ArticleThe Lancet. Public health2025
State of health and inequalities among Italian regions from 2000 to 2021: a systematic analysis based on the Global Burden of Disease Study 2021.
Article in The Lancet. Public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed.
- Scientific Clinical Trial Publication Productivity in Medical Oncology: A Comparative Analysis and Data Review of Northern and Southern Italy.Clinics and practice · 2026Review
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- Knowledge, Attitudes and Perceived Preparedness Regarding Cardiopulmonary Resuscitation and Automated External Defibrillator Use Among Health-Related University Students: A Cross-Sectional Study.Healthcare (Basel, Switzerland) · 2026Article
- Green radiotherapy: aitro survey on sustainability awareness among Italian radiation therapists.Technical innovations & patient support in radiation oncology · 2026Article
- The silent epidemic within the pandemic: pathophysiology and prediction of post-COVID-19 diabetes.Journal of translational medicine · 2026Review
- Variability in Post-Discharge Mortality Rates and Predictors over Time: Data from a Five-Year Ward-Wide Study.Journal of clinical medicine · 2026Article
- Clinical presentation and effectiveness of antiretroviral therapy in newly diagnosed people living with HIV before, during and after the COVID-19 pandemic.BMJ public health · 2026Article
- Unveiling and understanding health inequalities: A bi-clustering study on SDG3 implementation in the Italian regions.PloS one · 2026Article
- Multidimensional Stratification ofHealthcare (Basel, Switzerland) · 2025Article
- Access to and Use of Health Services by Older Men and Women Experiencing Frailty and Ageing in Place Alone in Italy.Healthcare (Basel, Switzerland) · 2025Article
- Screening and Diagnosis Access for Neglected and Tropical Parasitic Diseases in Italy: A National Survey.Tropical medicine and infectious disease · 2025Article
- Mortality of Three Major Gynecological Cancers in the European Region: An Age-Period-Cohort Analysis from 1992 to 2021 and Predictions in a 25‑Year Period.Annals of global health · 2025Article
- Global epidemiology, burden, and causes of lower extremity and pelvic fractures in the past 32 years.Frontiers in public health · 2025Article
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Abstract
backgroundOver the past two decades, the Italian National Health Service has been gradually decentralised, with Italy's 21 regional governments now responsible for managing their health services. This change, coupled with austerity measures and a steadily ageing population, has adversely affected universal health coverage and equity, exacerbating inequalities and regional disparities. This study aimed to analyse time trends and subnational differences in the burden of disease from 2000 to 2019, and from 2019 to 2021 to capture the effects of the COVID-19 pandemic.
methodsThis study uses estimates for Italy from the Global Burden of Diseases, Injuries, and Risk Factors Study 2021. We analyse trends and geographical differences in disease burden from 2000 to 2021. Metrics include life expectancy, health-adjusted life expectancy (HALE), years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs) observed at national, macroregional, and subnational levels. Percent changes in rates, with both all-age and age-standardised rates, and 95% uncertainty intervals (95% UIs) are reported.
findingsLife expectancy at birth in Italy increased from 79·6 years in 2000 to 83·4 years in 2019, dropped to 82·2 years in 2020 due to COVID-19, and recovered slightly to 82·7 years in 2021. HALE was 70·9 years (95% UI 67·4-73·8) in 2021. Substantial regional disparities were observed: in general, despite higher YLD rates, northern regions had better health outcomes, with higher life expectancy and HALE and lower YLL rates compared with southern regions. Overall, the top causes of YLDs were low back pain (1556·5 [1098·5-2080·2]), falls (926·2 [638·8-1253·8]), and headache disorders (858·0 [173·7-1808·2]). Anxiety and depressive disorders both had substantial increases in the period from 2019 to 2021 (19·8% and 17·3%, respectively). YLDs for Alzheimer's disease and diabetes increased substantially from 2000 to 2019 and 2019 to 2021 (70·6% and 3·0% for Alzheimer's disease and 46·8% and 7·9%, respectively for each timepoint). YLL rates declined for ischaemic heart disease from 2000 (-29·9% in 2019), but increased for Alzheimer's disease and other dementias (54·5%). DALY rates decreased overall from 2000 to 2019, but rose again in 2021 due to the COVID-19 pandemic.
interpretationThe study highlights considerable regional disparities in Italy's health outcomes, driven by demography, heterogeneous health service quality, and economic inequalities. Addressing the increasing burden of Alzheimer's disease, diabetes, and mental health disorders, as well as regional disparities, requires strengthened preventive measures, equitable health service access, and socioeconomic policies, both at the national and regional levels.
fundingBill & Melinda Gates Foundation.
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