The Italian Approach to Health and Homelessness. Perspectives on Policies and Services during the Covid-19 pandemic

The aim of this study is to understand how homelessness is represented in social and health measures in Italy during the period preceding the Covid-19 pandemic (2019-2020) and the period immediately after the initial outbreak (2020-2021). The analysis has been carried out with the help of the “What’s the Problem Represent to be?” approach, investigating on “problems” representations and proposed solutions. The two Regions protagonists in this analysis are Lombardy and Emilia-Romagna, with a specific focus on their two capital cities: Milano and Bologna. As Italy is a country characterised by a decentralized health system, these Regions were chosen not only because of their high-performance levels, but also because of their differences and for their roles as some of the early receivers of the Covid-19 pandemic. The documents analysed were the Local Area Plans for each city, together with Regional Guidelines, the normative framework surrounding these measures and, were applicable, National strategies used to approach marginalisation and healthcare. In Lombardy, local healthcare became important as an objective for future welfare planning. Integration within services and social marginalisation became evident as a health problem during the pandemic experience, while preparedness became a key word to operate on the territory. On another note, in Emilia-Romagna, the effects of the pandemic are visible in the way the concept of vulnerability exited the realm of poverty and it extended to the one of citizenship. Many characteristics of needs, together with some semantics once reserved for people experiencing homelessness, entered planning and policy documents for what concerns Italy and its Regions. To analyse the effects at the local level, several interviews have been conducted between services in Milan and Bologna. These interviews have served as tools so observe and discuss perception and implementation at the practical level of policies and measures. The material has been analysed with the help of thematic analysis of in-depth interviews. Furthermore, perspectives for the future of both research and provision of services are elaborated together with informers. The accent on people experiencing homelessness and their needs can still be represented as a subsidiary of poverty and/or other health vulnerabilities. While categorization can be dangerous, the representation of homelessness within the general social problems ensemble, often referred solely to the concept of poverty and material deprivation, risks to overlook specific obstacles that they might encounter when accessing services both before and after the pandemic.