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Emerging Infectious Diseases Journal


Volume 5: No. 3, July 2008

Using the Italian Surveillance System (PASSI) as a Model to Track Health Conditions and Risk Behaviors in Corsica


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Suggested citation for this article: Vignally P, Baldissera S, Arrighi J, Amoros JP, Binkin N. Using the Italian Surveillance System (PASSI) as a model to track health conditions and risk behaviors in Corsica [letter]. Prev Chronic Dis 2008;5(3).
. Accessed [date].

To the Editor:

In their study, Zindah et al (1) show that common risk factors (e.g., obesity, poor diet, inactivity) create a major chronic disease burden in Jordan. These findings illustrate the importance of a surveillance system for behavioral risk factors and chronic diseases.

In Europe, chronic diseases are also responsible for the majority of deaths, and the most important risk factors for chronic diseases (obesity, physical inactivity, diabetes, hypertension, tobacco use, alcohol use) are few and largely preventable (2). To assess the impact of health promotion and disease prevention programs and to identify subgroups at greatest risk, the World Health Organization’s 2002 report (3) recommended implementing risk factor surveillance. In the United States, the Behavioral Risk Factor Surveillance System (BRFSS) was established in the early 1980s to monitor the prevalence of health risk behaviors. In the last 20 years, several other countries have established similar surveillance systems. According to Bauman et al (4), key components influencing the successful establishment of such systems are the contributions of regional and local health staff in highlighting the value of locally relevant health risk behavior data, in garnering local resources and support, and in adapting data collection to local conditions. Other factors that characterize successful systems include flexibility and potential for adaptation, thereby balancing the need to collect comparable data across geographic areas against the unique needs of local areas.

In France, the National Institute for Economic Statistics has conducted surveys to obtain national estimates of health risk behaviors among adults. These data, however, are collected only at 5-year intervals, are not available regionally, and may not be appropriate for some regions. As a result, the system may not be particularly useful for regional health agencies that target resources to reduce behavioral risks and consequent illnesses (5).

The French island of Corsica shares common cultural and behavioral characteristics with the neighboring Italian regions of Liguria, Sardinia, and Tuscany. The European Union, through the Community Initiative for the European Regional Development Fund, promotes transnational and interregional cooperation. Specific projects are dedicated to cooperation between French and Italian border regions (6).

In Italy, a new system, PASSI (Progressi delle Aziende Sanitarie per la Salute in Italia), which adapts the BRFSS model to the local situation, is being implemented to monitor behavioral risk factors (7). We have developed a proposal for a pilot study using PASSI to track health conditions and risk behaviors in the Corsican population. Because similar data will be available for neighboring Italian regions, we will be able to compare the situation across regions and states.

The main objectives of the project are to measure health risk behaviors and preventive interventions in Corsica and to make available appropriate health indicators to regional and local policy makers. A series of activities is planned, including conducting the pilot study in Corsica; communicating results to all relevant stakeholders and promoting use of these findings for public health purposes; comparing results with those obtained from the PASSI surveillance system in Liguria, Tuscany, and Sardinia; and evaluating the feasibility of implementing an ongoing surveillance system in Corsica.

Pascal Vignally, PhD
Sandro Baldissera, MD, MPH
Nancy Binkin, MD, PhD

Italian National Institute of Health
National Center for Epidemiology, Surveillance and Health Promotion
Rome, Italy

Jean Arrighi, PhD
Corsican Observatory of Health
Ajaccio, France

Jean Pierre Amoros, MD, MPH
University of Corsica
Unité INSERM U707
Corte, France


  1. Zindah M, Belbeisi A, Walke H, Mokdad AH. Obesity and diabetes in Jordan: findings from the Behavioral Risk Factor Surveillance System, 2004. Prev Chronic Dis 2008;5(1). jan/06_0172.htm.
  2. Strong K, Mathers C, Leeder S, Beaglehole R. Preventing chronic diseases: how many lives can we save? Lancet 2005;366(9496):1578-82.
  3. The world health report 2002: reducing risks, promoting healthy life. Geneva (CH): World Health Organization; 2002. Accessed December 19, 2007.
  4. Bauman AE, Nelson DE, Pratt M, Matsudo V, Schoeppe S. Dissemination of physical activity evidence, programs, policies, and surveillance in the international public health arena. Am J Prev Med 2006;31(4 Suppl):S57-65.
  5. Figgs LW, Bloom Y, Dugbatey K, Stanwyck CA, Nelson DE, Brownson RC. Uses of Behavioral Risk Factor Surveillance System data, 1993–1997. Am J Public Health 2000;90(5):774-6.
  6. Regional policy: Interreg III. Brussels (BE): The European Commission. Accessed December 19, 2007.
  7. Coordinating Technical Group of the Behavioral Risk Factor System. PASSI (Progressi delle Aziende Sanitarie per la Salute in Italia): an Italian behavioral risk factor system. Rapporti ISTISAN: 07/30. Roma (IT): Istituto Superiore di Sanità; 2007. Accessed December 19, 2007.

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The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.


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