Mortality evolution in Italy: the end of regional convergence?

Abstract Between 1992 and 2007, the Italian healthcare system underwent a profound and complex transformation. This reform rekindled interest in the study of health and mortality inequalities in Italy, and fears were expressed that the new system could trigger a rise in health disparities across regions. We contribute to the debate examining the evolution of life expectancy across Italian regions from 1974 to 2019, focusing on regional convergence. Applying sigma- and beta-convergence analysis in a novel way, we detect structural breaks—marked trend variations—occurring shortly after the most significant policy reforms of the national health system, with stronger discontinuities among males. While not establishing any direct causal link, our findings suggest that the legislative changes of the period, focused on decentralizing responsibilities and management, may have halted the pre-existing trend towards homogenization and possibly opened up a new phase of re-emerging regional survival disparities.