancy mainly involves the northern regions, while it is more limited in the central, southern, and island regions. Thus, Northern and Central Italy have converged because life expectancy was higher in the central regions, while the South is disadvantaged. Differences are also substantial at the provincial level: for example, an inhabitant of Trento can enjoy a life expectancy of over 84.5 years, while someone from Naples stops around 81.2 years, as shown in the second map. Geographic disparities could also worsen over time due to migration. Although migrants are generally in good health upon arrival, it is widely recognised that their health deteriorates with prolonged stays abroad.\u00a0<\/span><\/p>\n

In health economics, an additional month of life expectancy is considered significant, so differences of years are astronomical. To understand the economic implications of this concept, it is useful to refer to a 2014 Italian National Institute of Statistics (Istat) study, which defined the average value contributed by an Italian worker as 342,000 euros.<\/span><\/p>\n

Growth in Life Expectancy Between 1992 and 2023 in Italian Provinces<\/b><\/p>\n

\"\"<\/p>\n

Life Expectancy in 2023 in Italian Provinces<\/b><\/p>\n

\"\"<\/p>\n

Source: Istat.<\/span><\/p>\n

Are We Living Healthier Lives?<\/b><\/h3>\n

Thus, life expectancy in Italy has increased. However, it is not clear whether the years we have gained, or at least a good part of them, are spent in good health. Again, as shown by the graph, significant differences emerge between Italian regions in the percentage of people in good health, with stark contrasts between the North and the South.<\/span><\/p>\n

Percentage of People in Good Health in Italian Regions in 2022<\/b><\/p>\n

\"\"
Note: The purple line represents the average value. Source: Istat.<\/figcaption><\/figure>\n

 <\/p>\n

This difference is crucial because spending more years in good health has intrinsic value for individuals and society. It is also crucial from an economic perspective as it helps contain healthcare costs and increases the contribution of older people to the workforce \u2013 a relevant factor for a country like Italy, which is facing a significant demographic crisis from declining births.<\/span><\/p>\n

Why Health is Not Equal Across the Country<\/b><\/h3>\n

What are the possible causes of the geographic differences in the population\u2019s health? Certainly, the level of healthcare spending plays an essential role: the per capita resources allocated by the Val D\u2019Aosta Region (2,705 euros in 2022) far exceed those of Calabria (2,041 euros in 2022). In Italy, healthcare resources are distributed centrally to the regions through \u201ccentralised taxes,\u201d but regions have autonomy in organising and planning health services and can secure additional resources from local taxation.\u00a0<\/span><\/p>\n

At the same time, higher healthcare spending does not necessarily translate into better health conditions. For example, some regional health systems are not only inefficient but are also, as reported in the news, at the center of corruption. These reduce the quality of care and waste available healthcare resources, which can then contribute to a decrease in life expectancy in some provinces.\u00a0<\/span><\/p>\n

There is another consideration. According to Harvard Business School studies using American data, what matters most in advanced countries is not healthcare spending itself but rather the adoption of medical technologies that are not particularly expensive but are effective in treating acute episodes. For example, using statins, beta-blockers, or aspirin within 24 hours of a heart attack have all been identified as extremely effective and low-cost interventions. However, they remain underutilised. We do not have similar studies for Italy, but it would be interesting to examine whether such medications are prescribed less frequently in Italian provinces with lower life expectancy. Given their low cost, these therapies could offer economic benefits to the regional and national healthcare systems. The National Agency for Regional Health Services has the resources needed to conduct such analyses in our country and should perhaps use them.\u00a0<\/span><\/p>\n

Regional differences also depend on community lifestyles, such as excessive alcohol consumption or smoking habits, which vary significantly from one region to another. As became evident at the recent Annual Health Economics and Policy Forum jointly organised by Brunel University London, Ca\u2019 Foscari University of Venice, and the University of Oxford, the transition from high-risk behaviours to less risky lifestyles (use of e-cigarettes and heated tobacco rather than traditional cigarettes, moderation in alcohol consumption, regular physical activity) can considerably improve life expectancy and quality. From an economic standpoint, the widespread adoption of healthier habits can reduce avoidable or at least compressible healthcare spending.\u00a0<\/span><\/p>\n

Life expectancy is relevant to understanding a country\u2019s health status, especially when considered alongside other socioeconomic indicators such as citizens\u2019 satisfaction with living conditions, quality of life, or per capita income. However, in informing citizens, it is essential not to overlook existing geographical disparities and to explore how we can reduce them. Regardless of where we are born, we all have the right to aspire to a longer and healthier life. Reducing the chance of a healthier life to a lottery where the winning ticket is determined by one\u2019s place of birth and growth should be considered unacceptable.<\/span><\/p>\n

Bio<\/em><\/p>\n

Francesco Moscone<\/strong> is a full professor of business economics at Brunel University London and an associate professor at Ca’ Foscari University of Venice.<\/span><\/em><\/p>\n

Elisa Tosetti<\/strong> is an associate professor at the University of Padua. She has worked at the European Commission and has published in numerous international scientific journals on economics and statistics.<\/span><\/em><\/p>\n","protected":false},"excerpt":{"rendered":"

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