The European Semester and health equity Findings from the Recovery and Resilience Plans in eight EU Member States

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Key findings from interviews with experts

  • Poverty risks have increased and are likely to worsen by both recent and long-term challenges (climate change, geopolitics balance, energy crisis, pandemic waves, supply chain and digital transformation).

  • Overall, experts provided positive feedback on the RRP. The large investment plan will put a number of projects in place and carry out much-needed structural reforms that would not have been possible otherwise.

  • Working conditions of healthcare workers should be improved (namely salaries) to attract new employees in areas where shortages are particularly high, such as primary and emergency care.

The Italian Recovery and Resilience Plan A short overview

POLICY AREA 4: Education and research
Strengthening the provision of education services at all levels through an educational reform 19.44
Local networks, facilities and telemedicine for local healthcare (to improve the national health system) 7.00
Innovation, research and digitalisation of the national health service to strengthen the infrastructure 8.63
POLICY AREA 5: Inclusion and cohesion
Employment policies (focusing on active labour market policies, strengthening of public employment services, upskilling and reskilling initiatives) 6.66
Social infrastructure, households, the community and the third sector (addressing major social vulnerabilities in terms of material poverty and housing deprivation, and acknowledging the importance of urban regeneration and sport) 11.17
Special interventions for territorial cohesion (investment for tackling education poverty, reform and infrastructural investment in special economic zones) 1.98

2022 Country specific recommendations for health equity

Each spring, the European Commission and European Council make Country Specific Recommendations to provide tailored advice to individual Member States on how to boost jobs, growth and investment, while maintaining sound public finances.

Italian Country Specific Recommendations 2022 that are most relevant for health equity

1. Ensure prudent fiscal policy, […], taking into account continued temporary and targeted support to households and firms most vulnerable to energy price hikes and to people fleeing Ukraine. […] Expand public investment for the green and digital transition and for energy security […]


  • Italy has one of the EU’s lowest birth rates
  • The old-age dependency ratio is high and increasing
  • Life expectancy at birth in Italy is higher than in the EU as a whole but fell in 2020
    due to COVID-19
  • Italy has significant regional inequalities in life expectancy


  • Addressing the causes of Italy’s low educational outcomes remains a priority
  • The risk of poverty and social exclusion remains high
  • For the social dimension of the green transition, ensuring access to essential transport and energy services is a significant challenge for Italy
  • As social spending is concentrated on pensions, the poverty risk for older people
    is much lower than for the average population
  • Despite recent reforms, the tax burden on labour remains very high


  • So far, Italy has met its EU and domestic greenhouse gas reduction targets
  • Italy is removing barriers to the development of renewable energy
  • Air quality in Italy remains a source of serious concern
  • Italy needs to reduce its energy dependency on fossil fuel imports

Country Report 2022

The accompanying Country Report analyse each EU Member State’s key socioeconomic challenges with the aim of providing a framework for the coordination of social and economic policies across the European Union.

Italy's 2022 report contained a number of elements that are directly relevant to health equity.

Project under the RRP

Coordinating care services for those most vulnerable

Increasing the number of primary healthcare units and improving quality of care contribute to better health outcomes and accessibility of services.

The project 'Community House' will become primary care homes that are used as a tool to coordinate care services, especially for those who are chronically ill.

The project will act as a single point of access to health services engaging with a multidisciplinary team, including general practitioners, paediatricians of choice, specialist doctors, community nurses, and other health professionals as well as social workers. Using IT infrastructure, a sampling point, and multi-specialist instrumentation the project aims to act as a continuous point of reference for the population. The investment provides for the activation of 1,350 community homes by mid-2026, which will use both new and existing structures.

Read more about the project here.

Other projects under the Italian Recovery and Resilience Plan

Suggestions for the future

  • Tackle gender inequalities

  • Provide better financial support and services for families

  • Foster the health equity perspective

  • Enforce more integrated approaches

  • Address workforce shortages

  • Strengthen primary care settings

  • Ensure an effective digital transition of health systems

“I believe the RRP missed the opportunity to include equity and wellbeing, as transversal issues to be addressed in a one health/health in all policies approach. Fortunately, there are other funds, such as Cohesion Fund, that come in useful in this regard.”

Expert at the Regional Healthcare and Social Affairs Agency of Pulgia (AReSS), Italy

“Gender inequalities are still a major concern in Italy. In some cases, even if the tools are available, they are not implemented. It is therefore necessary to work and invest not only in settings and services, but also in a cultural change to move away from archaic patriarchal systems.”

Expert at the Region of Tuscany, Italy

This report was produced by EuroHealthNet, the European partnership of organisations, institutes, and authorities working on public health, disease prevention, promoting health and wellbeing, and reducing inequalities. We aim to tackle health inequalities within and between European States through action on the social determinants of health. Read more about us on our website.


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