Socio-demographic data of the health sector in the World to know, even when applying narrative medicine: source, OECD official documents

On this occasion, we invite our readers to consult the website of the OECD, the Organisation for Economic Co-operation and Development, a body that includes 28 countries at a global level (including Europe, the Far East, Scandinavia, and the Americas) and that promotes economic development policies for the well-being of peoples around the world. On the OECD website, you will find data and information on the health status and on the impact of health determinants (such as lifestyle, education level, and well-being) in the associated countries. In particular, we would like to point out the document on life expectancy, which shows some significant differences in the different peoples surveyed.

On page 22 of the document, table 1.1 investigates the longevity of the population, comparing the average age of the male and female population, the average number of years lived after 65 years in the general population, the prevalence of mortality due to acute heart disease (ischemia, heart attack) and the prevalence of neurodegenerative diseases (senile dementia) in the different countries surveyed. Compared to Eastern European countries with the worst life expectancy results, Italy is very well placed in terms of life expectancy, in fourth place after Japan, Korea, and France. Women live on average four years longer than men, but aging is often marked by cognitive decline, with a high prevalence of dementia (see Table 1.1). On page 24 in Table 1.2, among the health risk factors assumed are smoking prevalence, average alcohol intake, obesity prevalence, and air pollution. These data show that smoking is particularly prevalent in Turkey, Austria, and Hungary, while the worst data on alcohol use were recorded in Austria, Belgium, and France, countries famous for their products such as beer and fine wines. Nordic countries such as Finland, Canada, and Iceland, and Switzerland are the least polluted of the countries surveyed. Italy is in the average for smoking, pollution and alcohol intake, while the Mediterranean diet seems to be a preventive factor from obesity, positioning itself among the most virtuous countries (see table 1.2).

Table 1.3 shows data on access to care (p. 26), by surveying insurance coverage, average expenditure not covered by health insurance, waiting time for a routine operation such as cataracts, and the percentage of visits canceled due to excessive cost. Even in this situation, Italy is in a central position, ensuring one of the highest insurance coverage (public health) and ensuring the shortest waiting time for routine operations. Chile, Estonia, Poland, and the USA, on the other hand, have shown that they have low benefits in accessing treatment (see table 1.3). Italy is also among the top countries for quality of care (table 1.4 on page 28) of respiratory diseases (asthma and COPD), maternity units (obstetric field capacity), and increased survival to heart attack and colon cancer. However, we are among the largest consumers of antibiotics, suggesting the need for an awareness campaign to reduce their use when not required.

Finally, Figure 2.4 on page 37 shows the main determinants of improved health, according to the survey. It is interesting to note that health expenditure is the key factor with the most impact, together with an adequate education and training system to maintain the well-being and health of the population. Table 3.6 on page 53 shows the incidence of mortality, by country, from cardiovascular diseases, cancer, respiratory diseases, neurodegenerative diseases, and external causes. As can be seen from the graph, Eastern Europe has the highest incidence of mortality from heart disease and cancer, while the highest index of deaths from neurodegenerative diseases seems to be present in European and North American countries, probably because of the longer life expectancy. On the same page, the following table compares the main causes of mortality between men and women. It is interesting to note that the greatest differences between the two populations emerge in the values of deaths from senile dementia (greater in women) and deaths from accidents (greater in men).

The last data, in our opinion very important, is the one we propose you to observe, starting from page 101 of the document: there are some items surveyed for which Italy, unfortunately, does not collect the data, either out of ignorance or insensitivity. These items are more related to listening to the patient, a topic that Narrative Medicine and the Health Area of the ISTUD Foundation have been promoting for years, so it is particularly relevant for us. In fact, the “Bel Paese” is not included in the surveys concerning the time dedicated to the visit, to the decisions shared with the caregivers, and to the communication to the patient. This suggests the need to continue to spread the narrative approach and to begin to pay more attention to the patient’s experience and to the quality of the medical examination that we offer to those who suffer.

Silvia Napolitano

Researcher at Healthcare Area of ISTUD Foundation. Master degree in Industrial Biotechnology at University of Milano-Bicocca, Post-graduate ‘Scienziati in Azienda’ at ISTUD Foundation. Expert in Medical Writing, especially in areas as the qualitative research and Narrative Medicine. She contributes to research and educational projects with the aim of improving the quality of life and quality of care of patients with chronicle or genetic diseases.

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