When analysing the organization and financing of public health in Italy two important aspects need to be considered. In addition, at the other end of the age spectrum, older people in Italy tend to be less healthy compared to their European counterparts, as measured by the average number of healthy life years at age 65, which in 2013 was lower than the EU average and the sixth lowest among this group of countries (OECD, 2015 Eurostat, 2016 Ministry of Health, 2011a). For example, in 2014 some 9.8% of children were obese and 20.9% overweight, placing Italy among the highest levels of childhood obesity in Europe (Okkio alla Salute, 2016). At the same time, Italy is lagging behind on some public health indicators, in particular the reduction of risk factors of chronic diseases. In 2013, average life expectancy in Italy was, at 82.8 years (OECD, 2015), the fourth highest in the OECD. The Law is commonly identified as a turning point, through its significant role in weakening or eliminating epidemics and in reducing mortality rates, trends that continued well into the 1940s. Italy has a long-standing tradition on public health and health promotion, with the 1888 Law on Hygiene, Health Protection and Public Health conceptualized and co-signed by Luigi Pagliani, the first Italian Professor of Hygiene and founder (in 1878) of the Italian Society of Hygiene, Preventive Medicine and Public Health (SItl). Since 1978, three major reforms have remodelled the publicly funded health system: they introduced elements of an internal market, gave managerial autonomy to local health authorities and public hospitals, and, with the reform of the Constitutional Law, gave more autonomy and power to Italy’s regions (Ferrè et al., 2014). In addition, human dignity, health needs and solidarity were set out as the guiding principles of the NHS. The main aims of the NHS are to provide equal access to uniform levels of health services, irrespective of income or location develop disease prevention schemes control health spending and ensure public democratic control (Ferrè et al., 2014). Italy has a tax-funded National Health Service (NHS Servizio Sanitario Nazionale, SSN), established in 1978, which guarantees the provision of comprehensive health services to the entire population.
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