Equity is one of the guiding principles of the Italian National Health Service (NHS), alongside universality of coverage and solidarity of financing. Since 2017, the Ministry of Health (MoH), together with its national institutions and the Regions, has proposed a strategy called Italy for Equity in Health. The general goal is to increase the ability to identify health inequalities within the NHS, to understand their generation mechanisms, and to tackle them with specific actions aimed at closing the gaps. This approach is called Health Equity Audit (HEA) and should help all NHS responsibility centres, at both national and local levels, to wear the “lenses of equity” in their daily actions.

As part of this strategy, and following the EU recommendations of the Joint Action Health Equity Europe (JAHEE) coordinated by Italy, the MoH has included the reduction of health inequities as a priority objective in its National Prevention Plan (NPP), requiring these be addressed as a concrete operational objective. The HEA has become mandatory in the design of both predefined and free programs of the regional prevention plans as an essential evaluation requirement for judging the level and quality of interventions and services.

“Environment, Climate and Health” is one of the predefined programs of the NPP. In Piedmont, the region that includes the metropolitan area of Turin, the introduction of the equity lens in the environmental plans has been translated into the call for a tool to support the strategic environmental assessment, focussing on the factors that can affect inequalities. In other words, for the first time in Italy, the regional environmental plan adopts an environmental equity approach, aimed at assessing the distribution of environmental hazards for health according to individual and contextual characteristics of socioeconomic position and vulnerability.

The Turin pilot study within the SDGs-EYES project fits into this context to provide the needed support to decision makers, following a co-creation process based on the involvement of the relevant stakeholders. In fact, it will develop a tool that will not only evaluate the impact of heat waves on health at the micro-area level, but will also detect the factors most predictive of health effects, and identify areas and socioeconomic subgroups of population most vulnerable to climate hazards.

The tool developed in SDGs-EYES will thus allow policy makers to set priorities for action by applying the HEA approach required by the national and regional prevention plans, and will support the governance of the planning process of climate change adaptation policies.