2
Spatial planning, health systems and ageing in the Alps
For more than a decade, demographic change has been a prominent theme in Eu-
ropean, national and regional policies. Ageing and population decline are the most 
challenging trends for the future, with critical variations in demographic patterns 
between the European regions, depending on several socio-economic factors. In 
addition, demographic trends have effects on the spatial conditions of the EU coun-
tries, with peripheral and rural areas as well as post-industrial urban and mountain 
areas at greater risk of de-population. These demographic trends have important 
socioeconomic and policy implications due to their impact on the provision of 
services of general interest, including social and healthcare services, and urban-rural 
population imbalances. Furthermore, demographic change is exacerbating the pro-
cesses of societal fragmentation and polarization of urban societies, with growing 
disparities in terms of social inclusion, economic capacity and service accessibility.
Demographic change is thus a mainstream topic involving various policy areas and 
levels of intervention, including social and healthcare systems, urban and rural 
planning, transportation and social infrastructure, economic and competitiveness 
growth, education, training and social innovation policies. Policy responses to these 
phenomena call for an interdisciplinary approach and relate to regenerative inter-
ventions, investments in infrastructure (transport, ICT and social infrastructure) 
and providing social services to improve the living conditions and wellbeing of the 
resident population and the fairest accessibility to services.
This new changing scenario has major policy implications necessitating novel spatial 
planning approaches that should complement standardised methods of territorial 
governance with lines of development inspired by innovation. Consequently, provi-
ding mobility and ICT-based services, social housing, healthcare for the elderly or 
community facilities, for example, must incorporate a certain degree of experimen-
tation in order to be tailored to the new social landscape. This requires an effort to 
promote social innovation for service provision and a strategy to make territorial 
governance more resilient to the changing scenario.
The EU cohesion policy, within the scope of territorial cooperation, can play an 
important role in supporting regional adaptation to demographic change and rever-
sing the risks of wider development gaps between regions into new opportunities 
for growth and inclusiveness. In this direction, the ERDF co-funded the SPHERA 
project, starting from the results and good practices gathered through experience 
in the Alpine Space Programme, has investigated possible new ways of combining 
spatial planning and healthcare policies for boosting wellbeing and inclusive growth 
into a more proactive approach in demographic policymaking. This path is also 
intended to offer an opportunity for reflection on mutual institutional learning and 
setting up a new generation of transnational activities.
Roberto Zuffada
Lombardia Informatica s.p.a., Milan, Italy