(1) Influenza causes a significant health and socio-economic burden every year, and health personnel (HP) are at higher risk of exposure to respiratory pathogens than the general population. (2) The study’s purpose was to describe and compare influenza vaccine uptake and its prognostic factors among Medical Doctors (MDs) and Non-Medical Health Personnel (NMHP) vs. Non-HP (NHP). We analyzed 2014–2018 data (n = 105,608) from the Italian Behavioral Risk Factor Surveillance System PASSI that, since 2008, has been collecting health-related information continuously in sampled adults. (3) MDs and NMHP represented, respectively, 1.1% and 4.6% of the sample. Among HP, 22.8% (CI 19.8–26.1%) of MDs and 8.5% (CI 7.5–9.5%) of NMHP reported to have been vaccinated vs. 6.3% (CI 6.1–6.5%) in NHP. This difference is confirmed in the three categories (MDs, NMHP, NHP), even more across age groups: in 18–34 yy, respectively, 9.9%, 4.4%, 3.4% vs. 28.4%, 13.9%, 10.6% in 50–64 yy. PASSI surveillance shows an increasing influenza vaccination uptake over time, especially among MDs (22.2% in 2014 vs. 30.5% in 2018). (4) Despite such an increase, especially among younger HP, influenza vaccination uptake is low. Even more under pandemic scenarios, these figures represent key information to address effective strategies for disease prevention and health promotion.

(1) The percentage of the world’s urban population is 56% and is expected to reach 68% by 2050. In this study, we have investigated the dimensions of individual health by relating them to the type of residing municipality. (2) We also analyzed the health status, prevention, lifestyle, and elderly conditions in illustrated from PASSI and PASSI d’Argento (PdA) surveillance systems data by estimating the prevalence rates and adjusted odds ratios (ORs) for different municipal residences. (3) Urban areas negatively influence some health outcomes, such as respiratory system diseases (OR = 1.24; 95% CI 1.18–1.30). With regards to the spontaneous participation in screening programs from female adults residing in urban areas, we observed ORs of 1.24 (1.13–1.37) and 1.30 (1.12–1.39) for breast and uterine cervix cancers, respectively. Urban contexts seem to promote healthy lifestyles, as there is a lower consumption of alcohol in both adult (0.92; 0.88–0.95) and elderly populations (0.85; 0.77–0.94), although sedentary life is more widespread. Compared to elderly residents living in rural settings, urban individuals find their neighborhood less safe and are less considered as a “resource”. (4) Urban areas promote some unhealthy conditions but can also be a valuable source of services and perspectives. According to the increasing urban population, public health policies towards implementing sustainable development should be established.

(1) Age-friendly health systems ensure access to quality healthcare services to all people, especially older adults. (2) We used data on elderly population collected from 2016 to 2019 by the Italian ongoing surveillance system PASSI d’Argento to analyze the prevalence and associations between accessing health services and modifiable risk factors included in the 25 × 25 strategy for the burden of noncommunicable diseases with health outcomes. (3) Chronic diseases and hospitalization as descriptors of health status showed that the elderly perceived as having poor access to care and prevention incurred a higher risk of hospitalization. The association between difficulties in accessing health services and hospitalization was always the highest in terms of the adjusted prevalence ratio (aPR), regardless of the other behavioral risk factors considered, controlling each model with sociodemographic conditions. Elderly hospitalized at least once for two days or more in the last 12 months had greater risk to have problems in accessing health services, whereas the model included health conditions such as obesity (aPR = 1.95 95% CI 1.75–2.17), smoking (aPR = 1.95 95% CI 1.76–2.16), alcohol use (aPR = 1.93 95% CI 1.73–2.14), hypertension (aPR = 1.92 95% CI 1.73–2.13) and diabetes (aPR = 1.91 95% CI 1.73–2.12). (4) Health policies should encompass socio-economic and living environment barriers which prevent access to care among older adults.

(1) Influenza causes a significant health and socio-economic burden every year, and health personnel (HP) are at higher risk of exposure to respiratory pathogens than general population. (2) The study purpose was to describe and compare influenza vaccine uptake and its prognostic factors among Medical Doctors (MDs) and Non-Medical Health Personnel (NMHP) vs Non-HP (NHP). We analysed 2014-2018 data (N=105,608) from the Italian Behavioural Risk Factor Surveillance System PASSI that, since 2008, has been collecting health-related information continuously in sampled adults. (3) MDs and NMHP represented, respectively, 1.1% and 4.6% of the sample. Among HP, 22.8% (CI 19.8% - 26.1%) of MDs and 8.5% (CI 7.5% - 9.5%) of NMHP reported to have been vaccinated vs 6.3% (CI 6.1% - 6.5%) in NHP. This difference is confirmed in the three categories (MDs, NMHP, NHP), even more across age groups: in 18-34yy, respectively, 9.9%, 4.4%, 3.4% vs 28.4%, 13.9%, 10.6% in 50-64yy. PASSI surveillance shows an increasing influenza vaccination uptake over time, especially among MDs (22.2% in 2014 vs 30.5% in 2018). (4) Despite such increase, especially among younger HP, influenza vaccination uptake is low. Even more under pandemic scenarios, these figures represent key information to address effective strategies for disease prevention and health promotion.

Insufficient physical activity (PA) or physical inactivity (PI) is one of the ten leading risk factors for global mortality. PI leads to 20-30% increased risk of all-cause mortality and monitoring its current levels and trends in general population is essential to track progress towards health targets, identify at-risk groups, assess policies' effectiveness, guide future planning. PASSI (Progressi delle Aziende Sanitarie per la Salute in Italia - Progresses in ASSessing adult population health in Italy) is an ongoing cross-sectional Behavioral Risk Factor Surveillance System (BRFSS) that monitors prevalence and temporal trends for the major modifiable health-related risk factors in the adults (18-69 years) residing in Italy. Data are collected in the Local Health Units (LHU) by trained personnel who administer a standardized questionnaire telephonically to sampled people. In the period 2015-2018, 132,717 people were interviewed in more of 90% LHUs (89 out of 101 in 2018), achieving a response rate above 80%. Concerning PA/PI, respondents are classified as per the WHO indicators in: (i) Active - basing on levels achieved in leisure time and/or heavy work; (ii) Partially active - in leisure time and/or moderate work or in spare time and without regular work; (iii) Inactive - in leisure time with sedentary work or in spare time and without regular work. PASSI calculates prevalence of PA/PI overall and by socio-demographic characteristics, including 95% confidence intervals (CI), and a logistic regression model estimates adjusted prevalence ratios (APR). In Italy, 28.8% (CI95%:28.5-29.1%) of adult population is featured by a sedentary lifestyle: PI is greater among women (32.4% vs. 25.1%; APR: 1.26), grows with age (34% in over50 vs. 24.7% among 18-34 year-old; APR: 1.34), is higher among deprived people both per economic difficulties (41.7% if many vs. 22.4% if none; APR: 1.39) and for education level (23.7% university vs. 47.2% primary/any; APR: 1.33). We observed a highly evident geographic gradient: PI amounts to 18.3% in the North, 25.2% in the Centre and 40.6% in the South. A multivariate analysis confirms these values are statistically significant. PASSI data provide strong evidence to support community prevention interventions on territorial planning or advice by health professionals.

Background: Worldwide, approximately 50 million people live with dementia. The Lancet Commission, in its latest report in 2020, identifies 12 ‘modifiable’ risk factors associated with dementia, estimating that they account for about 40% of overall dementia cases. The study aimed to estimate the population attributable fraction (PAF) of dementia cases in Italy due to these factors. Methods: Relative risks (RR) of each factor and formulas for estimating PAF are derived from the Lancet Commission’s report. Prevalence data were obtained from the Italian surveillance systems PASSI and PASSI d’Argento (PdA), which provide information on 11 of the 12 identified risk factors. The total sample 2017-19 included 86,494 individuals aged 18-64 and 48,516 individuals aged over 65. The Communality, used for ‘weighted’ estimates of PAFs, was calculated via principal components analysis of the inter-risk-factor tetrachoric correlation matrix, using data derived from the overall PASSI and PdA sample. Results: In Italy, it is estimated that 39.5% of dementia cases are attributable to 11 of the 12 modifiable risk factors, equivalent to 445,150 out of 1,126,961 estimated cases as of January 1, 2023. Among the risk factors with the greatest impact are hypertension before the age of 65 (weighted PAF=6.3%); sedentariness after the age of 65 (weighted PAF=5.9%); low education in youth (weighted PAF = 5%); depression and social isolation after the age of 65 (weighted PAF=4.5% and 4.4%), as well as diabetes (weighted PAF=3.9%) and smoking (weighted PAF=2.4%). Conclusions: Although it is necessary to to gather further evidence on the role and mechanisms of action of each factor, the importance of prevention and promotion of health and social well-being in the field of dementia is now evident. Key messages: • Having an overall national sample of adults and elderly people is a unique tool that allows an estimation of dementia cases attributable to modifiable risk factors. • Dementia prevention may also be possible by acting on modifiable risk factors.