The accelerated growth of older adults (the over-65s) in Italy fits within the context of the complex, hybrid nature of the pension system and the welfare benefits financed by tax revenues, which often overlap. As a result, older adults are experiencing growing inequalities in living and health conditions across the three Italian macro-areas (the North, Centre, and South and Islands), as well as between genders. This study aims to examine the sustained growth of older adults in Italy, with a particular emphasis on their most vulnerable segment—i.e., the over-85s. Drawing on mortality trends and the consequent increases in life expectancy at advanced ages, through indicators of mortality and life expectancy, the analysis explores how variations in the structure and distribution of pension benefits have produced significant territorial disparities. These disparities have, in turn, contributed to widening inequalities in household living conditions, especially regarding access to social assistance and long-term care services.

The accelerated growth of older adults (the over-65s) in Italy fits within the context of the complex, hybrid nature of the pension system and the welfare benefits financed by tax revenues, which often overlap. As a result, older adults are facing growing inequalities in living and health conditions, both in the Centre-North and the Southern regions, as well as between genders. Through differential analyses, this paper aims to illustrate the progressive increase in older adults, focussing on their most vulnerable component (i.e. the over-85s), especially concerning social assistance and care issues. Our study considers the current characteristics of social ageing and mortality trends that determine older adults’ growth and number, highlighting the pronounced gender disparities that emerge at older ages. Our findings reveal an ongoing process of change that has led to significant territorial disparities in the types of pension benefits and social allowances. This has exacerbated, in turn, inequalities in living conditions across households and between genders.

As Italy faces rapid demographic aging, understanding the healthcare mobility of older adults (over 65) has become a crucial challenge for regional planning and ensuring equitable access to care. This study examines interregional health migration among individuals aged 65 and over, shedding light on the patterns of elderly patients moving across Italian regions in search of hospital services. The main objective of this research aims to explore the determinants of health-related mobility for older adults and assess the territorial inequalities that drive these flows. Specifically, it investigates whether demographic factors, economic capacity, healthcare quality, and geographic proximity affect the direction and intensity of elderly patient mobility between regions. The analysis is based on integrated data from Istat, the Italian Ministry of Health, and AGENAS (National Agency for Regional Health Services). The methodological approach employs count gravity models (Poisson and Negative Binomial), with interaction effects between healthcare quality – measured through LEA (Essential Level of Care) scores – and economic development (GDP per capita) of the receiving regions. These models help to assess how both the performance of regional healthcare systems and the economic capacity of regions influence the decisions of elderly patients to move in search of medical care. Preliminary findings reveal significant disparities across regions. Older adults are more likely to move from Southern to Northern and Central regions, driven by better healthcare performance and infrastructure. The interaction between higher LEA scores and regional wealth strengthens a region’s attractiveness.

This paper examines the geography of frail ageing in Italy by analysing how longevity, health conditions, non-self-sufficiency and assistance needs intersect across territories. Its distinctive contribution lies in moving beyond a purely demographic reading of population ageing, linking the extension of life to the quality of later-life survival and to the uneven territorial distribution of public assistance. Drawing on official data from Istat, Eurostat and INPS, this study adopts a regional comparative approach, with evidence disaggregated by sex, age group and macro-area. The analysis combines indicators of demographic structure, residual life expectancy at age 65, healthy life expectancy, severe limitations in daily activities, multimorbidity and assistance benefits. This framework makes it possible to distinguish between ageing as a numerical increase in the older population and ageing as a differentiated condition of vulnerability, dependency and welfare need. The findings show that Italy’s high longevity conceals marked territorial and gender inequalities. While the centre–north displays more favourable survival and health profiles, the south and the islands have higher levels of frailty, functional limitations and reliance on public assistance. Women appear to be particularly exposed to this imbalance, living longer but spending more years in conditions of disability and dependency.

This second volume of this Special Issue of Land, entitled ‘Ageing, Gender and Environment: Problems and Challenges from Different Disciplines’, continues the intellectual trajectory launched with the first compendium of 16 articles, which covered the years 2021–2022 and helped consolidate an emerging field at the intersection of land, ageing, gender, and environmental challenges