Chapter 2

5.2.4 Comments
The results of the analysis conducted in this study confirm the notion that despite
improvements registered over the last years, the problem relative to avoidable death
in our country is still very present and needs to be faced with growing attention.
In particular, this data firmly demonstrates how necessary it is to act through primary
and secondary prevention plans; this should be done not only at the general level of
population, but also by differentiating the plans themselves by gender. As a matter of
fact, it is very clear how necessary it is to increment primary prevention plans for both
genders, although a prevalence may be noticed in males (over 75% of the national
figure for males compared to slightly less than 50% for females); while, for that which
regards secondary prevention, it is necessary to pay greater attention to the female
sphere (31,4% of avoidable mortality referred to women and “only” 2,3% to men),
since the pathologies in question prevailingly regard this gender. Regional variations
for males go from a minimum of 18,2% in the Liguria Region and a maximum of 31,2%
in the Province of Bolzano; instead for females it goes from a minimum of 10,5% in
Campania and a maximum of 16,3% in the Molise Region.
And once again confirming the statistics illustrated in the CEIS Health Report 2005
relative to death mean values, it is necessary to eliminate the unjustified different geographical
distribution of avoidable mortality. The present study in fact demonstrates
(as has already been illustrated by ERA) that there is a very complex geographical
variability inside the groupings of causes considered. In particular, the figure that
preoccupies the most is referred to the third group (mortality amenable to suitable
sanitary and medical care) which confirms the Rapporto CEIS Sanità 2005 data stating
that the southern Regions are prominently behind compared to those in the north
and centre. Moreover we must not neglect the fact that, although less prominently, the
same situation of tardiness can be verified even in relation to the second group –
especially for that which regards the female population (confirming a certain degree of
tardiness in establishing screening programmes, etc.).
The second part of the study has also underlined a positive and encouraging aspect
relative to public healthcare interventions for the three groups of avoidable mortality,
which have always been highly relevant to our country (lung cancer, cervix cancer and
ischemic heart diseases). From a general standpoint, the three groups have in fact
demonstrated a constant reduction. But alongside this positive figure it is important
to stress the onset of a specific problem relative to the female gender. The above diagrams
(Diagram 6) demonstrate how women are registering an increase in lung cancer
which contrasts the decrease reported for males. This calls for increasing campaigns
against female smoking. By doing so, there is the possibility of reaching the
same positive results that are being obtained for cancer of the cervix. This is especially
thanks to widespread screening for early detection, which is determining a
decrease in death rates for this type of cancer.
It is therefore obvious that there is still an important margin for reducing mortality, on
condition that all the requisites for facilitating suitable prevention policies be in place
and that, at the same time and through the same, there be an attempt to reduce the
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CEIS Health Report 2006