Active and Healthy Ageing Policies in Italy: A Scoping Review on Social and Territorial Inequalities

Active and healthy ageing has become a strategic objective in European and national policy agendas, grounded in grounded in internationally recognised definitions and policy frameworks such as the Madrid International Plan of Action on Ageing (MIPAA) and the European Innovation Partnership on Active and Healthy Ageing (EIPAHA). In Italy, the translation of this paradigm has taken place within a fragmented welfare system characterised by strong regional autonomy and persistent social and territorial inequalities, particularly along regional and gender lines. This scoping review has a twofold aim: (1) to map the Italian scientific and grey literature on active and healthy ageing, identifying dominant dimensions, priorities and gaps, and (2) to examine how policies and interventions frame, address or overlook social, territorial and gender inequalities across the life course Following established scoping review methodological frameworks and PRISMA-ScR guidelines, the review systematically identified, selected and synthesised Italian scientific studies and institutional documents published between 2012 and 2024. An inductive thematic analysis was conducted across four main areas—health and wellbeing; social inclusion and participation; indicators and measurement tools; and governance and public policies—with specific attention to the explicit and implicit treatment of inequalities. The analysis reveals a heterogeneous and regionally unbalanced policy landscape. While some territories have developed more integrated approaches linking prevention, participation and social inclusion, others remain largely confined to sectoral and fragmented interventions. Gendered patterns of unpaid care, differential access to programmes and services, and uneven territorial distribution of resources emerge as key dimensions of inequality shaping opportunities for active ageing. A partial discontinuity can be observed after 2019, with the introduction of national coordination mechanisms, although substantial differences in regional implementation capacity persist. The findings highlight the need for more coherent and equity-oriented strategies capable of integrating health, social and educational dimensions through a life-course and intersectional perspective. Strengthening multi-level governance and explicitly addressing social, territorial and gender inequalities as structural determinants—rather than residual variables—appears crucial to enhancing both the effectiveness and the fairness of active and healthy ageing policies in Italy.