In the Sole 24 Ore of Monday 20 May the new index, the result of an elaboration on data from Iqvia, the Ministry of Health and Istat. The index will be used in the 2019 Quality of Life Survey, this year in its thirtieth edition. The index is the result of an analysis of 12 indicators, from which the Health Index was born. The economic newspaper evaluated the incidence of diseases in the area, the possibility of treating them through drugs, access to treatment and the availability of specialized personnel, from childhood to old age, or the need to move elsewhere. There 
ranking is the result of the average of the scores obtained by the various territories in the individual indicators.
The first three provinces ranked see Bolzano in first place, with 651.6 points, followed by Pescara, 633.7 points and Nuoro with 630, 2 points. In last place are Rovigo, Alessandria and Rieti, with 328.1 points.
Over twenty-three million six hundred thousand pills a day to treat hypertension. These are the volumes of drugs consumed in 2018 by Italians for a chronic disease which, unfortunately, affects the population more and more. To cure it are above all the inhabitants of Terni, Rieti and Ferrara, where the highest per capita consumption is recorded. Healthier, from this point of view, are instead the residents of South Sardinia, Bolzano and Sondrio. To say it are the data extracted by the service company for thehealthcare Iqvia on drug consumption hypertension, diabetes and asthma, used for the 2019 Health Index of the Sole 24 Ore. The data are expressed in minimum divisible units - i.e. tablets, pills, vials and so on - purchased and distributed in the following ways: direct sale in local pharmacies (through wholesalers and companies that supply points of sale); distribution of medicines reimbursed on behalf of local health authorities; supplies to public and private hospitals.
From reading Iqvia's data, one emerges higher incidence of some chronic diseases in the southern provinces. For example, in the case of diabetes, the largest number of drugs per capita is consumed in Agrigento, Messina and Taranto. While Bolzano is last in the standings. Furthermore, according to the Passi epidemiological report of the ISS, the incidence of diabetes is higher in people with a low level of education and with economic difficulties, without forgetting the associated risk factors such as familiarity, lack of physical exercise and being overweight. In the case of hypertension, about which again affects lifestyle, the geographical characterization is instead less evident, being widespread throughout the country.
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Considerations
The chosen indicators mainly examine three factors: the demographic aspect for each province (which, as we will see, is very decisive in the interpretation of the ranking), the socio-health phenomena and, then, also the levels of access to health services, from these derive the other indicators. So, the observatory of 
Sole24ore is not a ranking that compares the quality of care provided by healthcare companies. There are other certified tools for evaluating the performance of local health authorities, such as the PreVale study: the regional program for evaluating the outcomes of health interventions.
The demographic factor influences many of the indicators published by the observatory and they are decisive in drawing up the final classification. For example, regarding the mortality rate, the increase in life expectancy and the consumption of medicines for citizens with chronic conditions. In fact, the correlation between the rate of seniority and the consumption of drugs is clear, especially for chronic pathologies. Furthermore, drug consumption itself is not an indicator of the appropriateness or otherwise of the treatments. We omit the considerations on the other parameters considered.
It must be stated that there is no scientifically univocal definition of health. According to the World Health Organization, health implies not only the absence of disease, but also a concurrence of conditions related to the overall well-being of the individual. Not only life expectancy, but also years of life lived in good health. From this point of view, the social and economic conditions of individuals and the population are, in particular, the most important determinants of health.
The Sole24ore observatory should be taken for what it is: a useful tool that provides a picture of the provinces by examining the state of health of its citizens and starting from the analysis of some indicators, excluding many others.
Extract from observations of ASL Viterbo
Related news: P.Re.Val.E. 2018
