7.1 General context
- 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 data from the V surveillance of HBSC Italy, referring to the questionnaires administered in 2018 to 58,976 children aged 11, 13 and 15 years, show that adolescents have a high perception of their quality of life, feel supported by friends and classmates and have a good relationship with teachers. The survey, however, highlights how some wrong and risky health habits persist.
Among the topics investigated are:
• Smoking: 24.8% of boys and 31.9% of girls report having smoked cigarettes at least one day in the last 30 days, highlighting a marked gender difference at 15 years. The percentage of young people who smoked at least one cigarette in their life is slightly down compared to 2014, the year of the previous survey;
• Cannabis use: Consumption of cannabis for at least one day in the last 30 days shows a slight difference between boys (16.2%) and girls (11.4%) at 15. This question was not asked of the 11 and 13 years old. The percentage of young people who have reported using cannabis at least once in their life is slightly higher than in 2014;
• Alcohol consumption: the share of those who claim to have consumed alcohol at least 1 day in the last 30 days increases with age in both boys and girls, with gender differences in all three age groups. This phenomenon is in line with 2014;
• Binge drinking (drinking 5 or more glasses of alcoholic beverages). Binge drinking is a more frequent phenomenon in boys (22.8% compared to 17.1% of girls) and increases with age. The phenomenon of binge drinking is on the rise compared to 2014;
• Drunk at least once in the last 30 days: the data show that the phenomenon does not present particular differences in % of children) and increases with age;
• Gambling at least once in their life and in the last 12 months: the percentage of 15-year-olds who said they have bet or played money at least once is 42.2% (in their lifetime) and 31.4% (in the past twelve months). It is characterized as a purely male phenomenon: 62.5% of boys compared to 22.9% of girls have gambled at least once in their life. The results show a slight increase in the phenomenon compared to 2014;
• Problematic risk gambling in the last 12 months: 8.7 % of girls and 19.8% of boys aged 15 (total 16.0%) have been found to be at risk or problem gamblers (i.e. having at least two symptoms of gambling disorder such as stealing money to gamble). The results are on the rise compared to 2014;
• Nutritional status and eating habits: 16.6% of children aged 11-15 are overweight and 3.2% obese; excess weight decreases slightly with age and is greater in males. The results tend to be stable compared to the 2014 survey.
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. Compared to 2014, there was a slight deterioration. Only a third of boys consume fruit and vegetables at least once a day (contrary to recommendations) with higher values in girls. Compared to 2014, the consumption of vegetables increased, at least once a day, but fruit consumption decreased in all three age groups as well as for both genders. Bread, pasta and rice are the most consumed foods. Sugary/carbonated drinks are mostly drunk by 11-year-olds and males: this consumption is down compared to 2014 in all three age groups considered and in both genders;
• Motor activity: the majority of young people practice at least 60 minutes of physical activity, 2 to 4 days a week. 9.5% of 11-15 years old practice physical activity on a daily basis. Boys are on average more active than girls.
• Time spent in front of a screen: international guidelines recommend not to exceed 2 hours per day in activities dedicated to watching a screen (video games/computers/internet). From the HBSC data, it emerges that about a quarter of young people exceed these times, with a similar trend for both genders, with values increasing after 11 years (stable data compared to 2014).
From the ISTAT surveys of 2019-2020, some of the issues investigated are the same subjected to HBSC surveillance. The data shown below, differentiated by thematic area, refer to the latest surveys conducted in 2019-2020.
Smoking: In 2020 the data in young people who declare to be smokers increased in comparison with 2019. Young people from 14 and 17 that declare to be smokers are the 6,3% compared to the 5,9% of 2019 (ISTAT survey “Lifestyle and health”).
The highest percentage is found among 25-34 years old (23,7% in 2019 and 24,2% in 2020), 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.
In 2020, almost half of young people say they consume up to 5 cigarettes a day (45.7%) while 32,3% of young people consume 6 to 10 cigarettes a day. Compared to 2019, the number of young people who consume from 11 to 20 cigarettes per day increased from 17,6% to 18,1% in 2020.
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 Multiscopo 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%).
Alcohol: In 2020 the number of young people consuming meals outside mealtime increased for all age groups (ISTAT Multiscope Survey on families “Aspects of daily life”).
From 2019 t0 2020 the percentage of young people belonging to the 14.17 years-old group who drink alcohol outside mealtime went from 13,4% to 14,2%, the same tendency is recorded in all the age group, with a significant increase for the 18.19 group, that goes from 42,7% to 45,9% and for the 20-24 years old (49,2% in 2019 and 52,5% in 2020).
Obesity and physical activity: According to what is reported in the Annual Italian Statistic for 2020, in 2019 the highest number of people who continuously perform sports is in the 6-17 group, particularly in males between 6 and 10 years old (61,9%). With the increase in age the sport practice diminishes.
The least assiduous in sports are young people between 25 and 34 years old.
Suicide: in 2017, the incidence of suicides among young people was 13.7% of the total causes of death, (ISTAT - Survey on the causes of death). Among young people in the 15-34 age group (out of the total population), the figure stood at 14.3% in 2017 (ISTAT), a slight decrease compared to the previous year in which it stood at 13.9% compared to an EU average of 27.6% (Eurostat). A focus on age groups shows that in 2017, the youth suicide rate was the lowest compared to the rest of the population.
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 2019, published in March 2021, it has recorded 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 (67,4 on 10.000 citizens for males; 70,9 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 2020 in Italy there were 1303 new diagnoses of HIV infection, with 2,2 new cases every 100.000 residents. The incidence of new HIV diagnoses is constantly diminishing since 2012. In the 79,9% of the cases the people who found out to be HIV positive in 2020 were men. The average age is 40 years old for men and women alike and the highest incidence is in the 25-29 age group. (5,5 new cases every 100.000 residents) and 30-39 (5,2 cases every 100.000 residents)
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.