What it is
The European Health Interview Survey (EHIS), carried out in all EU Member States , focuses on the main aspects of the population’s health conditions and use of health services. This survey is important for the possibility to compare the main health indicators not only among the Italian regions but also among Member States. The survey results are of great social relevance as they allow monitoring main aspects of health, essential for the national health planning to meet the citizens’ needs and contribute to defining European policies.
The survey is required by Regulation (EU) n. 255/2018 of the Commission, dated 19 February 2018 (which implements Regulation (EC) No 1338/2008 of the European Parliament and of the Council as regards statistics based on the European Health Interview Survey – EHIS).
The survey is included in the National Statistical Programme (cod. IST 02565), which collects the statistical surveys in Italy.
Who is interviewed
The survey is carried out on a sample of approximately 30,000 households, resident in almost 840 Italian municipalities heterogeneous in terms of population size.
The whole members of the randomly selected household are interviewed. If one of the members is away from home, the interviewer will request an appointment within the survey timeframe. Each member has to respond personally to questions. Some exceptions are allowed: a family member can respond on behalf of the person concerned if this person is absent for the entire survey timeframe, if he/she is hospitalized or if he/she has a serious permanent health problem (proxy technique). Furthermore, if the person is aged under 15 the answers must be provided by a parent or adult of the family.
How the households are selected
The households are randomly extracted from the municipal registry lists or from the list of households in the sample of municipalities used for the census of 2018. The sampling design provides a statistically representative sample of the resident population in Italy.
Some days before starting the survey, the households selected are sent an informative letter signed by the President of ISTAT (Italian National Institute of Statistics) introducing the survey.
The survey is conducted during two periods: April-June and September-December 2019. Some of the sample municipalities participate in both survey periods, while others are involved in only one of the two periods.
How data is collected
The information is gathered by a face-to-face interview, using a paper questionnaire filled in by an interviewer (PAPI technique: Paper and Pencil Interviewing), and by two questionnaires self-administered by the members of the household, as indicated below.
The interviewer collects the information face-to-face with the yellow questionnaire (Questionnaire A). This questionnaire includes a general sheet, the family questionnaire and the individual forms, one for each member. Two other questionnaires are self-administered : a blue one, for people aged 15 and over (Questionnaire B) and a pink one, for women aged 18-54 (Questionnaire C).
It should be noted that most of the questions are set by Regulation (EU) n. 255/2018, which requires information on the population aged 15 and over regarding health conditions, health care and health determinants, as well as socio-demographic characteristics.
Furthermore, the European Commission has invited Member States to include other topics on a voluntary basis. ISTAT decided to add questions on mental well-being, social participation, patient experience and others related to the children’s health to support health policies on childhood and adolescence. Finally, to meet specific national and international information needs, ISTAT has further integrated the EHIS questionnaire with a few additional questions addressed to respondents aged 15 years and over.
How data is stored at the end of statistical processing
The identification data (names of the household members) are deleted at the end of the processing, at the latest after 24 months from the end of the survey. The other data, appropriately processed and pseudonymised, are stored by ISTAT beyond the end of the survey for a maximum of 120 months, because they are necessary for further statistical processing.
How to consult the results of the survey
The main survey results are made available on the ISTAT website both through the statistical reports, under the topic “Health and health care”, and through data tables. Furthermore, the individual data collected (“microdata files”) are made available, free of charge, for users and researchers for scientific research purposes. In any case, these files lack the identifying data of the individuals, as well as any other data that allows, even indirectly, to trace back the household or its members.
For the previous wave of the survey, performed in 2015, the results are available on the ISTAT website:
- Elderly: health conditions in Italy and in the European Union – Statistics report
- Mental health conditions at various stages of life – Statistics report
- Prevention and lifestyles in Italy and in the European Union (in Italian only) – Dataset
- Health conditions and use of health services in Italy and in the European Union (in Italian only) – Dataset
- Microdata for public use
- Microdata for researchers
As regards the metadata of the survey, as well as the information collected, the activities of prevention, control and evaluation of the error and the indicators of coverage and non-response, the SIQual quality information system can be consulted.
Obligation to respond
This survey, is included in the 2017-2019 National Statistical Program (code IST-02565), approved by the Presidential Decree 31 January 2018, and in the National Statistical Program 2017-2019 – Update 2018-2019, currently being approved. ISTAT is obliged to carry it out by law.
The progress of the approval process for the aforementioned National Statistical Program can be found in the Regulations section.
The obligation to respond for this survey is established by the art. 7 of the Legislative Decree n. 322/1989 and by the Presidential Decree 31 January 2018 of approval of the National Statistical Program 2017-2019 reporting the list of surveys with the obligation of response for private subjects. For children under 15 years old there is no obligation to respond.
Special categories of personal data (sensitive data)
The current legislation establishes that the respondent has the right to answer or not to sensitive questions (special categories of personal data – Article 9 Reg. (EU) 2016/679). Those questions are reported by the interviewer during the interview and they are easily identifiable in the questionnaires because they are marked with a letter “S” in red, in correspondence of the single question or group of questions (Sections). Furthermore, in the case of completing the individual questionnaire (MOD.ISTAT / EHIS3 / A.19 – Yellow model) with the proxy technique, the interviewer can report the reason for the proxy response in question 2 of the section “Reserved to the interviewer ” only after having acquired the consent of the person who provided the information.
All questions relating to children under 15 years old, including those of a non-sensitive nature, are not subject to a response obligation.
Following the prescriptions of the Italian Data Protection Authority (provision n. 94 of 11 April 2019), the list of sensitive questions has been expanded and reported in the information letter to households signed by the President of ISTAT. Therefore, the sensitive questions for which there is no obligation to respond are:
- for the individual questionnaire (MOD.ISTAT / EHIS3 / A.19 – Yellow Model): all the questions of section 2; for section 3, question 3.1; all the questions of sections 4, 7, 8, 9, 10, 11, 12, 13, 14, 15; for section 16, questions 16.1 and 16.2; for section 17, question 17.1; all the questions in sections 18, 19 and 20; for the section 21 the question 21.3; all the questions of the section 25; as well as for the part “Reserved to the interviewer ” at the end of each individual form, the question 2;
- for the questionnaire for self-compilation (MOD.ISTAT / EHIS3 / B.19 – Blue Model): the questions of sections 3, 4, 5 and 6;
- for the questionnaire for self-compilation for women aged 18-54 (MOD.ISTAT / EHIS3 / C.19 – Pink Model): all the questions of the model.
Protection of confidentiality
The information collected is protected by statistical confidentiality (Article 9 of Legislative Decree No. 322/1989) and subject to the legislation on the protection of personal data (EU Regulation 2016/679 and Legislative Decree No. 196/2003 and d.lgs. n. 101/2018). This information may be used, also for subsequent processing, by the subjects of the National Statistical System, exclusively for statistical purposes, as well as to be communicated for scientific research purposes under the conditions and according to the procedures set forth in art. 5-ter of the legislative decree n. 33/2013. The same data will be disseminated as aggregate data so that it is not possible to trace back to the people who supplied, thus ensuring maximum confidentiality.
ISTAT – National Institute of Statistics, Via Cesare Balbo, 16 – 00184 Rome is responsible for personal data processing (art. 24 of Regulation (EU) 2016/679). ISTAT, has assigned specific tasks and functions connected to the treatment of personal data to the Director of the Central Directorate for Social Statistics and the Population Census and to the Director of the Central Directorate for Data Collection according to their respective tasks (Article 2-quaterdecies Legislative Decree No. 196/2003).
The Directors can be contacted:
- as concerns the rights of people involved in the survey;
- to know the names of the persons responsible for personal data processing on behalf of ISTAT in the phase of data collection and in the management of the toll-free number (pursuant to art. 28 of the Regulation (EU) 2016/679).
To exercise those rights, it is possible to write to the address: firstname.lastname@example.org.
The exercise of the aforementioned rights will be guaranteed in compliance with the provisions of Chapter III of the Regulation (EU) 2016/679, without prejudice to the exceptions and limits set by art. 6-bis of the legislative decree n. 322/1989 and by art. 11 of the Deontological Rules for treatments for statistical or scientific research purposes carried out within the National Statistical System. Furthermore, the interested party has the right to lodge a complaint with the Italian Data Protection Authority or other competent control authority (art. 77 of EU Regulation 2016/679).
Toll free numbers:
First period: 800.811.177 working from 12 April to 30 June 2019 Monday-Friday 9am-7pm.
Second period: 800.188.847 working from 2 September to 15 December 2019 Monday-Friday 9am-7pm.