Population challenges at a regional level. The social and health districts of Italy

Giuseppe Gesano, IRPPS, CNR, Italy
Frank Heins, IRPPS.CNR, Rome

In 2000 the foundations for a new system to provide social and health assistance in Italy were laid. The goal is the formation of social and health districts (about 700) through the cooperation of the national/regional health system and the social services of the municipalities. Municipalities and the social and health districts are and will be the institutions that have to deal with the regional aspects of population challenges. Italy is characterised by significant regional differences in population distribution, population structure (ageing), demographic trends (population growth/decline) and immigration. A typology of population challenges, based on the formulation of appropriate critical thresholds, will be attempted. The following dimensions of regional population challenges are considered: (1) The settlement density, (2) the population change over the last decennia with important population decline as well as population growth considered a challenge, (3) the ageing of the population measured by the share of the population 65 years and older in the total population, (4) the presence of an immigrant population and its structure. The individual population challenges and the summarizing typology are presented for all social and health districts and sample districts serve to illustrate the existing disparities in detail. The research concludes with an analysis of the perception of the population challenges through local and regional authorities and their, still infrequent, attempts to formulate a response to these challenges (legislation, plans and policy documents governing the workings of the districts). In fact, in Italy the policies of all levels of government continue to rely very often on the family as a provider of social and health assistance. In the meantime the Italian family emerges increasingly as an employer of foreign labour to be able to continue to provide assistance to family members.