Invecchiamento e politiche sanitarie: le sfide per un sistema sostenibile

This article discusses the challenges of today’s health care systems in the international setting, with a closer look on the Italian situation. It offers a wide set of arguments explaining the mech- anisms, which guided the health care systems evolution in the last decades. It presents the challenging aspects related to demographic aging and rising life expectancy rates, where the next fifty years will see a remarkable increase in the prevalence of the elderly, with contemporaneous low fertility rates. Moreover, it discusses the recent situation related to the burden of chronic disease, showing how the gains in life expectancy entail a decrease in the proportion of disability free lived years, due to an anticipation in the offset of pathologies. Finally, the article discusses the need for prevention action, proposes a set of policies and the areas of their application rele- vant from the point of view of this discussion.