Friuli Venezia Giulia, Italy the Gradual Ageing of the Population Is Partly Offset the Gradualageingof Populationispartlyoffset Group

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© Foto Archivio PromoTurismoFVG FVGR coversageographicalareaof7862km motorways, railwaysandportnetworks. enhanced byappropriateinfrastructures,suchas with bothnorthernandeasternEuropeis south. Itsstrategicpositionforcommunication Slovenia totheeastandAdriaticSea north eastofItaly, borderingAustriatothenorth, region withspecialstatutesituatedintheextreme Friuli Venezia Giulia (FVGR)isanautonomous General overview Friuli Venezia Giulia, Italy the gradual ageing of the population is partly offset the gradualageingof populationispartlyoffset group. Thebirthrateinthe regionisverylow, but passed infavourofdeveloping policiesforthis (Table 1) inconnectionwithwhichalawhasbeen There isaverylargeproportionofolderpeople most withfewerthan5000inhabitants(71.3%). total forItaly)distributedamong216municipalities, FVGR hasapopulationof1217872(2%the comprises parks,naturereservesandbiotypes(1) . and isstronglyprotected:17.1%oftheterritory to thesouth.Biodiversityaddsvalueregion down tothehills(19.3%),plains(38%)andcoast out tothenorth(42.6%ofterritory)andslopes where only5.2%ofthepopulationlives,stands the regionisveryvaried:Alpsmountainrange, (2.6% ofthetotalareaItaly).Thelandscape 2 chronic diseases. for peoplesufferingfrom acuteand,especially, an effectivenetwork,providing adequatecare in theregionarewellintegrated andconstitute nongovernmental organizationsandagencies of themunicipalities,variousassociations, The regionalhealthsystem,thesocialservices care; paediatricandpublichealthcentres. mental heathandaddictionservices;palliative and rehabilitation);long-termcare;home hospitals (specializinginoncology, paediatrics network ofservices,including:threetertiary provinces throughanintegratedandcapillary health authoritiesprovidecareinallthe Beveridge model(2).InFVGR,fivelocal In Italy, thehealthsystemisbasedon universities. Studies, theAreaSciencePark andtwo Physics, theInternationalSchoolforAdvanced such astheInternationalCentreforTheoretical internationally acknowledgedscientificinstitutes, is quitesubstantial.FVGRhostsseveral Annual investmentinresearchanddevelopment of thepopulation)(1). by thepresenceofyoungforeignresidents(8.6% Miramare Castle,Trieste Table 1. Socioeconomic indicators, FVRG and Italy, 2017

Indicators FVGR Italy Gross domestic product (GDP) (euros per capita) 28 600 26 700 GINI index 0.27 0.33 Unemployment rate (%) 6.9 11.3 Research and development (euros per capita) 457.4 366.7 Life expectancy at birth (years) 82.4 83.1 Male 80.3 80.6 Female 85.4 85.1 Gender gap 5.1 5.5 Old-age index (%) 208.8 165.1 Structural dependency ratio (%) 61.4 55.8 Old-age dependency ratio 41.5 34.8 People at risk of poverty/social exclusion (%) 16.7 29.9 Severe material deprivation rate 6.5 12.1 Total annual health spending (euros per capita) 2 474 2 418 Out of pocket expenses (euros per capita) 561 569

Source: Regione in cifre 2017 [Region in figures 2017](1) .

As in most developed countries, the top three social policies is equivalent to 55% of that of the causes of death in FVGR are cardiovascular, Regional Government. oncological and respiratory diseases and, In FVGR, there is a strong orientation towards the therefore, much effort is spent on health- voluntary sector and 1196 voluntary organizations promotion programmes (Table 2). The budget are actively engaged in voluntary activities. for health care, health promotion, prevention and

Table 2. Health indicators, FVRG and Italy, 2017

Indicators FVGR Italy Self-rated health status (at least “very good”) (%) 82.7 81.2 Overweight (%) 35.3 31.7 Obesity (%) 10.6 10.5 Average use of tobacco (a day) 10 11.5 Habitual excess consumption of alcohol (%) 11.9 10.4 People who practise sport (%) 39.5 34.8

Source: Regione in cifre 2017 [Region in figures 2017](1) .

FVGR has been working for years towards being a “region for everyone” with a friendly and supportive environment suitable for children, people with disabilities and older people. It has also been engaged for a very long period in efforts to reduce inequities in health and pursue an equity-in-all-policies approach.

Friuli Venezia Giulia, Italy Strengths

The strengths of FVGR are the following: 99 high respect for the environment; 99 awareness at the political level of the importance of 99 quality health and social services that are easily investing in health promotion and primary prevention; accessible to everyone; 99 the dedication of a high percentage of the regional 99 well-integrated health-care and social services; budget to health and social services. 99 intersectoral programmes involving institutions, local agencies, nongovernmental organizations and volunteers working towards creating a friendly environment in the region;

Aspirations

It is the aim of FVGR to: 99 keep politicians interested in investing in prevention 99 reduce inequities in health and meet citizens’ needs, projects; within the available budget; 99 increase the budget for health promotion and 99 reduce out-of-pocket expenses. prevention;

Challenges

These relate to: 99 an ageing population; 99 a high unemployment rate; 99 a low birth rate; 99 increased poverty in the fragile segments of the population.

Potential areas of collaboration

FVGR is interested in collaborating with other regions on: 99 empowering and educating people, using a life- 99 gender-transformative health promotion; course perspective from childhood; 99 building citizens’ resilience and increasing their 99 projects related to “ageing in place” and “silver participation in health-related decision-making economy” to tackle the challenges of an ageing processes. society;

Friuli Venezia Giulia, Italy Working groups

FVGR is interested in participating in working groups on: 99 the Sustainable Development Goals (SDGs) (3)/equity; 99 women’s/men’s health; 99 participatory approaches/resilience; 99 the all-of-government approach/intersectoral action.

People active in the Regions for Health Network (RHN)

Renata Bagatin Gianna Zamaro Vice president of the Regional Health Commission Health Promotion and Prevention Friuli Venezia Giulia Region Central Direction of Health Trieste Friuli Venezia Giulia Region Email: [email protected] Trieste Email: [email protected]

References

1. Regione in Cifre 2017 [Region in figures 2017]. Trieste: Department of Strategic Planning, Management Control and Statistics of Autonomous region of Friuli Venezia Giulia; 2017 (http://www.regione.fvg.it/rafvg/cms/RAFVG/GEN/ statistica/FOGLIA40/, accessed 4 February 2017). 2. Beveridge W. The Beveridge report, 1942. In: Internet Archive [website]. San Francisco, CA: Internet Archive; 2018 (https://archive.org/stream/in.ernet.dli.2015.275849/2015.275849.The-Beveridge_djvu.txt, accessed 25 February 2018). 3. Sustainable Development Goals. In: Sustainable Development Knowledge Platform [website]. New York: United Nations; 2018 (https://sustainabledevelopment.un.org/sdgs, accessed 21 February 2018).

Friuli Venezia Giulia, Italy