Socioeconomic inequality in non-communicable diseases in Europe between 2004 and 2015: evidence from the SHARE survey

Background The scope of this work was to investigate socioeconomic inequalities among European adults aged 50 or older in chronic diseases and behavioural risk factors for these diseases, namely, smoking habits, obesity and physical inactivity, between 2004 and 2015. Methods Data for this study were drawn from the Survey of Health, Ageing and Retirement (SHARE) in Europe, which is a panel database of microdata on health, socioeconomic status and social and family networks of people aged 50 years or older, covering most of the European Union. The predicted number of non-communicable diseases (NCDs) was used to estimate the concentration index and to find the contributions of determinants to socioeconomic inequalities in chronic diseases. Results The inequality disfavoured the poor in both years, but the effect was stable from 2004 (C = 120.071) to 2015 (C = 120.081). Inequality was shown to be attributed mostly to physical inactivity and obesity and this contribution increased during the study period. Among socioeconomic status (SES) determinants, education and marital status were the most concentrated in both years, while physical inactivity and obesity were the most concentrated behavioural risk factors in both years. Conclusions To prevent chronic diseases, health policy should aim not only to improve individual health behaviours in the population, but also to reduce socioeconomic inequality. Our study suggests promoting a healthy lifestyle in the most disadvantaged socioeconomic classes as a strategy to improve the health conditions of the whole population

European Union commitment towards RES market penetration: From the first legislative acts to the publication of the recent guidelines on State aid 2014/2020

Abstract During the last three decades, the European Union (EU) commitment towards the Renewable Energy Sources (RES) market penetration has been very complex, involving several aspects pertaining to the economic and political action of Member States. This paper seeks to overview the historical development of the legislative EU framework, including a description of the main financial programmes established and managed by the EU Directorates General. Moreover, the work will proceed with the picture of some Investment Funds, ad hoc created for RES undertakings, and managed by the European Investment Bank (EIB) in collaboration with the EU or other foreign Bank Institutes. The delicate matter of State aid is discussed, paying particular attention to the transition from 1999 to the recent EU Guidelines (2014/2020), as these wider scopes could lead to an effective and well functioning European Energy Single Market. Focusing the attention on three case-studies, we have produced final remarks on the correct functioning of the EU political framework, giving attention to important improvements needed at infrastructural level. The EU awareness of the power grid limits, that are currently recorded in Europe has lead to further reforms of the legislation, as shown by the new EU Guidelines that will probably support Member States in dealing with the infrastructure challenge

Measuring sustainable economic development through a multidimensional Gini index

This paper analyses the evolution of sustainable economic development inequality in Italy as regards the efforts made by each administrative Region, as a response to the main EU policies issued by the environmental and energy sector. For this purpose a multidimensional generalization of the Gini index has been performed, taking into account two different dimensions (energy and environment), in a time frame of six years (2008-2013). The multidimensional Gini results confirm the positive effect recorded by certain EU policies in determining a reduction in the inequality levels among the Italian Regions. A counterfactual analysis further underlined the relevant role played by the energetic dimension against the environmental one in strengthening Regional performance

L'ACCESSO ALL'ABITAZIONE DI RESIDENZA: UN'ANALISI MULTILEVEL SULLE FAMIGLIE ITALIANE

Objectives. Income inequalities depend on a large range of components, which influence living conditions of private households. Not all these elements are strictly monetary, and non-monetary components sometimes can be even more important than monetary ones. While international literature has devoted considerable attention to the study of distribution, relevance and inequalities concerning monetary income, the same cannot be said for its non monetary components. Despite this lack of attention in the literature, non monetary components often influence dramatically living conditions of private households. One of the most important component of non-monetary income is imputed rents from owner-occupied housing. The main objective of this article is to evaluate the impact of income advantages deriving from owner occupied housing (from now on IR) on income inequalities of Italian households. Methods. Inequality indices measures considered are: Generalized Entropy and Atkinson class, Gini coefficient and percentile ratio. The analysis was carried out using the data set SILC for Italy on the European Statistics on Income and Living Condition collected for Italy from Istat (the Italian National Institute of Statistics). The data set are referred to year 2004 and consider information regarding income and living condition. Results. The analysis show larger income inequalities between groups, once considered IR. In particularly, main differences emerge comparing owner with loan or mortgage and without it with renting households. In the meanwhile, introducing IR causes reductions in income inequalities within groups. If we analyse the distribution of household type, the introduction of IR produces a decrease in income inequality for all household types. Such a generalized decrease determines, as a consequence, an increase in the inequality between groups (from 11% to 16%). Conclusions. The analysis of income distribution in term of classes of age shows an increase in income inequality between age groups for classes of age including elderly people. This result concern the incidence of owners in those classes of age

Risk exposure to vibration and noise in the use of agricultural track-laying tractors

Human exposure to mechanical vibration may represent a significant risk factor for exposed workers in the agricultural sector. Also, noise in agriculture is one of the risk factors to be taken into account in the evaluation of workers’ health and safety. One of the major sources of discomfort for the workers operating a tractors is the noise to which they are exposed during work. The aim of this study was to evaluate the risk of exposure to whole-body vibration for the operator driving track-laying tractors in vineyard orchard and the noise level. The experimental tests were performed with six different track-laying tractors coupled with the same rototilling machine. The results showed that the vibration values of track-laying tractors coupled to rototilling machine, referred to the 8-hour working day, were always higher than 0.5 m s-2, the daily exposure action value established by Directive 2002/44/EC of the European Parliament. The daily noise exposure levels always exceeded the exposure limit value of 87 dB(A) established by Directive 2003/10/EC of the European Parliament. The ANOVA repeated measures model showed that the factor ‘site’, namely, the soil characteristics, did not influence the vibration level on the X and Y-axes of the tractors measured, regardless of their age. In the Z-axis, the vibration level was enhanced as the soil structure increased. As tractor age increased, the influence of soil characteristics was less important. In term of the age of the tractor and the number of hours worked, it was possible to identify three risk classes, which were up to 3,000 hours worked and offered a low risk; from 3,000 – 6,000 hours worked with a medium risk, and over 6,000 hours with a high risk level

Evaluating the effect of organization and context on technical efficiency: a second-stage DEA analysis of Italian hospitals

Objective: the purpose of this study was to compare the technical efficiency of Italian hospitals at a regional level and to examine if differences could be explained by organisational and contextual factors. Technical efficiency was defined as the ability of the operating units evaluated to use optimal resource levels for their level of output. Methods: the effect of external factors was explored through a second stage Data Envelopment Analysis (DEA). Efficiency scores were calculated for each hospital using the DEA method (Stage I). Through Tobit regression analysis, the estimated efficiency scores were regressed against a set of organisational and contextual characteristics beyond managerial control, which reflected differences in the population demographics and regional health expenditure (Stage II). Stage I and Stage II efficiency scores were compared in order to indirectly assess managerial contribution in relation to hospital efficiency. Results: the highest efficiency (M±SD) was observed in hospitals in the North-West (75.7±15.1), followed by those in the North-East (75.5±15.1), Central Italy (73.9±16.4) and then Southern Italy (70.6±17.9). Hospital Trusts (HTs) were shown to be more technically efficient than Local Public Hospitals (LPHs). Organisational and contextual indicators were statistically significantly different at Tobit regression analysis for HTs and LPHs. Emilia Romagna and Lombardia were the regions whose management contributed to increased efficiency. Conclusions: in our study, the distribution of regions according to technical efficiency only partly reflected the North-South gradient shown by other studies regarding the gap of expenditure. The important role of organisation and environment in establishing efficiency differences among hospitals was demonstrated

Lifestyle medicine and psychological well-being toward health promotion: a cross-sectional study on Palermo (Southern Italy) undergraduates

(1) Aim: To assess the attitude toward Lifestyle Medicine and healthy behaviours among students in the healthcare area and to demonstrate its association to psychological well-being; (2) Methods: A cross-sectional study is conducted among 508 undergraduates of the University of Palermo (140 (27.6%) in the healthcare area and 368 (72.4%) in the non-healthcare area), during the academic year 2018–2019. Psychological well-being is measured through two dimensions of eudaimonia and hedonia, using the 10-item Hedonic and Eudaimonic Motives for Activities-Revised (HEMA-R) scale, with answers coded on a 7-point scale. The association between demographic and modifiable behavioural risk factors for chronic diseases is assessed through crude and adjusted Odds ratios with 95% confidence intervals; (3) Results: Orientation to both hedonia and eudaimonia is significantly associated to the Mediterranean diet (ORAdj = 2.28; 95% CI = (1.42–3.70)) and drinking spirits less than once a week (ORAdj = 1.89; 95% CI = (1.10–3.27)) and once a week or more (ORAdj = 6.02; 95% CI = (1.05–34.52)), while these conditions occur together less frequently for current smokers (ORAdj = 0.38; 95% CI = (0.18–0.81)). Students inclined to well-being consider healthcare professionals as models for their patients and all people in general (OR = 1.96, 95% CI = (1.28–3.00)); (4) Conclusions: The positive relation found between a virtuous lifestyle and psychological well-being suggests the construction, development and cultivation of individual skills are a means to succeed in counteracting at risk behaviours for health