The role of Mayors in protecting citizens’ health: a brief report from Italy

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Lorenzo Blandi
Vincenzo Navobi Porrello
Carlo Signorelli
Anna Odone


Mayor, City, Urban Health, Prevention, Welfare System


The World Health Organization has identified urbanization as one of the most important public health challenges of our century. Nowadays, about half of the world’s population live in urban areas, thus municipal authorities can influence multiple determinants of health through Urban Health strategies. However, the health policies and welfare systems are usually managed by multi-level political governments. The aim of this report is to describe the legal and operational competences attributed to mayors and municipal councils with reference to health, taking Italy as case study. Our report summarises and analyses the national, regional, and local Italian legislations. Our results identified the mayors as the highest local health authorities. Indeed, the mayor can issue specific regulations for their local area or order contingent and urgent measures for preventing or delimiting serious health hazards for the safety of their citizens. Moreover, among their duties, municipalities play a crucial role in social care. Hence, municipalities are expected to cooperate with National Health Service at the regional level, to integrate their contributions in a single welfare system. In conclusion, mayors represent the institutional figures closest to the citizens. Municipalities and regional governments should coordinate and integrate their strategies and policies to meet health and social needs of citizens, providing easy access to shared pathways. Municipalities also regulate autonomously fundamental aspects related to the urban environment and can promote and protect health and improve the quality of life for citizens.


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1. Costituzione Italiana - Articolo 32 [Internet]. [cited 2023 Feb 16]. Available from:
2. Legge Costituzionale 18 ottobre 2001, n. 3 [Internet]. [cited 2023 Feb 16]. Available from:
3. La regionalizzazione e la leale collaborazione tra i livelli di governo - [Internet]. [cited 2023 Feb 16]. Available from:
4. Libro bianco sui principi fondamentali del servizio sanitario nazionale [Internet]. [cited 2023 Feb 16]. Available from:
5. Testo unico delle leggi sull’ordinamento degli enti locali [Internet]. [cited 2023 Feb 8]. Available from:
6. Henderson V. The urbanization process and economic growth: The so-what question. Journal of Economic Growth. 2003 Mar;8(1):47–71. doi:
7. Urban Development Overview [Internet]. [cited 2023 Feb 16]. Available from:
8. Annuario statistico italiano 2021 [Internet]. [cited 2023 Feb 8]. Available from:
9. Lowe M, Adlakha D, Sallis JF, et al. City planning policies to support health and sustainability: an international comparison of policy indi-cators for 25 cities. Lancet Glob Health. 2022;10(6):e882-e894. doi:10.1016/S2214-109X(22)00069-9
10. Signorelli C, Odone A, Buffoli M, Capolongo S. Building codes and public health on both sides of the Atlantic. J Public Health Policy. 2016;37(3):385-387. doi:10.1057
11. Il ruolo delle città per la lotta alle malattie croniche e agli incidenti stradali [Internet]. [cited 2023 Feb 8]. Available from:
12. Tsouros A. City leadership for health and well-being: back to the future. J Urban Health. 2013;90 Suppl 1(Suppl 1):4-13.
13. XIII Rapporto Qualità dell’ambiente urbano - Edizione 2017 [Internet]. [cited 2023 Feb 8]. Available from:
14. Wuerzer T. Urban Health. Encyclopedia of Quality of Life and Well-Being Research. 2014;6835–7. doi: 10.1007/978-94-007-0753-5_3127
15. Friel S, Akerman M, Hancock T, et al. Addressing the social and environmental determinants of urban health equity: evidence for action and a research agenda. J Urban Health. 2011;88(5):860-874. doi:10.1007/s11524-011-9606-1
16. Finocchiaro G, Iaccarino S. Qualità dell’ambiente urbano –
XIII Rapporto (2017) ISPRA Stato dell’Ambiente 74/17 pagg. 30-39
17. European Association of Science Editors. 2018. EASE Guidelines for Authors and Translators of Scientific Articles to be Published in English. European Science Editing 44(4):e1-e16. doi:10.20316/ESE.2018.44.e1
18. Regio Decreto 27 luglio 1934, n. 1265 [Internet]. [cited 2023 Feb 16]. Available from: https://www.normattiva
19. Regio Decreto 27 luglio 1934, n. 1265 [Internet]. [cited 2023 Feb 9]. Available from:
20. Legge 23 dicembre 1978, n. 833 [Internet]. [cited 2023 Feb 16]. Available from:
21. Decreto Legislativo 30 dicembre 1992, n. 502 [Internet]. [cited 2023 Feb 9]. Available from:
22. Decreto-Legge 27 agosto 1994, n. 512 [Internet]. [cited 2023 Feb 16]. Available from:
23. Buffoli M, Capolongo S, Odone A, Signorelli C. Salute e Ambiente. Igiene edilizia, urbanistica e ambientale. EdiSES, Napoli, 2016, pagg. 1-374. ISBN 978-88-7959-894-1
24. Gola M, Signorelli C, Buffoli M, Rebecchi A, Capolongo S. Local health rules and building regulations: a survey on local hygiene and build-ing regulations in Italian municipalities. Ann Ist Super Sanita. 2017;53(3):223-230. doi:10.4415
25. Signorelli C, Capolongo S, Buffoli M, et al. Italian Society of Hygiene (SItI) recommendation for a healthy, safe and sustainable housing. Epidem Prev 2016; 40(3-4): 265-270. doi: 10.19191/EP16.3-4.P265.094.
26. Signorelli C, Gattinoni A. Le ordinanze del Sindaco a valenza igienico-sanitaria: presupposti, applicabilità e condizioni per poter derogare norme di legge. Atti 43° Congresso Nazionale SItI. Panorama della Sanità, 2008;36(S1):467
27. DGR n. XI/6762, Regione Lombardia - Regolamento di funzionamento della conferenza dei sindaci, del collegio
dei sindaci, del consiglio di rappresentanza dei sindaci e dell’assemblea dei sindaci del distretto [Internet]. [cited 2023 Feb 16]. Available from:
28. World Health Organization & UN-Habitat. (2016). Global report on urban health: equitable healthier cities for sustainable development. World Health Organization. https://apps
29. Arribas-Bel D, Kourtit K, Nijkamp P, Steenbruggen J. Cyber Cities: Social Media as a Tool for Understanding Cities. Appl Spat Anal Poli-cy. 2015 Sep 1;8(3):231–47; doi: 10.1007/s12061-015-9154-2
30. Blandi L, Sabbatucci M, Dallagiacoma G, Alberti F, Bertuccio P, Odone A. Digital Information Approach through Social Media among Gen Z and Millennials: The Global Scenario during the COVID-19 Pandemic. Vaccines (Basel). 2022;10(11):1822. Published 2022 Oct 28. doi:10.3390/vaccines10111822
31. Incidenti stradali, anno 2021. Report ISTAT [Internet]. [cited 2023 Feb 16]. Available from:
32. Azzopardi-Muscat N, Brambilla A, Caracci F, Capolongo S. Synergies in Design and Health. The role of architects and urban health planners in tackling key contemporary public health challenges. Acta Bio-med. 2020;91(3-S):9-20. Published 2020 Apr 10. doi:10.23750/abm.v91i3-S.9414

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