The 17 European countries that, according to the WHO, perform better than Italy in healthcare.

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The World Health Organization has released the new Health and Environment Scorecards 2025, an assessment system that captures the state of environmental health in countries around the world. The goal is to measure, with concrete indicators, how environmental risks impact population health and how effectively governments respond with appropriate policies. The scorecards are divided into three dimensions: exposure to environmental risks, health impact, and public policies. Each country is assigned a score from 0 to 100. The global average stands at 51 points, with scores ranging from a minimum of 25 to a maximum of 81. The WHO clarifies that these are not rankings: the numbers do not take into account economic, social, and regional differences . Rather, they should serve as an internal compass to understand where a country stands and where improvements can be made. In the European context, average scores exceed the global average. The Nordic countries – Norway (81), Sweden (77), Finland (77), Germany (76) – have a positive impact due to the high level of environmental policies, low exposure to pollutants and structured healthcare systems. However, some Eastern European countries remain below 50 points, highlighting critical issues regarding air quality, waste management or water safety.

With an overall score of 69, Italy performs well but not excellently. It is above the global average and some peer economies, but seventeen European countries perform better. This places Italy in a medium-high range, despite its strengths: other European countries are integrating health and the environment more rapidly into their public policies. Specifically, Italy achieves a health score of 77 out of 100, suggesting that, despite environmental challenges, the national health system is able to maintain high levels of health protection. The country has adopted essential regulatory tools: legal standards for fine particulate matter (PM2.5), limits on lead in paint, and regulations on electromagnetic fields and artificial tanning devices. A poison control center is operational, and Italy participates in the Minamata Convention on mercury. On the radiation front, the national emergency response capacity (IHR) stands at 80 percent, a sign of good preparedness. Another positive aspect is biodiversity. Between 1990 and 2020, forest cover increased by 26 percent. However, there are challenges. One of the most serious concerns air pollution: the annual average PM2.5 is almost three times the WHO guideline value. An estimated 15 percent of deaths from stroke and ischemic heart disease are attributable to this pollution. Despite specific regulations, Italy does not comply with the WHO guidelines, highlighting a gap between legislation and implementation. Access to water and sanitation is also problematic: 7 percent of the population lacks safe drinking water and 21 percent lacks adequate sanitation. Another critical issue is energy dependence: 81 percent of the energy consumed in Italy comes from fossil fuels or traditional biomass. There is no updated national policy on domestic energy and, more importantly, no national health plan for adapting to climate change. Finally, updated data on heat-related mortality, the electrification of healthcare facilities, or the full implementation of WASH standards (water, sanitation, and hygiene) are lacking. Filling these gaps will require stronger political and institutional commitment, coupled with targeted investments and strengthened environmental and health data collection. The message for Italy is clear: the foundations are in place, but bolder decisions are needed to catch up with the best performing European countries. Investing in environmental sustainability can be considered a public health priority.

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