The Health profile in Tuscany Fabio Voller Regional Health Agency of Tuscany

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1 The Health profile in Tuscany Fabio Voller Regional Health Agency of Tuscany Agenzia regionale di sanità della Toscana Intersectoral approaches for active and healthy aging October 2014 Villa la Quiete Florence,Italy

2 Tuscan demography in brief Residents are births and deaths took place in 2012 The currently high life expectancy at birth is increasing, it is one of the highest in Italy and in the world Life expectancy is higher for women than for men Life expectancy at the age of 65 is high and growing Foreigners are 9.5% (350,761) and increasing Births and fertility are low Mortality is low Ageing is pronounced Source: ISTAT data as at 31/12/2012

3 Life expectancy at birth Tuscany vs Italy Age Source: ARS on ISTAT data For the last 30 years the life expectancy of the Tuscan population has been growing (+11.8% for M and +7.8% for F). Life expectancy at birth is higher for women: 84.8 years vs 80.1 for men. Tuscany presents a higher life expectancy in comparison to Italy (IT-M: 79.6 years; IT-F: 84.4).

4 Life expectancy at birth in some developed countries Country Age males Age females Japan Tuscany Italy Sweden France Germany UK USA Lithuania Source: WHO 2008

5 An overview of Tuscan demography Low number of births, low fertility + Low mortality Ageing 22.8% over 65

6 Resident foreign population % Source: ARS on ISTAT data 350,761 foreigners are in Tuscany as at 12th Dec 2012.

7 Effects of demographic change Increase in demented (97,600 in 2020) and disabled (85,600 in 2020) elderly people Increase in the prevalence of chronic diseases and disability Women living longer but with more health problems Weakening of women s family care-giver role Foreigners mitigating the negative demographic impact

8 Mortality in Tuscany General mortality is constantly and progressively decreasing, and is always lower than the Italian average Infant mortality is decreasing, and is always lower than the Italian average Maternal mortality is lower than the Italian average Premature mortality is decreasing, and is lower than the Italian average

9 General mortality - Tuscany vs Italy Standardized ratio * inhabitants Source: ARS on ISTAT data. ISTAT data are not available. General mortality is constantly and progressively decreasing, and is always lower than the Italian average.

10 Lifestyles in Tuscany

11 Smoking habit (%) >14 years Year 2012 In Tuscany: The smoker s profile is similar to the Italian one 23% of smokers are adult (about ) smokers are decreasing, above all males New smokers are not decreasing girls (14-19) smoke more than boys, and the number is increasing smoke-related mortality is decreasing, especially in males Smoking habit Tuscany Italy Males Smokers Ex-smokers Non-smokers Females Smokers Ex-smokers Non-smokers Total Smokers Ex-smokers Non-smokers Source: ARS on ISTAT data

12 Alcohol in Tuscany Consumption is more regular (above all wine) Adults drink more than in the rest of Italy, but above all during meals Binge drinking and getting drunk are less widespread Total alcohol consumption is decreasing, and alcohol-related mortality is decreasing (as it is in Italy) Youths fit with national and international patterns (drinking at weekends, more binge drinking, not at meals, on social occasions) The risk of road accidents is high for youths drinking while driving Adolescents (especially girls) prematurely start drinking in excess, as in the rest of Italy

13 Binge drinking Year 2012 % population >11 years consuming at least 6 alcohol units (glass of wine and/or beer and/or aperitive and/or spririt in one occasion (binge drinking) Fonte: ARS su dati ISTAT

14 Death causes of Tuscan residents Every year about 41,500 people die from all causes 2/3 die from cardiovascular diseases (CDV) and cancers CDV mortality is falling and lower than the national average (care is improving) Cancer mortality is falling and is lower than the national average (care and prevention are improving)

15 Deaths by cause in Tuscany Year 2011 Nr = 41,690 Source: ARS on Regional Mortality Registry data

16 Cardiovascular mortality Tuscany vs Italy Standardized rates by age Source: ARS on ISTAT data. ISTAT data are not available. Adults: cardiovascular diseases represent the main cause of death, tumors the second highest cause. Elderly people: circulatory system diseases are the main cause of death after the age of 80 years, for both men and women.

17 Cancer mortality Tuscany vs Italy Standardized rates by age * 100,000 inhabitants Source: ARS on ISTAT data. ISTAT data are not available. Men: tumors are the first cause of death after the age of 45 years until the age of 84, then they are surpassed by circulatory system diseases. Women: tumors are the first cause of death after the age of 45 years until the age of 64, before being surpassed by circulatory system diseases.

18 Tumors in Tuscany vs Italy Incidence (number of new cases) is stable or increasing, in line with the Italian average Mortality is decreasing because care and prevention are improving, more than in Italy: survival is improving but prevalence (number of cancer-deseased people) is increasing Stomach cancer incidence and mortality are high (diet and genetics) Female breast, and colon-rectum cancer incidence is high, but mortality is low (protective screening effect?) (Breast, uterus, colon-rectum) screening has better indicators than in Italy

19 Cancer mortality in Tuscany Year 2010 Standardized rates x 100,000 inhabitants Tuscany Italy All tumors Stomach Colon-rectum Lung Breast Source: (INT ISS)

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