Italy: Preventive Healthcare - World Health Systems Facts

Life expectancy at birth, 2021: 82.2 years
Maternal mortality ratio (per 100,000 live births), 2020: 5
Under-five mortality rate (per 1,000 live births), 2022: 3
Neonatal mortality rate (per 1,000 live births), 2022: 2
New HIV infections (per 1,000 uninfected population), 2022: 0.04
Tuberculosis incidence (per 100,000 population), 2022: 4.6
Probability of dying between age 30 and exact age 70 from any of cardiovascular disease, cancer, diabetes, or chronic respiratory disease, 2019: 8.9%
Suicide mortality rate (per 100,000 population), 2021: 7.0
Age-standardized prevalence of hypertension among adults aged 30-79 years, 2019: 33.8%
Age-standardized prevalence of obesity among adults (18+ years), 2022: 17.3%

Source: World health statistics 2024: monitoring health for the SDGs, Sustainable Development Goals: Statistical Annex. Geneva: World Health Organization; 2024. Licence: CC BY-NC-SA 3.0 IGO. Last accessed June 6, 2024.

Population aged 15 years and over rating their own health as bad or very bad, 2021: 8.1%
Population aged 15 years and over rating their own health as good or very good, by income quintile, 2021
– Highest quintile: 79.1%
– Lowest quintile: 72.0%
– Total: 73.5%
Life expectancy at birth, 2021: 82.7 years
Infant mortality, deaths per 1,000 live births, 2021: 2.4
Maternal mortality rate, deaths per 100,000 live births, 2020: 4.6
Congestive heart failure hospital admission in adults, age-sex standardized rate per 100,000 population, 2021: 160
Asthma and chronic obstructive pulmonary disease hospital admissions in adults, age-sex standardized rate per 100,000 population, 2021: 23
Adults aged 65 and over rating their own health as good or very good, 2021: 43%
Adults aged 65 and over rating their own health as poor or very poor, by income, 2021
– Lowest quintile: 24%
– Highest quintile: 14%
– Total: 20%
Limitations in daily activities in adults aged 65 and over, 2021
– Severe Limitations: 16%
– Some Limitations: 32%

Source: OECD (2023), Health at a Glance 2023: OECD Indicators, OECD Publishing, Paris, doi.org/10.1787/7a7afb35-en.

“Over the past 15 years, while the SSN’s [National Health Service] essential structure has not undergone significant changes, most regional health systems have consolidated their governance, planning and delivery systems. However, the government has made substantial adjustments at the national level in the areas of prevention and hospital care, as well as rationalization of the national benefits programme and monitoring. For prevention, the Ministry of Health released a plan to expand vaccination coverage and target populations, increase the number of vaccines to be offered as part of the benefits package and set up an online vaccination registry, as well as enhance measures to improve patient safety.”

Source: de Belvis AG, Meregaglia M, Morsella A, Adduci A, Perilli A, Cascini F, Solipaca A, Fattore G, Ricciardi W, Maresso A, Scarpetti G. Italy: Health system review. Health Systems in Transition, 2022; 24(4): pp.i–203.

“At the local level, the local health authorities provide preventive medicine and public health services, primary care – including mental health, family medicine and community services – and secondary care. The territory of each local health authority is further divided into health districts that directly control the provision of public health and primary care services, manage commissioning and promote integration with social services. In detail, the competences of local health authorities cover:

“ preventive medicine and public health services, delivered by local health authorities’ departments of prevention;
“ community services, including mental health services, primary medical and nursing care, home and residential care for the elderly and the disabled, and hospice care;

“ primary care and GP services, coordinating with health districts;

“ secondary care delivered directly by directly-managed hospitals; accredited private hospitals and specialists;

“ social care and social welfare services delivered by municipal authorities, with varying degrees of integration and coordination with local health authorities.”

“Compared with similar institutions in other countries, the Italian Ministry of Health has broader ‘horizontal’ administrative competences. In addition to health financing and planning, its mandate includes protecting citizens’ health through preventive oversight within industry (e.g. biotechnologies, health and safety at work) and agriculture (e.g. veterinary public health and food safety) and the exchange of specific categories of goods (e.g. manufacturing and marketing of medicines, medical devices and cosmetics). Moreover, enforcement of certain environmental health standards (e.g. air and water quality) also fall within the remit of the Ministry, as does the monitoring of their implementation through SSN structures. Furthermore, the Ministry of Health has close links with the Ministry of Economy and Finance, especially with regard to setting the health care budget, and the Ministry of Labour and
Social Policies for the coordination of social services with SSN infrastructure (Ferrè et al., 2014). The integration of social and health services has been a policy target with an increasing number of interventions: currently, some regions (e.g. Basilicata, Emilia-Romagna, Tuscany, Lombardy) utilize planning approaches that promote the integration of health, social and socio-health care programmes. However, we do not have a clear picture of the actual level of integration between social and health care across the country due to the absence of a social service information system and discharge charts from semi-residential facilities.”

“In 2020, the mortality rates from causes considered generally preventable and treatable in Italy were over 27 % lower than their respective EU averages (Figure 13). Against the backdrop of a nearly 17 % surge in the EU’s preventable mortality rate in 2020, Italy experienced a 29 % increase, reflecting significantly higher COVID-19 mortality among its population under 75 years of age compared to most other EU countries. Despite this increase, Italy’s significantly lower disease prevalence and mortality from ischaemic heart disease, stroke and colorectal cancer contributed to keeping the overall preventable mortality rate low. The main causes of Italy’s preventable mortality were COVID-19 and lung cancer, collectively accounting for over 40 % of all potentially preventable deaths in 2020.

“Over the past decade, Italy’s treatable mortality declined at a rate in line with the EU average, reflecting improvements in mortality rates from ischaemic heart diseases, colorectal and breast cancer. These conditions remained nevertheless the leading causes of death that could be avoided through timely healthcare interventions, accounting for nearly half of all deaths from treatable conditions.”

Source: OECD/European Observatory on Health Systems and Policies (2023), Italy: Country Health Profile 2023, State of Health in the EU, OECD Publishing, Paris/European Observatory on Health Systems and Policies, Brussels.

“In 2021, Italy’s expenditure on prevention reached an unprecedented 6.8 % of total health spending, as additional spending was driven by the procurement of COVID-19 vaccines and tests.”

“Population risk factors such as tobacco consumption, unhealthy diets and alcohol can be attributed to around one third of all deaths in Italy in 2019. In particular, tobacco and dietary risks are major contributors to mortality (Fig. 1.2). In 2020, 46.1% of the adult population was overweight, while 10.8% was obese (IBDO Foundation, 2020), with a higher prevalence registered in the southern regions. Moreover, the proportion of overweight or obese people increases proportionally with age, reaching a peak in the 65–74 age group before declining slightly among the very elderly (IBDO Foundation, 2020). Childhood overweight and obesity rates in Italy are also comparatively high: the European HBSC survey records that almost 19% of 15-year-olds were overweight or obese in 2018 while a national survey of primary school children highlights that 30% of 8- and 9-year-olds were either overweight or obese in 2019 (OECD/European Observatory on Health Systems and Policies, 2021).

“According to national data, the proportion of smokers among the adult population in April 2020 was 21.9% down from 23.8% in 2003, when Law 3/2003 banned smoking in public spaces. But this rate grew throughout the pandemic to 24% in November 2020 and again to 26.2% in May 2021 (ISS, 2022). Smoking cigarettes is more common in young adults and more prevalent among men than women. In 2020, 66.4% of the population consumed alcohol during the year, with 20.6% drinking alcohol every day (Ministero della Salute, 2021a).

“Notwithstanding the important results gained in health status, geographical differences remain in terms of health conditions and lifestyles, as well as in the supply and quality of health services. Southern regions score lower in life expectancy, lifestyles, access to care and quality of services. These data underscore how the tenuous balance between centralized and regional and local control is shifting over time, impacting population health outcomes, and resulting in, arguably, as many as 20 different health care systems within Italy (Ricciardi & Tarricone, 2021).”

“Primary care is generally well developed, though underresourced, and in recent years has experienced a reorganization. It aims to strengthen the role of GPs and paediatricians (who act as gatekeepers to specialist care), promote the integration of care between GPs and other professionals through advanced information technology, and foster the involvement of primary care in preventive activities, including personalizing health interventions based on patients’ risk profiles and being more proactive with healthy individuals. Despite this progress, most GPs still work in solo practices with limited opportunities to share knowledge with other colleagues and no access to diagnostic technologies. Attempts to incentivize different forms of group practice have only taken hold in a handful of regions. Moreover, because of retirements and limited new hirings, the number of GPs has declined over time and a major shortage is expected in the years to come.”

“Prior to the onset of the pandemic, Italy’s screening rates for cervical and colorectal cancer were consistently below the EU average, while the breast cancer screening rate was slightly above it (Figure 15). As in most other EU countries, the pandemic-induced reconfiguration of health services had a negative impact on cancer screening programmes in Italy. Screening activities were halted completely in March and April 2020, and although they gradually resumed over the course of May and June, there were notable variations in the extent of activity resumption both across regions and within them (National Institute for Health, 2022c).

“The temporary suspension of screening programmes led to a significant decline in the breast cancer screening rate, which droppedby nearly 10 percentage points to 52 % in 2020 following a decline of nearly 38 % in the number of mammographies performed compared to 2019. (Osservatorio nazionale screening, 2023). Likewise, the cervical cancer screening rate decreased by 4.3 percentage points to 34 %, and the colorectal cancer screening rate fell by 6.4 percentage points to 34 %. The most substantial reductions in screening rates were observed in the Northern regions, where healthcare systems faced more severe disruptions due to the impact of the COVID-19 pandemic. The combined effects of disruptions in cancer screening activities, lower GP availability and reduced patient adherence resulted in an unprecedented decline in the identification of new malignancies in Italy in 2020. Estimates indicate that disruptions to routine cancer screening pathways in 2020 postponed the detection of at least 3,300 cases of breast cancer, 2,700 cases of cervical cancer, and 1,300 cases of colorectal cancer (Ministry of Health, 2023a). Diagnostic delays have also contributed to an increase in the number of cases diagnosed in later stages, albeit with notable geographical variations linked to the population’s varying levels of engagement in secondary prevention programmes (AIOM, 2022).

“As screening activity volumes rebounded in 2021, screening rates for breast and colorectal cancer partly recovered to levels 92 % and 95 % of their pre-pandemic levels respectively, while the screening rate for cervical cancer even slightly exceeded its 2019 rate.”

Italy: Preventive Healthcare - Lifestyle, environment, nutrition- National Policies - World Health Systems Facts

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Page last updated February 24, 2025 by Doug McVay, Editor.