Achieving Health Equity in Decentralized Healthcare: An Innovative Approach to Preventive Care in Southern Italy.

This contribution focuses on the Italian Ministry of Health's Decree No. 77 of 23 May 2022, aimed at standardizing preventive healthcare nationwide. The implementation of Ministerial Decree 77 represents a crucial step in strengthening preventive care in Italy, by redefining community-based healthcare models and promoting proactive, population-centered interventions. It highlights regional disparities in healthcare access and explores innovative approaches, including Regulation 13/2023 of the Apulia Region (Southern Italy), to improve health outcomes. In this context the comparison of healthcare management systems of northern and southern Italy, particularly on vaccination rates, chronic disease management and the integration of environmental health is relevant. It examines the Apulian regulatory model, emphasizing environmental determinants such as air quality monitoring and predictive analytics to mitigate climate-related health risks. The Apulia model led to significant health improvements, including a 25% reduction in waterborne diseases and a 12% reduction in heatwave-related hospitalizations. Multidisciplinary collaboration and community engagement enhanced policy effectiveness and public confidence. This work underscores the importance of balancing national health guidelines with regional autonomy to address health inequalities. The Apulia model demonstrates the need for integrating environmental health factors and offers a replicable framework to improve health equity and resilience. Recommendations include strengthening administrative capacity, fostering inter-regional collaboration, and promoting innovative regional healthcare approaches.