Italians are living longer than two decades ago, but gains are uneven across the country, and mental‑health problems have climbed since COVID‑19, a new analysis in The Lancet Public Health warns.  

What’s new

Researchers used Global Burden of Disease (GBD) 2021 data to track life expectancy, healthy life expectancy, and the leading causes of death and disability across Italy’s 21 regions from 2000–2021. They also looked at “fatal burden” (years of life lost) and “non‑fatal burden” (years lived with disability) to show where people are dying earlier and where chronic illness is most common.  

Key numbers

• Life expectancy rose from 79.6 years (2000) to 83.4 (2019), fell to 82.2 (2020) with COVID‑19, and ticked up to 82.7 (2021). Healthy life expectancy in 2021 was 70.9 years.  
• North–South divide: Northern regions generally have higher life expectancy and healthy life expectancy and lower early‑death rates than the South and the Islands—despite carrying more non‑fatal, age‑related illness. The pandemic hit the North harder in 2020, but it rebounded in 2021, while outcomes worsened in the South and Islands.  
• Mental health surged: From 2019 to 2021, anxiety disorders rose 19.8% and depressive disorders 17.3%, and have not returned to pre‑pandemic levels.  
• Chronic disease pressure: Disability from Alzheimer’s disease and diabetes has increased over time (Alzheimer’s +70.6% in 2000–2019 and +3.0% in 2019–2021; diabetes +46.8% and +7.9%). The top causes of disability remain low back pain, falls, and headache disorders.  

A country of health contrasts

A map in the study shows that the highest rates of years of life lost cluster in southern regions when age differences are accounted for, whereas the North looks comparatively better on early deaths. This geographic split underscores how where Italians live shapes their health prospects. (Figure 5, p. 8).  

Why it matters

Italy is one of the world’s oldest countries, and an aging population means more long‑term, non‑fatal illnesses—even as people live longer. Women, who live about 4.5 years longer than men, also shoulder more non‑fatal illness, especially conditions like dementia and diabetes. Closing regional gaps will require stronger public services and targeted prevention, the authors argue.  

What experts recommend

The study calls for re‑investing in public health care, curbing out‑of‑pocket costs, and focusing on healthy aging—from preventing high blood pressure and obesity to expanding screening and community care. Strengthening local services and surveillance, lessons reinforced by COVID‑19, would also boost resilience for future crises.  

Caveat

The authors note gaps in outpatient and mental‑health data and caution that the 2019–2021 window may understateCOVID‑19’s full impact—so some uncertainty remains around specific conditions.  

Source: GBD 2021 Italy Subnational Burden of Disease Collaborators, The Lancet Public Health (April 2025).  

Editor’s note: This article is for information only and is not a substitute for professional medical advice.