National Recovery and Resilience Plan - using the Health Project programming tool in Sardinia: Social Health Districts' mortality and aging index analysis from 2017 to 2021
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School of Hygiene and Preventive Medicine, Medicine Faculty, University of Cagliari, Italy
School of Hygiene and Preventive Medicine, University of Cagliari, Cagliari, Italy
Medicine Faculty, School of Hygiene and Preventive Medicine, University of Cagliari, Cagliari, Italy
Publication date: 2023-04-27
Popul. Med. 2023;5(Supplement):A13
  Background and Objective: A better reorganization of territorial assistance responses depends on identifying the specific social welfare needs of both individuals and collectivity. Focusing on Sardinia Region, in line with recent Italian National Recovery and Resilience Plan’ indications, Population Medicine setting and Health Project programming tool, we should take into account its peculiar heterogeneity: population’ size and demographic characteristics; variation in mortality; oro-geographical aspects of the Social-Health Districts (SHD). Methods: Retrospective observational study on the Italian and Sardinian resident population from 2017 to 2021. Population (Istat demographic data detailed for each municipality to depict Sardinian SHD) divided into 21 age groups, each including five years (0-4/100+). Ratios: Aging index and age-adjusted standardized mortality ratios (SMRs) calculated for the period 2017-2019, for 2020 and 2021, divided by SHD (age groups 0-64/65+). Standardized death rate calculated for the 21 age groups (reference: Italian population, same year). The excess mortality compared to the average baseline deaths calculated for the years 2020 and 2021 (group 0-100+; 0-64; 65+). Results: The regional trend of standardized mortality rate shows an increase in 2020 and a slight decrease in 2021, confirmed by the excess mortality analysis. The SMRs show instead an overall increase in all Districts from 2020 to 2021, except in 7 of them, for the 0-64 range. The aging index is progressively increasing in all Districts, more incisively in some areas. Conclusions: Sardinia has the highest Italian aging index, with uneven dynamics across the Districts. The demographic aging will heavily test healthcare and social security costs. Health professionals and policymakers should therefore work together using as key concepts healthy aging and aging in-place, and paying attention to the elders’ idea of health as “the ability to adapt and self-manage”, focusing more on social environments and ability to use resources and manage restrictions.