Domenighetti and the Cantonal Health Section
Gianfranco Domenighetti completed his studies in economics at the University of Fribourg and began his professional activity in 1969 in the Department of Social Affairs of Canton Ticino (today Department of Public Health and Welfare). He directed the Health Section of this department for 37 years, until 2007.
His professional interest focussed on the investigation of health market mechanisms. Using social and economic indicators he developed strategies and actions of health information, prevention and health promotion. Domenighetti intended to increase people’s skills to make informed decisions (empowerment) and thus to promote fairer and more informed access to health care and services. In the 1980’s, he was part of an international study on risk factors of cardiovascular diseases (MONICA) whose results he used to confirm and improve health promotion campaigns in Ticino related among others to nutrition, smoking, physical activity. These health promotion campaigns are still part of the memory of Ticino population.
In search of the most influencial determinants of health, Domenighetti and his team of collaborators paid particular attention to physical, economic and social environment.
Domenighetti was one of the first to understand the necessity of a multisectoral action, needed to support a health-friendly eco-socio-economic environment. Among the objectives of health policy, intersectoral interventions became a priority.
In this context the Health Section developed studies to periodically monitor the health of the Ticino population. In addition, providing information for patients to improve doctor-patient relationship and to know the determinants of consumption of health care and services became important issues of health economics.
Gianfranco Domenighetti was one of the few in Switzerland and internationally to raise attention to the problem of (over)medicalization of society. He pointed to the negative effects of a health policy which was not based on the needs of the population but on the supply of goods and services by the health system.
Domenighetti explained: “once upon a time people asked to be treated because they felt ill; today subjectively healthy people are induced to undergo a whole series of diagnostics to reassure them that they are not “sick”. This was extremely true for the sequel of genetic tests arriving on the health market.
In this context Domenighetti often paraphrased the cavalier Rinaldo in Ariosto’s “Orlando furioso” who, invited to test the loyalty of his wife, replied: “How insane would be whoever would seek what he did not want to find”.
Wisdom is timeless.
Antoine Casabianca
former head of the Health Promotion and Evaluation Office of the Health Section