Read the following passage and mark the letter A, B, C, or D on your answer sheet to indicate the correct answer to each of the questions

People in the UK enjoy fewer years of good health before they die than the citizens of most comparable European countries as well as Australia and Canada, a major report shows. While life expectancy has improved by 4.2 years in the UK over the two decades, other countries have improved faster. In 2010, Spain topped the league. Its people could expect 70.9 years of healthy life - before disease and disability began to take a toll. Second came Italy, with 70.2 years and third was Australia, on 70.1 years. In the UK, we can expect 68.6 healthy years of life.

Hunt said the UK was a long way behind its global counterparts and called for action by local health commissioners to tackle the five big killers - cancer, heart disease, stroke, respiratory and liver diseases. Drinking and drug use have been the main issues behind the worsening of the UK's ranking in early deaths among adults aged 20-54. In 2010, drugs were the sixth leading cause of death in this age group and alcohol was 18th - up from 32nd and 43rd place respectively 20 years earlier. Hunt will on Tuesday announce a strategy to tackle cardiovascular disease, which he says could save 30,000 lives a year. "Despite real progress in cutting deaths, we remain a poor relative to our global cousins on many measures of health, something I want to change," he said. "For too long we have been lagging behind and I want the reformed health system to take up this challenge and turn this shocking underperformance around.” However, the problem is only in part to do with hospital care much of it is about the way we live. Our diet, our drinking and continuing smoking habits all play a part, which assumes its responsibilities on 1 April.

https://www.theguardian.com

The word “it” in paragraph 2 refers to ________?