Luca De Biase & Enrico Giovannini
29 May 2024
Enrico Giovannini, scientific director of the Italian Alliance for Sustainable Development, ASviS.
The sustainable development model is about meeting the needs of the present generation without jeopardizing the ability of future generations to meet their own needs. Agenda 2030 is a global action plan to guide the world population to move in this direction and it was approved by the United Nations on September 25, 2015. The Italian Alliance for Sustainable Development (ASviS) was born on February 3, 2016, “to raise awareness on the importance of the 2030 Agenda and to mobilize Italian society, economic and social actors, and institutions in order to achieve the Sustainable Development Goals.” The third of the 17 goals of the 2030 Agenda concerns health and well-being: “Ensure health and well-being for all and for all ages.” Every year ASviS produces a Report that assesses how close Italy has come to achieving the 2030 Agenda goals. And in the latest report, we do not find particularly comforting results regarding Goal 3. Indeed, the indicator developed by ASviS reports that while up to 2019 there was a clear improvement-particularly due to the 1.4-year increase in life expectancy between 2010 and 2019-then the trend is less positive. Since then, alcohol consumption and smoking are back on the rise, along with an increase in sedentariness. “The share of people who report smoking increases by 1.51 percentage points from 2019 to 2022, while the share of sedentary people increases by 0.8 percentage points.” In addition, there is a regional polarization, with the differences between the average of the five best and five worst regions increasing.
The sustainable development model is about meeting the needs of the present generation without jeopardizing the ability of future generations to meet their own needs. Agenda 2030 is a global action plan to guide the world population to move in this direction and it was approved by the United Nations on September 25, 2015. The Italian Alliance for Sustainable Development (ASviS) was born on February 3, 2016, “to raise awareness on the importance of the 2030 Agenda and to mobilize Italian society, economic and social actors, and institutions in order to achieve the Sustainable Development Goals.” The third of the 17 goals of the 2030 Agenda concerns health and well-being: “Ensure health and well-being for all and for all ages.” Every year ASviS produces a Report that assesses how close Italy has come to achieving the 2030 Agenda goals. And in the latest report, we do not find particularly comforting results regarding Goal 3. Indeed, the indicator developed by ASviS reports that while up to 2019 there was a clear improvement-particularly due to the 1.4-year increase in life expectancy between 2010 and 2019-then the trend is less positive. Since then, alcohol consumption and smoking are back on the rise, along with an increase in sedentariness. “The share of people who report smoking increases by 1.51 percentage points from 2019 to 2022, while the share of sedentary people increases by 0.8 percentage points.” In addition, there is a regional polarization, with the differences between the average of the five best and five worst regions increasing.
Luca De Biase
What is the relationship between sustainability, health, and well-being?
What is the relationship between sustainability, health, and well-being?
Enrico Giovannini
The whole 2030 Agenda suggests an integrated approach between all the dimensions that are needed by humanity to define a new development model, aiming at sustainability from all perspectives. The goal of health is obviously linked to the goals of fighting poverty and hunger, for example, just as it is linked to education. The central point, however, is that the health of people and the health of the environment are fundamentally connected, indeed they are two sides of the same coin, a concept that is referred to as “One Health.”
The whole 2030 Agenda suggests an integrated approach between all the dimensions that are needed by humanity to define a new development model, aiming at sustainability from all perspectives. The goal of health is obviously linked to the goals of fighting poverty and hunger, for example, just as it is linked to education. The central point, however, is that the health of people and the health of the environment are fundamentally connected, indeed they are two sides of the same coin, a concept that is referred to as “One Health.”
Luca De Biase
However, all this also requires the adoption of a similarly integrated model of development. And an idea of health that in turn integrates lifestyles, treatment strategies, prevention…
However, all this also requires the adoption of a similarly integrated model of development. And an idea of health that in turn integrates lifestyles, treatment strategies, prevention…
Enrico Giovannini
Of course, and in order to achieve innovation, bold initiatives must also be taken. For instance, in order to improve lifestyles and simultaneously lower health care costs, it is emerging the idea to recognize that poor nutrition should also be discouraged by stipulating that obese people have some penalty when it comes to drawing up priority lists for access to health care facilities. This is a very controversial measure, but the fact that we are talking about it is very significant.
Of course, and in order to achieve innovation, bold initiatives must also be taken. For instance, in order to improve lifestyles and simultaneously lower health care costs, it is emerging the idea to recognize that poor nutrition should also be discouraged by stipulating that obese people have some penalty when it comes to drawing up priority lists for access to health care facilities. This is a very controversial measure, but the fact that we are talking about it is very significant.
Luca De Biase
That might have an educational effect, for sure. But doesn’t it require a willingness of public facilities to take on very heavy responsibilities?
That might have an educational effect, for sure. But doesn’t it require a willingness of public facilities to take on very heavy responsibilities?
Enrico Giovannini
There is the risk of creating an “ethical state”. In China, this is not a problem, as we know: social scoring is now integrally part of the system by which values advocated by the state become obligations for citizens. In Western civilizations, the freedom to choose one’s own food or to decide one’s own lifestyle are considered unquestionable values, only to then complain about the enormous costs of hospital care. In any case, it must be admitted that an integrated approach also means addressing these kinds of problems, while acknowledging that for many people, poor nutrition is not the result of choice, but stems from limited economic resources.
There is the risk of creating an “ethical state”. In China, this is not a problem, as we know: social scoring is now integrally part of the system by which values advocated by the state become obligations for citizens. In Western civilizations, the freedom to choose one’s own food or to decide one’s own lifestyle are considered unquestionable values, only to then complain about the enormous costs of hospital care. In any case, it must be admitted that an integrated approach also means addressing these kinds of problems, while acknowledging that for many people, poor nutrition is not the result of choice, but stems from limited economic resources.
Luca De Biase
Well, in some ways, the issue was also raised when the vaccine requirement was introduced.
Well, in some ways, the issue was also raised when the vaccine requirement was introduced.
Enrico Giovannini
Exactly, that instance shows that certain public choices can be made in the name of collective interest. Perhaps they should be made not on the basis of ethical motivation, but rather on true scientific analysis.
Exactly, that instance shows that certain public choices can be made in the name of collective interest. Perhaps they should be made not on the basis of ethical motivation, but rather on true scientific analysis.
Luca De Biase
A scientific analysis that some people will always end up disputing but that in the end is the best way to build models of public action that integrate diverse interests and goals.
A scientific analysis that some people will always end up disputing but that in the end is the best way to build models of public action that integrate diverse interests and goals.
Enrico Giovannini
Yet it is a path that can uncover realities that are ultimately good for everyone. It is about really dealing with data, with an open mind and attention to even seemingly minor facts.
Yet it is a path that can uncover realities that are ultimately good for everyone. It is about really dealing with data, with an open mind and attention to even seemingly minor facts.
Luca De Biase
For example?
For example?
Enrico Giovannini
An interesting case was the result of an initiative of the Clinton Foundation. In that case the goal was to reduce the distribution of carbonated beverages to children at school. Of course, the manufacturers were opposed to this. But the Foundation was able to show that if children drink too many carbonated beverages, they increase their chances of developing diabetes. And it linked this to a new perspective on the interests of the manufacturers themselves. People with diabetes obviously stop drinking carbonated beverages for life. And so the math is quickly done. If a manufacturer sells carbonated beverages to children, it risks losing the ability to sell them to the same people for a much longer time when they have become adults. So if a manufacturer avoids selling carbonated beverages to children, it increases its total sales and thus its long-term profitability.
An interesting case was the result of an initiative of the Clinton Foundation. In that case the goal was to reduce the distribution of carbonated beverages to children at school. Of course, the manufacturers were opposed to this. But the Foundation was able to show that if children drink too many carbonated beverages, they increase their chances of developing diabetes. And it linked this to a new perspective on the interests of the manufacturers themselves. People with diabetes obviously stop drinking carbonated beverages for life. And so the math is quickly done. If a manufacturer sells carbonated beverages to children, it risks losing the ability to sell them to the same people for a much longer time when they have become adults. So if a manufacturer avoids selling carbonated beverages to children, it increases its total sales and thus its long-term profitability.
Luca De Biase
All of this can be contemplated only by reasoning scientifically, even in the smallest choices of communal life. However, it is necessary to follow a trajectory of thought that is more open than the one that only considers health as an achievement of care, rather than a consequence of prevention…
All of this can be contemplated only by reasoning scientifically, even in the smallest choices of communal life. However, it is necessary to follow a trajectory of thought that is more open than the one that only considers health as an achievement of care, rather than a consequence of prevention…
Enrico Giovannini
The essential interpretative model must indeed change. Once, it was expected that the graph of people’s health and well-being would inevitably be characterized by a declining line as age increases. Today, the aim is to strive for a rectangular-shaped figure, where health remains at an optimal level until the end, before declining rapidly. But to achieve this goal, one must consider that care and prevention are indispensable throughout life. This is why public health institutions should encourage citizens to choose a healthy diet and lead an active lifestyle: these suggestions are an integral part of the health policy itself. Furthermore, a public authority offering its services in this way must, in turn, integrate them into a policy that fights poverty and hunger, ensures quality food for all and at all ages, and commits to improving education at all levels.
The essential interpretative model must indeed change. Once, it was expected that the graph of people’s health and well-being would inevitably be characterized by a declining line as age increases. Today, the aim is to strive for a rectangular-shaped figure, where health remains at an optimal level until the end, before declining rapidly. But to achieve this goal, one must consider that care and prevention are indispensable throughout life. This is why public health institutions should encourage citizens to choose a healthy diet and lead an active lifestyle: these suggestions are an integral part of the health policy itself. Furthermore, a public authority offering its services in this way must, in turn, integrate them into a policy that fights poverty and hunger, ensures quality food for all and at all ages, and commits to improving education at all levels.
