1. Main trends in the health conditions of young people

2. Main concepts

1. Main trends in the health conditions of young people

Youth trends in the health and well-being of young people in Italy are mainly examined through the research activities of HBSC (Health Behaviour in School-aged Children) Italy (Cf. 7.4.) and the surveys of the National Institute of Statistics (ISTAT). ISTAT collects and systematizes the surveys on adolescence and adolescents in the Giovani.Stat database, divided into thematic areas including “Lifestyles and health”.

Italy has participated in the HBSC study since 2001.

The HBSC surveys carried out in 2010, 2018 and 2022 were coordinated by the ISS in collaboration with the Universities of Turin, Siena and Padua, with the contribution of the Ministry of Health and the support of the Ministry of Education and Merit.

In addition to 11, 13 and 15-year-olds, the HBSC-Italia 2022 sample also included, for the first time, the 17-year-old age group. Data collection took place in the schools and classes sampled starting from February 2022 and ending in June. All the information was collected through online questionnaires that were self-completed by students and school managers.

In the first and second grade secondary schools, 6388 classes were sampled among all the Italian regions.

In the 2022 survey, a section was included in the questionnaire with a set of questions concerning the impact that the COVID-19 pandemic has had on various aspects of the life of boys and girls, such as what were their main sources of information related to COVID-19 and the protective measures they adopted.

Among the topics investigated are:

• Smoking: The data relating to the 2022 survey show that the percentage of adolescents who declare to have smoked at least one day in the last month increases significantly with age: if at 11 the percentage is around 1% in both genders , it rises to 6% and  9% for boys and girls respectively at 13, while the phenomenon reaches 20% among boys and 29% among girls at 15. The percentage of young people who smoked at least one cigarette in their life is slightly down compared to 2018, the year of the previous survey;

• Alcohol consumption: Although there has been a trend towards a reduction in consumption over the years, alcohol remains the most used substance by adolescents, especially among fifteen-year-olds. The share of Italian children who declare having consumed alcoholic beverages in the last 30 days increases with age, going from 9% and 5%, respectively, of 11-year-old males and females, to 23% and 24% of thirteen-year-olds and exceeds 50% in fifteen-year-olds (50% among boys and 54% among girls). The data therefore show a clear gender reversal for alcohol at the age of 15, with girls declaring a higher consumption of alcohol than their male peers;

• Gambling at least once in their life and in the last 12 months: The percentage of 15-year-olds who declared having bet or gambled with money at least once in their life is 47.2% for boys compared to 21.5% of girls. For the percentage of gamblers in the last 12 months, 37.5% of boys compared to 14% of girls thus characterising the phenomenon as predominantly male. Even though the results are in clear reduction for young people in general compared to 2018;

• Nutritional status and eating habits: Overweight teenagers (overweight + with obesity) in Italy are 22.6% (overweight 18.2% and with obesity 4.4%). Different levels of excess weight are found in the Italian Regions, with an increasing distribution from North to South. The highest prevalence of ponderal excess weight are found in Campania, Molise, Sicily, Puglia when compared to the Central and Northern Regions. Compared to the data from the previous survey, there is an increase in the proportion of overweight and/or obese children. This increase is evident for all age groups considered and for both genders.

As aforementioned, a section of questions concerning the impact that the COVID-19 pandemic was included in the questionnaire in the 2022 survey.

According to this section 54% of adolescents declared a positive impact on family relationships and 42% on school performance, while 41% believe that their mental health has been negatively affected, as well as 37% who saw an impact on their life in general. The data show that the positive effect on family relationships decreases with age, from 67% of eleven-year-olds to 45% of seventeen-year-olds, and between eleven and fifteen years old it is predominantly male, while no gender differences are observed in the older ones. The same trend by age was also recorded on the positive impact of school performance, from 50% of the youngest to 37% of 17-year-olds, with no substantial differences between males and females. The negative effect, on the other hand, is mainly a female phenomenon and increases with age. Regarding the question about their mental health, 52% of girls declare a negative impact compared to 31% of boys, and this response is observed in 29% of 11-year-olds (33% of girls and 25% of boys) and in 53% of 17-year-olds (66% and 41%, respectively).

The habit of not eating breakfast is common in adolescents and the percentage of girls who do not eat breakfast is greater than that of males in all three ages considered. National data from the HBSC 2022 study referring to 11, 13 and 15 year olds indicate that the habit of eating breakfast on school days is more frequent in boys and decreases with age. The lowest consumption frequencies are found in girls and at the age of 15. This trend is in line with what was observed in the 2018 survey;

• Physical activity: Compared to the 2018 survey, there is a slight reduction (44.1% vs 40.8%) in the percentage of young people who carry out at least 4 days a week of moderate-intense physical activity (60 minutes a day). Differences by age and gender confirm the trend observed in the past.

• Time spent in front of a screen: Compared to the data from 2018, it’s possible to observe  an increase in the problematic use of social media, especially among girls, whereby the prevalence increases by 5% (from 11.8% to 16.9%, compared to boys who switch from 7.8% to 10.3%). This increase is also particularly marked among 15-year-old girls and 11-year-old boys.

Some of the issues investigated in the 2020-2021 ISTAT surveys are the same subjected to HBSC surveillance. The data shown below refer to the latest surveys conducted in 2020-2021 differentiated by thematic areas.

Smoking: In 2021 the data regarding young people who declare to be smokers decreased in comparison with 2020. Young people from 14 and 17 that declare to be smokers are the 5,7% compared to the 6,3% of 2020 (ISTAT survey “Lifestyle and health”).

The highest percentage is found among 25-34 years old (24,2% in 2020 and 25,7% in 2021), followed by 20-24 years old and 18-19 years old, always with a slight increase in percentage between the two years. The lowest percentage concerns young people in the 14-17-years-old group. 

Table 1. Percentage of young people who declare themselves smokers

Alcohol: in 2019, 6.8% of young people aged 11 to 34 declared that they drink alcohol on a daily basis (ISTAT Multiscope Survey on families “Aspects of daily life”). 57.4% declare a moderate consumption of alcoholic beverages, while 16.8% assume behaviours considered at risk with a high habitual consumption both outside meals (17.9%) and during meals (53.7%), especially in the 11-17 age group. Binge drinking is more common among young people aged 18-24 (16%) followed by young people between 25 and 34 (13.8%).

In 2021 the number of young people consuming meals outside mealtime decreased for all age groups (ISTAT Multiscope Survey on families “Aspects of daily life”).

From 2020 to 2021 the percentage of young people belonging to the 14.17 years-old group who drink alcohol outside mealtime went from 14,2%, to 10,4%, the same tendency is recorded in all the age groups.

Obesity and physical activity: According to what is reported in the Annual Italian Statistic for 2021, in 2021 the highest number of people who continuously perform sports is in the 11-14 group. With the increase in age the sport practice diminishes. With the increase in age the sport practice diminishes.

The least assiduous in sports are young people between 25 and 34 years old.

In 2021 the least assiduous in sports are young people between 20 and 24 years old.

Suicide: The latest available data on suicide in Italy are those of 2019; compared to 2017, there was a slight decrease in suicide cases: from 566 cases in 2017 (15-34 years) to 514 registered cases in 2019.

Regarding mental health and the spread of HIV among young people, the Ministry of Health disclosed the following data:

• According to the latest Mental Health Report 2021, published in October 2022, there has been an increase in the number of young people who got in touch for the first time with the Mental Health Departments. This applies to boys and girls and especially for the age group 18-24, for which it’s been observed a high percentage (72,2 per 10.000 inhabitants for male and  92,8 per 10.000 inhabitants for females).

•The data related with the new surveillance system for the diagnosis of HIV infection (data from the High Institute for Health) report that in 2021 in Italy 1,770 new HIV diagnoses were reported, with an incidence of 3.0 per 100,000 inhabitants. In 2021, HIV incidence in Italy was lower compared to that estimated in the European Union (4.3 new diagnoses per 100,000 inhabitants). Since 2018, an evident decrease in the number of new HIV diagnoses is observed, with no relevant differences in transmission modes. In 2021, the highest incidence of new HIV diagnoses was found in the 30-39 age group.

2. Main concepts

Health: Italy has adopted the definition of health and well-being present in the Constitution of the World Health Organization (WHO) according to which: “Health is a state of complete physical, mental and social well-being, and not simply the absence of disease or of infirmity”. Health is influenced by a series of socio-economic factors upon which it is necessary to act through global strategies of promotion, prevention, treatment and recovery in a global government approach. In accordance with this premise, Italy has adopted policies that are increasingly oriented towards considering the complex of life, work and social and economic contexts in which each person lives, with specific reference to the different age groups, so much so that, in as part of the counseling centres, a “youth space” has been set up, dedicated to people aged between 14 and 20 (Cf. paragraph 7.7).

Prevention and screening: to ensure equity in access to early diagnosis, the National Health Service carries out three screening programs for the prevention of breast, cervical and colorectal cancers.

The PAP Test for cervical cancer screening is offered free of charge every three years to young women between the ages of 25 and 30.