1.5. The impact of diseases

When talking about disease impact and the indicators used in the prevention initiative area, a special role is played by avoidable mortality. A cause of death is considered “avoidable” when actions are known that can reduce the number of deaths it causes, particularly in the non-elderly population. Overall, in 2008, deaths amongst the population below the age of 75 attributable to groups of causes considered as being preventable with primary prevention schemes amount to just under 51,000. The comparison with the data for previous years shows a decreasing tendency in mortality for this group of causes. Important differences in gender can be observed. Whereas deaths for this group of avoidable causes represent a mere 3.8% of total female deaths, amongst men the percentage rises to 14.0% and, if we consider deaths in the under-75s, the weight of the group of causes that are avoidable with primary prevention rises to 36.9% for men and 18.5% for women. Overall in this group, the largest component is represented by cancer (43.8%) particularly lung cancer (34.7%); followed by cardiovascular diseases, represented entirely by ischaemic heart disease (31.9%), and trauma (22.2%).

In 2008, of approximately 12 million hospital discharges, just under 940,000 indicated one of the diseases in the group avoidable with primary prevention schemes as the main diagnosis. Similarly to mortality, for hospital admissions too there are important gender differences. “Avoidable” hospital admissions accounted for 4.8% of all female admissions and 11.3% of those amongst males and, if we consider the population under 75, these percentages rise to 14.2% for men and 6.1% for women.

The largest component of the group of causes of hospital admissions that could be avoided by primary prevention is constituted by “external” causes, i.e. poisoning and trauma, which overall account for 62.6% of the group of causes considered, but reach 73.2% amongst women (compared to 57.6% in men). In second place, in percentage terms, comes ischaemic heart disease (which accounts for 27.7% of the total amongst men and 18.1% amongst women), followed by the cancer group (12.1% in men and 6.6% in women).