Torino - URBACT

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Torino - URBACT Powered By Docstoc
					Torino - Italy

Maria Carmela Ricciardi
Turin City Council - Urban Regeneration and Development Sector
26th of July 2008


General socio-economic context: current situation and main issues related to health

Torino is the capital city of the Piedmont Region and it is Italy’s fourth biggest city.
It has been, until the economic crisis of the Eighties, the industrial capital of the country and it is now
transforming its economy towards a more high-tech and knowledge based one. Car industry, in
particular the production of car components, is still an important sector in the local economy. Other
important industrial sectors in the city include industrial automation, aeronautical parts, information
technology and satellite systems. The food and drink industry is also a large employer together with
textiles, banking and insurance and the publishing sector. Torino is home to a large number of
research and development activities with the highest proportion of private spending on R&D in Italy.

Population
Torino has 910.941 inhabitants (June 2008), with a slight increase of population after two decades of
demographic decline (in 2001 it had 899.806 inhabitants, and in 1991 979.839). The female
population is of 474.589 units (52.1%) and the male one is of 436.352 (47.9%).
The increase of the population that Torino is experiencing is mainly due to migration flows and, in a
smaller amount, to the natural birth rate (which is slightly higher than in the rest of the country) (L.
Conforti and A. Mela, 2008).
Torino seems attractive both to skilled and highly qualified professionals and to other workforce
without any specific skill. It is possible to witness, in fact, the co-presence in the city of wealthy
inhabitants and of the poorest part of the population, while the middle class is still moving towards the
surrounding municipalities of the metropolitan area (and this is also due to the rising prices in the
house market). In the city centre there is an higher percentage of professionals and medium-high
income inhabitants, while less qualified workers and low income inhabitants are more concentrated in
the peripheral neighbourhoods (in District 5 and District 6, above all, that is to say in the Norther part
of the city; see fig. 2).

Tab. 1 – Population per age (June 2008)
                  Age                         M         F         Total     %
                  0 – 14                      53.492    50.555    104.047   11,42
                  15 – 24                     38.088    35.906    73.994    8,12
                  25 – 29                     25.212    24.812    50.024    5,49
                  30 – 49                     145.174   141.543   286.717   31,47
                  50 – 64                     83.817    91.053    174.870   19,20
                  65 – 74                     50.757    61.821    112.578   12,36
                  75 – +                      39.812    68.899    108.711   11,93
                  Overall total               436.352   474.589   910.941
From: Elaboration on the Statistics Unit Data - 2008




Fig. 1 – Structure of the population per age and sex (2008)
           1000000

            900000

            800000

            700000

            600000
                                                                                                               M
            500000                                                                                             F
                                                                                                               Overall total
            400000

            300000

            200000

            100000

                   0
                         0 - 14    15 - 24    25 - 29    30 - 49    50 - 64   65 - 74     75 - +   Overall
                                                                                                    total


From: Elaboration on the Statistics Unit Data - 2008


The demographic data shows a certain fragility in the population structure visible in every city
districts due to a majority of grown-up population (from 30-49 to 50-64 y.o.) and elderly (from 65-74
to over 75 y.o.), in comparison with the younger part of the population (from 0-14 to 15-24 y.o.).
If we consider the growth of the ageing index1 as well as the dependency index 2 over the last six
years (tab. 2), it is clear that there is an ongoing progressive ageing of the resident population (also
noticed at the regional and national levels) as well as a critical situation in terms of the imbalance of
the structure of the resident population, with a strong dependency from the active population
due to general ageing.

Tab. 2 – Ageing and dependency indexes
Turin Municipality
                                                                                        2008 (June)      2002 (December)
Ageing index                                                                            212,7            188
Dependency index                                                                        55,55            47
From: Statistics Unit web site: http://www.comune.torino.it/statistica/dati/demog/indicat.htm


The percentage of foreign population compared to the total population of the city is of 12,1% (June
2008).

Tab. 3 – Foreign population
Turin Municipality
Area                           N. of foreigners               Overall Population         Foreigners/Residents (%)
Turin Municipality             110.353                        910.941                    12,1
From:Elaboration on the Statistics Unit Datas - 2008


In 2006, the Report of the “Interinstitutional Observatory on Foreigners of the Province of Torino”
classified, within the city area, District 7 and District 6 at the first and second rank, respectively, in
terms of foreign residents, while identifying the 5 city areas with the highest presence of foreign

1
  The ageing index represents a dynamic indicator that assesses the ageing level in the population: values higher than 100 show a major
presence of elderly in comparison with youngsters and children.
2 The dependency index is an indicator of economic and social relevance which highlights the number of inactive subjects every 100 units
of active population (15-64 years old).
population: Borgo Dora (27,3%), Aurora (24,1%), Monterosa (23,5%), Villaretto (22,8%), San
Salvario (22,3%).

Fig. 2 – The districts in the Municipality of Torino




It is interesting to see that 4 out of these 5 zones are in the Northern part of the City: this polarisation
in the territorial distribution of foreigners highlights the stronger attractiveness that these areas have
with respect to the city centre and the Southern part of the city. These areas have been, in fact,
interested by economic and social regeneration processes and offer, as a consequence, a more
dynamic property market. For this reason, some parts of the central area provide a first and poor place
to settle to migrants (especially those without any legal document), which is abandoned for better
places as soon as the migrants increase and stabilise their income.
As far as the age structure of the foreign population, the most represented age groups are the 30-49
y.o. and the 0-14 y.o. There is also a good presence of young people (15-24 and 25-29 y.o.) while the
over 50 are under-represented and the over 60 nearly non-existent. The most represented countries in
term of population are: Rumania, Morocco, Albania, China and Peru. 21% of the foreign population is
self-employed (12% for the Italians) and also the level of education shows some differences: only
8,2% has the lower degree of education, compared with the 23,2% of the Italians. There is also a high
rate of migrants with high school and university degree.

Employment
In 2004 the unemployed population in Torino were of about 12.000 people. The majority of them
were women (55,1%). Concerning the age, young people below 24 y.o. were represented 15,8% of the
total amount, those between 25 and 29 y.o. the 17%, while the most consistent part had an age
between 30 and 49 y.o. (52%), while the over 50 y.o. were the 15% of the total.
Adult jobseekers with strong social difficulties are then the most represented, together with the
foreign population (22%) (especially in comparison with the wider territory of the Province of Torino,
where the foreign population sums up to 12% of the unemployed). The combination of the two above
mentioned characteristics shows that the unemployment in Torino is more fragile in terms of
educational profile, which is lower for adults and not legally recognised and valorised for foreigners.
But also graduates are slightly more present in Torino’s unemployed rate: they are 7,4% of the total
amount, compared with a national figure of 5,5%.

Tab. 4 – Unemployment rate (2004)
       Turin Municipality
      M                                                                                                         6,86
      F                                                                                                         9,81
      Overall estimated value *                                                                                 8,14
      *The City unemployment rate has been estimated comparing the official rate in the Province of Torino and the data of the
      jobseekers in the Province and in the Municipality.
      Source: SRF, 2004


In 2005 the City had 434.000 employed people. The industrial sector had 96.000 employees (half of
them in the automotive sector). Service sector employs 336.000 units (81.000 of whom in business
services, 66.000 in health and education services and 58.000 in commerce).
The bigger sectors of female employment are health and education (nearly 50.000 units), business
(40.000), household care (28.000) and commerce (24.000).
The high concentration of male employment (42.000) is in industry (36.000), commerce (34.000) and
buildings (21.000).
In 2004 new job opportunities available in the city were more than 100.000. Among them: 12,2% as
temporary jobs; 60,7% as short term contracts; 27,1% as permanent jobs. One opportunity out of 5 is
created by the industrial sector (20,9%), while 4 out of 5 by services (78,6%). Job offers are addressed
for 1/3 to qualified personnel and for 2/3 to unskilled personnel (2004), showing that the city can
actually provide good working opportunities to unskilled workforce, even if in a rather smaller
amount that in the past.

Health and quality of life
Health depends on several variables: genetic inheritance, lifestyle, exposition to risk factors such as
addictions, working place safety, ageing, etc.
The role of the population socio-economic characteristics as important health determinants, tough,
should be stressed: social status, differences on education, culture, job and income, exclusion and lack
of social relations are thus other factors which influence people’s life and health conditions.
Besides the more traditional elements that refers to health promotion (regarding the welfare and
prevention systems), some emergencies are coming out in recent years that needs specific attention.
Among these:
 the progressive ageing of the population. In percentage, Piedmont is the Italian “oldest” Region
    and anticipations elaborated by the National Institute of Statistics (ISTAT) highlight that within
    50 years the over 65 y.o. age group will represent more than 40% of the total population;
 an increasing social vulnerability, which is the exposition to the risk of poverty which affects a
    growing part of population and is mainly caused by the crisis of the welfare system, by the
    constant increase of the cost of life (which does not correspond to an adequate salary growth), and
    by the excessive flexibility – in terms of short-term contract – of the labour market which
    increase the young people dependence on their parents families and concerns an increasing
    number of adult unemployed workers with fewer chances to find a new job and, therefore, obliged
    to modify their lifestyles;
 the growth of migration flows, which requires cohesion and social inclusion policies to promote
    integration and equal access to public services, health services in the first place (it must be
    stressed, however, that the Italian law grants the right to health care to every person that lives –
    even if temporarily and without legal documents – in Italy).

In Italy the right to health for all citizens (ruled by the art. 32 of the Italian Constitution) is assured by
the National Health Service (SSN).
The SSN guarantees all its activities through the regional health services (Local Health Agencies, i.e.
ASL, and public hospitals), by national bodies and institutions and by the State, whose main aim is
to assure health assistance and safeguard as an individual fundamental right and a collective interest,
to respect each person’s dignity and freedom. The SSN is a public system, it has a universalistic
character and it is funded by the general taxation system and by the direct incomes drawn by the
Local Health Agencies (health tickets, that is a partial contribution to overall costs of a medical
service and full payment for other services). The SSN is characterised by a health programme system
articulated in a National and many regional Health Plans.

The Piedmont Regional social and health plan 2007–2010 defines the political, organisational and
administrative lines for health protection and promotion in the region. It outlines, in general terms, the
medium-long term evolution of the health system starting from the analysis of the determinants of
social and health claims and needs related to gender, age and different degrees of biological and social
fragilities.
Its main principles are:
 the centrality of health, which has to be assured by the welfare system, but also by practising and
     enhancing disease prevention;
 prevention, by removing or tackling factors that can negatively affect health (i.e. general socio-
     economic factors, gender and age inequalities, environmental and biological factors);
 the centrality of women and men, which has to be achieved also through the inclusion of
     newcomers in order to preserve their rights, facilitate their access to services and respect their
     lifestyles;
 a clear and responsible involvement of local institutions in planning and programming health care
     and promotion actions. Evaluation of the quality of services and of the effectiveness in responding
     to the population needs is another priority;
 information;
 functional, intersectoral and inter-institutional integration within and among all health care sub-
     systems, particularly on the issue of prevention, support and rehabilitation of those persons who
     are in socio-economic difficulties or in fragile and vulnerable conditions;
 a transparent and rational management of health which pursues equality, respects subsidiarity and
     promotes co-operation and solidarity within a framework of sobriety and austerity;
 promotion of a responsibility ethics and willingness of health professionals to tackle issues on the
     basis of social and gender diversities.

The health network
All citizens refer to the health services through the general practitioner (family doctor), the
emergency unit, the medical practitioner, the hospital, the semi-residential, residential or home
assistance. Prevention, diagnosis, care and rehabilitation interventions are delivered by local health
agencies or public hospitals, private hospitals and nursing homes, research and scientific care
institutes (IRCCS), and private laboratories.
Public hospitals and University-college hospitals assure, among the others, hospital care, day hospital and
day surgery services and medical practitioners examinations.
The Local Health Agencies (ASL) deliver their health care services in district structures and in
hospitals. ASL are organised in health districts which assure the basic health
assistance and social-sanitary services, general and paediatric medical assistance,
nursing support, home care, extra-hospital assistance, residential and semi-
residential care for elderly and disabled people; other services and activities.
Some ASL services and departments in Torino and Piedmont are, for instance:
 the Mental Health Departments (DSM): delivering psychiatric assistance;
 the Addictions Services (Ser.T): devoted to tackling addictions to illegal and legal substances
     (alcohol, drugs, etc.);
 the Piedmont network of Mother and Child Departments: delivering medical services to
     families, women, children and adolescents such as prevention, diagnosis, care and rehabilitation;
 the Family Advisory Bureau: delivering assistance and support to families. It is a reference point
     for tackling issues such as preventions, sexuality, pregnancy, women’s health and children
     protection;
 the Paediatric Advisory Bureau: delivering services devoted to protect children’s health by the
     means of individual and collective prevention initiatives, in collaboration with the SSN
     paediatricians;
   the Health Information Centres for Migrants (ISI): experimental institutes created in 1996 by
    the Regional Council beside the ASL, in order to better organise health services for the temporary
    present foreigners.
As far as the right to health for temporary resident foreigners in concerned, the Regional Authority for
Health and Welfare edited in 2008 a Guidebook for Health Services for Migrants, addressed to all
public and private professionals working in the Torino metropolitan area who deliver health and care
services to those migrants which are not registered in the SSN. Another initiative in this field regards
the Protocol of Intent signed by the Municipality, the ASLs and by one of the City Public Hospital to
improve the social and health services addressed to foreigners.

Health related initiatives
The topic of health and quality of life promotion engages all local bodies – first of all the Municipality
as it is the “closer” institution to citizens. One of the city priority is the development of a functional,
intersectoral and interinstitutional integration aiming at better using resources and shaping sectoral
policies (e.g. regarding education, labour market, welfare, urban planning, environment, culture, sport
and leisure time) towards health in a co-ordinate way.
Since 2004 Torino participates in the Healthy Cities Project, promoted at the international level by
the World Health Organisation and whose guidelines, methodology and objectives has been adopted,
giving priority to health and well being of the local community in an interdisciplinary and
intersectoral approach.

The following experiences , which are directly linked or follow the start of the Healthy Cities project,
aim at creating useful instruments for programming policies in the city:
 the Epidemiological Observatory on Women’s Health (2003), in collaboration with the
   Regional Service of Epidemiology;
 the Socio-cultural Observatory on elderly people (2005), is linked with the Healthy Cities sub-
   network “Healthy ageing” (phase IV);
 the Observatory on Young People World (1987), its aim to influence the definition of policies
   for young people;
 the Observatory on Health (2006), set up by the Municipality in collaboration with the Regional
   Service of Epidemiology. Its main role is to influence the definition of related policies by working
   with other thematic observatories. The work of the Observatory is also related to the existing
   processes of local participative planning, to which it provides scientific and technical resources on
   health and socio-economic systems determinants.
 the City of Health Centre. Involving different municipal departments, the city districts, the
   ASLs, the CIPES Piemonte (Italian Confederation for Health Promotion and Health Education),
   IUHPE (International Union for Health Promotion and Education), the University, private bodies,
   co-operatives and voluntary associations. The Centre hosts the Healthy Cities Municipal Office
   and the European Centre HIUPE-CIPES.

The Municipal Social City Plan which is also an objective of the “Torino Metropolitan Area Second
Strategic Plan”. Its main objective is to connect in a synergic way local interventions aiming at
producing positive effects on: citizens’ social well-being and quality of life, knowledge and
promotion of the territory, equal opportunities and social cohesion. It is articulated into 6 Technical
Boards: elderly, disabled, youngsters, children, integration of migrants, professional training and
adults employment.

The Torino Social Services Plan 2003-2006 is one of the first Italian examples of participated
planning in this field. It is the result of all local political, institutional and social actors involvement
(more than one thousand people and two hundred organisations) which results in a widely shared
project with well defined actions and objectives. The Plan concerns the following policies: for
foreigners and Roma people; for adults, families, children, disabled people and elderly; for home care.
Theme 1: Health Impact Assessment (HIA) and the use of urban health indicators

Torino has no experience in using HIA.
Indicators on “urban health”, but more generally on “quality of life” have been used in the context
analysis developed for designing tools, policies and public calls launched by the regional, provincial
and municipal bodies. These indicators are not, though, part of a system of monitoring and assessment
that explicitly refers to quality of life.
At the regional level, in the socio-sanitary programme (e.g. in the “Regional Social Health Plan 2007
– 2010” or in the “Health Atlas in Piedmont”) the following indicators can be identified:
     - social and demographic context: number and composition of the population, age groups,
        households, features of the migrant population, employed/unemployed, level of education,
        etc.;
     - health conditions: working conditions, lifestyles, drug, game and alcohol addictions, diseases
        incidence, vulnerable groups, strength and weakness of the health system, territorial
        distribution of health determinants, etc.

At the city level the experience of the “City Social Plan” should be highlighted. The Plan aims at
monitoring those dynamics that link social wellbeing with competitivity, taking into account that there
is a relation among social inequality, wellbeing and interventions to regenerate specific part of the
city. The main chapters of the Plan are dedicated to: training, job and growth; ageing population;
younger population; inclusion and accessibility for disabled; integration for migrants. Policies that
addresses these issues refer to different department of the Municipality and the Plan should help to co-
decide and co-operate, with public and private actors, in the definition of new measures and actions to
tackle, especially through transversal strategic axes, several problems. The Plan foresee, besides, city
district boards to follow more closely the development dynamics of the different part of the city.
These boards will mainly work to define an Health and Wellbeing Profile and to monitor the activities
developed at district level.

The evaluation of the impact on citizens’ health (in its wider sense of quality of life) of all policies
and interventions, not only the sanitary and welfare ones, is an open debate among all private and
public actors working in the city, the province and the region.
The “Regional Socio-Sanitary Plan 2007-2010” clearly shows this approach as it underlines the
importance of «protecting and promoting health» as a task for all policies. The Regional Authority for
Health Protection supports and promotes public authorities’ assumption of responsibility with the
purpose of driving local administrators to include the impact that every policy has on health in their
decisions, in order to concretely contribute in the improvement of general life conditions. The
objective is that Local Authorities implement actions to protect and promote health within the
framework of their plans and programmes, starting from the evaluation of the quality of services and
of their effectiveness in supplying the collective need for health.
This topic will be treated during the 8th IUHPE3 European Conference on Health Promotion and
Education, “New frontiers: future political, cultural and scientific challenges for Health Promotion”,
which will be held in Torino from the 9th to the 13th of September 2008. This conference will be an
occasion for deepening and comparing different competencies (public administrators, political
representatives, researchers, professionals – not only on health - working in different public, private
and voluntary sectors) on the basis of a partnership approach.
CIPES Piemonte (Italian Confederation for Health Promotion and Health Education) activities are
part of this strategy. CIPES is a member and founder of the IUPHE, a body that in more than fifty
years of life has supported worldwide strategies and projects on health promotion in collaboration
with WHO, Unesco and Unicef. CIPES Piemonte is composed by individual, collective, public,
private and institutional members (such as the Region, Provinces, Municipalities and Districts). Its
core activity is the management of the network of members and the facilitation of their exchanges in
order to disseminate information and to compare experiences in every theoretical and practical field
dealing with health promotion and health education.
3
    International Union for Health Promotion an Education.
Theme 2: Policies and actions for an active and healthy ageing

The ongoing ageing of the population is a national phenomenon which is even more visible at
regional level (being Piedmont the Italian “oldest” region, in percentage) and at the local one.
An extensive research on the condition of elderly in the Region shows how the concurrence of diverse
factors (low or insufficient income, family and environmental conditions determining isolation,
psycho-physical conditions precluding an autonomous life), obliges nearly 8% of the over 65 y.o. to
live in more or less serious conditions of dependency. On the contrary, 92% of them is still able to
live an autonomous life, keeping a good level of health, even from a psychological point of view,
which gives them the opportunity of carrying on many activities including a further value compared to
younger people: free time.
The Piedmont Region promotes several initiatives aiming at supporting elderly’s participation in
social life: jobs, cultural and recreational activities which foster people’s development and growth and
contribute to prevent psycho-physical decay and, in the same time, allow to preserve seniors’
experiences and skills. For the partially or totally non-self-sufficient elderly persons, the offer of
services is mainly structured to keep the person in his/her own home, avoiding hospitalization and
improving the qualitative level of the welfare services delivered in structures.

The Municipality of Torino promotes numerous initiatives for supporting active and healthy ageing.
For instance:
     A.A.A. – Agenzia Anziani Attivi (Active Ageing Agency). A project involving many
        Company Pensioner Associations and the Municipality. Its purpose is to match the
        pensioners’ demand for voluntary activities and the “offer” of the related organisations;
     Pass60. A yearly card which offers the possibility of participating in cultural, sport and leisure
        initiatives devoted to over 60;
     the Silver Games, which are now at their tenth edition. Created in 1997, in collaboration with
        SUISM (Interfaculty University of Motorial Sciences) they give over 60 the opportunity to
        practice sport and have now become a city event;
     A Silver Year, promoting different activities such as the “Silver Menus”, the “Silver Games”,
        “New Year Party” and the “Silver Fan”;
     Civic Grandfather, voluntary activities carried out by seniors;
     the Self-help Service: a municipal strong reaction to criminality, which unfortunately hits
        elderly very frequently. It is a free service which helps elderly people victims of violence by
        offering them concrete supports delivered by highly qualified associations and by the
        Municipal Social Services.

In the whole city a network aiming at keeping elderly people in their own environment is active. The
network offers a set of interventions which vary from ready-made meals, laundry service or tele-aid to
the daily and/or nightly hospitality. Temporary hospitalizations are sometimes accepted in order to
ease and support families, and, for those who can no longer live in their own homes, permanent
hospitalizations are provided. Projects addressed to elderly people in difficulty are activated by
districts social services and by the ASL Geriatric Evaluation Unit (GEU) Commissions. These
commissions are made of a multidisciplinary team composed by ASL health professionals and by
municipal social workers. Social Services and GEU Commissions grant the request for intervention
and elaborate a socio-sanitary project which seeks, when possible, to keep the patient at home. The
Service also informs the senior and his/her family on the procedures to get the needed services.
To the purpose a Guide of the Facilities for Elderly People has been produced, to provide updated
information on the resources for the population. The city has 31 dedicated structures for the elderly
and the province 61, while 40 are spread in the rest of the Region (taking into account that in the
Torino metropolitan area and province the majority of the population of the Region is concentrated).
Priority, needs, challenges

Income: many elderly have low incomes and live in poverty or at risk of if also because of the
increasing cost of life.
Isolation: many elderly persons live alone and often cannot lean on any family or neighbourhood
networks, so it is difficult to contact them and find proper solutions to their problems.
Health system accessibility: the available amount of information on the health system structures and
facilities does not always reach in a clear and user-friendly way the target population.
Disabled elderly persons: there is a growing number of disabled elderly people that exceeds the
availability of places and services in the existing structures and facilities.


Theme 3: Healthy Places and Healthy Environment

The ongoing processes of regeneration in some city areas, especially in previous industrial sites and
brownfields (as, for instance, in and around the “Backbones” areas), has physically changed the face
of the city. These development processes are to transform these areas (which, considering only the
industrial sites consists of more than 2 millions of square meters) in new residential areas, university
campuses, commercial and services areas in which attention is paid (not always with good results) to
the quality of the built environment and public spaces.
These processes does not always result in positive transformations, mainly because the different
timing of the interventions allows for the creation of marginality enclaves in which the lack of
security and the rate of micro-criminality increase. In these cases, e.g. in the so-called “Toxic Park”
on the Stura river banks, the Municipality is trying to fight exclusion and criminality with culture
(summer festival and a temporary concert hall), while the development project is searching for funds.
Another important development process regards the closing waste deposit area of the city, Basse di
Stura, a 540 he area on the Northern borders of the Municipality that will be regenerated and
transformed in a green area with public facilities and a waste-to-energy plant.
Some other city areas are still characterised by high level of unemployment, social marginalisation,
residents’ lack of identity and sense of belonging, lack or insufficient aggregative spaces and green
areas, lack of social and cultural services, concentration of social housing blocks in bad conditions,
with a socially excluded population. In this cases a certain economic and productive vitality can be
fostered, while the presence of historical, cultural and above all environmental potentialities need to
be valorised.

For over ten years the City is taking forward urban regeneration interventions, part of a broader
development policy. These initiatives, such as the Special Project for Neighbourhoods, the Urban
Pilot Project (UPP) “The Gate – Living and not leaving”, the CI Urban II “Mirafiori Nord” are part of
the city development and growth plan and they have been implemented alongside experiences like the
“Torino Internazionale Strategic Plan for the City”.
This development policy was influenced by the participation of Torino in the European and national
debate on the themes of regeneration and promotion of urban development related to policies and
more effective instruments for achieving these objectives. This political approach have been also
developed thanks to the active participation of the City in European networks such as Eurocities and
Quartiers en Crise. What the municipal Urban Regeneration and Development Sector experienced,
and continues to do in targeted areas, is a global strategy and an innovative methodology. Its aim is to
address the issue of urban regeneration adopting the integrated approach boosted by the European
Union in the Urban I and II Community Initiative Programmes. The challenge is to renew parts of the
city "attacking" urban deprivation from a physical, but also social, cultural and economic point of
view.
To this aim, since the Nineties the city has adopted and experimented several integrated programmes
of urban regeneration, using ordinary and special funds.
Among these experiences:
    - the Urban Renewal Programme (PRU), targeted for deprived neighbourhoods with high rate
         of public housing estates. The structure of this programme is inspired to the European Union
        URBAN Initiative, thus paying attention to the social and environmental part of the renewal
        process, other than the physical one. Furthermore, the PRU is always carried on together with
        a “Piano di Accompagnamento Sociale”, that is a specific plan addressing the issues of
        participation and community development. The city district that had a PRU are the no. 5, 6
        and 10.
    -   the Neighbourhood Contracts, first and second phase. Also dedicated to deprived areas with
        public housing estates. In this case the funds are to be used only for physical interventions on
        the buildings, while the Municipality, and other players if any, finances all the other actions
        that regards, for instance, regeneration of public spaces and cultural activities. These contracts
        regards the district 1 (for the first phase) and the districts 2, 5 and 6 (for the second phase).
    -   the Parco Dora Committee, that refers to a vast area (more than 1 million square meters) in
        the Backbone no. 3. The Committee, created by the Municipality, districts 4 and 5, and other
        public and private actors, is a multi-functional contact point for the area regeneration and
        provides a monitoring on the ongoing transformations.

The “Barriera di Milano” borough
For over ten years the City of Turin has promoted and carried out many studies and researches aiming
at measuring and examining the differences among different city areas in terms of demographic,
occupational, socio-cultural and economic structure, with the purpose of adapting urban policies to the
city needs.
One of these studies made clear how the combination of critical elements were concentrated in a
relative small number of areas, mainly located in the Northern part of the city (in the former working
class boroughs) and in their big social housing blocks. These areas hugely experienced the economic
crisis due to the transition from the Fordism economy to the post-Fordism phase (closure of big
industrial plants, increase of unemployment and related social problems, etc.) (L. Conforti and A.
Mela, 2000). A recent research has confirmed that in the Northern part of the city, and in particular, in
the Barriera di Milano borough, social deprivation due to the combination of several problematic
factors is still present (L. Conforti and A. Mela, 2008). Over the last years Barriera di Milano is, in
fact, experiencing dramatic transformations in its social, economic and spatial structure, so that it can
be described as «a place at the margins […] not so much from the city, but rather from the economic,
cultural, social and, even, territorial development processes» (T. Ciampolini, ed., 2007, p. 56).
Barriera di Milano is progressively and ineluctably loosing its identity as a city neighbourhood
developed as a factory borough, but it is also an area that needs new tools for diagnosis and
interventions in order to find a proper way of “steering” new and positive changes.
Barriera di Milano is located in District 6 (Northern – Eastern part of the city) and it is historically
divided into four boroughs: Montebianco, Monterosa, Maddalene and Cimitero Generale.
It is still a popular and working class neighbourhood, which has been experiencing different
migration flows. These waves started in the first decades of 1900 with farmers leaving the
countryside, followed between 1955 e 1965 by Southern Italy workers attracted by the car industry
development and finally, in the last decades, by migrants coming from all over the world. Till the
Eighties, the area was a kind of enclave within the city structure as its inhabitants’ working and social
life was mainly carried out within its borders. In those years the homogeneity of the working class
contributed in defining strong identity and sense of belonging characterised by a solidarity that led to
the development of many local associations. Then, the crisis of the industrial system and of the
Fordist social organisation, the occupational and economic uncertainty, the arrival of new inhabitants
with different cultures and religious beliefs as wells the occurrence of new urban poverties have
produced a fragmentation of the social classes, a lack of identity and an overspread feeling of
insecurity.

Population
The population (2008) is of 50.338 inhabitants, nearly 50% of District 6 total population and 5,5% of
Torino population.
It is interesting to highlight that, in this area, ageing population is less a problem than in the rest of
the city, since the population is younger than average.
Tab. 5 – Ageing index (June 2008)
Barriera di Milano’s boroughs                                   Ageing index
                                                                No.                    Position
Cimitero Generale                                               199,02                 Medium high
Maddalene                                                       228,12                 Very high
Monterosa                                                       137,96                 Medium low
Montebianco                                                     114,27                 Medium low

The Monterosa and Montebianco boroughs actually show a lower ageing index than the city average
(212,7) as well as the District one (184,9), this because of a strong presence of younger migrants.
These boroughs, on the basis of the 2008 Municipal Statistics Office data, show a larger presence of
families with children in comparison with the total of Torino population: nearly 11%, versus a city
average of 9,5% and a District one of 10%. Actually in these two areas the dependency index has
less critical values than in the rest of the city.
In June 2008 the relevance of the foreign population, compared with the total of the population, is
clearly higher than in District 6 and in the whole city (see tab. 6, below). In line with the general
positive trend of the foreigners’ presence at city and district level, these boroughs show an increase of
2-3 percentage points over the past three years.

Tab. 6 - Foreign residents (June the 30th 2008)
                                Number of         Total        Foreigners/residents   Foreigners/residents   -
Area                            Foreigners        population   - % (June 08)          % (December '06)
City of Torino                  110353            910941       12,1                   9,4
District 6                      17539             106562       16,5                   12,60
Barriera di Milano:
Cimitero Generale               127               852          14,9                   n.a.
Maddalene                       1267              13261        9,6                    7,2
Monterosa                       8049              26370        30,5                   23,5
Montebianco                     2703              9855         27,4                   21
From: Elaboration on the Statistics Unit Data - year 2008

Concerning the countries of origin, in the whole Barriera di Milano Rumanians are the majority
(33,7%), followed by Moroccans (24,5%) and Chinese (6,8%).
The structure per age and sex of the resident foreign population has similar characteristics than the
rest of the foreign population living in District 6.

The most represented age groups are those between 30-49 y.o. (47%), followed by the very young 0-
14 (20%) and by a good presence of young people, 15-24 and 25-29 y.o. (respectively 12% and
11,5%). The over 50 y.o. are under-represented (7%), while the over 65 y.o. are nearly absent
(below1%). The structure per sex is fairly homogeneous.
Unlike the city central areas, the majority of foreigners living in Barriera di Milano choose to stay in a
permanent way, often with their families, children attending to the neighbourhood schools, sometimes
buying a flat.
The population density of the area is very high: 15.194 inhab/sqkm (nearly three times more than the
city one, even higher than in District 6) with a peak in the Monterosa borough (31.318,29
inhab/SqKm).
The population increase is mainly due to the attraction the area wields towards migrants above all, as
there is a certain availability of relatively low rent housing and property values are more accessible in
comparison with the rest of the city.
Generally speaking, in Barriera di Milano two housing typologies can be identified: the houses built
in the beginning of 1900 (above all in Montebianco) and the blocks of flats built between 1950 and
1970 (in Monterosa). Buildings are mainly private owned: 63% of the population own its flat, 32%
rents a house and 5% has houses cost-free. In the area there are few social housing blocks, while in
neighbouring areas (in Regio Parco, for instance) the situation is completely different.
Fig. 3 – Structure of the population per age and sex, District 6

     20000

     18000

     16000

     14000

     12000
                                                                                      M
     10000                                                                            F
                                                                                      Overall total
      8000

      6000

      4000

      2000

           0
                 0 - 14    15 - 24 25 - 29 30 - 49 50 - 64 65 - 74   75 - + Overall
                                                                             total

From: Elaboration on the Statistics Unit Data - 2008


Employment

The District 6 is placed at the second place in the city (after District 7) for the number of jobs
available, with a peak in Monterosa and in Regio Parco boroughs. More generally, in District 6, the
number of unemployed per 1000 inhabitants in working age is 16.3%, the highest score in the City.
A survey concerning employment in this area was carried out in 2004, following the creation of a
Local Board for monitoring employment issues, a body composed by different public and private
actors that at a district level, promotes actions in support of vulnerable groups in the labour market (S.
Ronconi, ed., 2004).
The large majority of jobseekers is represented by women, has a poor school curricola and is
generally composed of un-skilled labour force (Torino Employment Centre – CPI, 2003).
The City Job Information and Orientation Services deals especially with low qualified unemployed
within an age group of 45-50 y.o. and more, since they often do short-term or occasional jobs, have
poor competencies, and often social and family problems. The available instruments of the active job
policy, on the other hand, do not clearly respond to the age issue and the lack of skills. As regards
women, beside the emerging phenomenon of migrant women, they are the biggest group in the Job
Orientation Services, especially those over 45 y.o, with low educational qualifications and income
difficulties.

Economy
The economic activity balance 2006-2007 is positive, in line with the city trend. The situation of the
economic growth in Barriera di Milano (+3,5%) is even better than in comparison with the District 6
average (2,8 %) and to the whole city (1,7%). Higher values can be seen in some boroughs,
particularly Cimitero (5,9%), Montebianco (+4,2%) and Monterosa (+ 4%).
Barriera di Milano is characterised by a typical industrial city economic structure, with a substantially
stable trend. Its main characteristics are:
    - there is an high number of enterprises in the “Commerce” sector, (higher values in
         comparison with the city average), followed by the “Services” sector (lower values in
         comparison with the city average). Enterprises in the “Industry” sector have a higher presence
         in comparison with the city average, the economic crisis notwithstanding;
    - there is a relevant number of enterprises still working in the automotive sector, while there is
         a weak presence of ICT enterprises, even if their number is growing in the last years;
    - as regards other sectors than industry, there is an high incidence of handicraft enterprises and
         a predominance of “services to enterprise”.

Public services, facilities and spaces
In Barriera di Milano there is lack of local public services and facilities (such as schools, green
areas, meeting an aggregation spaces, car parks, sport facilities, etc.), also related to the arrival of
households which will settle in the new housing development estates in the Spina 4 borough. There is
also a lack of public social services, this causing insecurity and precariousness, especially among
elderly people.
As regards the ageing population, the lack of aggregation centres must be highlighted, since they do
not only respond to the necessity to spend time in an active way, but also to meet other people and
carry on common activities.
As regards migrants, there is a need for services and places encouraging migrants’ integration in the
social fabric; their growing number, besides, requires integration policies as foreigners are often seen
as those who “withdraw” the resources from the territory without giving nothing back. The presence
of migrants is often represented as a cause of discomfort and unsafety.
As regards the use of public spaces, the presence of handicraftsmen who work in the courtyards
represent, on one hand, a resource used also by people who do not live in the area, but, on the other
hand, it is important to underline that this kind of activity may cause discomfort for the lack of proper
spaces and adequate structures: actually they increase the level of the already existing noise pollution
and contribute in the road system collapse, a phenomenon which constantly happens in some streets
and in rush hours.
[Sources: Osservatorio Lavoro – Divisione Lavoro (elaboration on CCIAA and EAAEP data, 2005, 2006,
2007)].

Built environment
The housing estates are generally in need of initiatives favouring their renewal, taking into account
that the majority of the households (those of the migrants above all) cannot guarantee a proper
maintenance of the buildings due to their low income.
Abandoned buildings, irregular maintenance of the apartment blocks, low quality in lighting and the
general lack of infrastructures, combined with the lack of green areas and services as well as unstable
safety conditions in some parts of the borough, shape a context poor of attractive elements and with
low urban values.
The link between the environmental degradation and safety is clear, but the preservation of public
spaces is one of the most difficult issue that the Local Authority has to deal with. Brownfields, with
random squatting, constitute a serious problem. The area around the ex-INCET factory, for instance,
is described as an unsafe one, especially in the evening and at night, because of the presence of drug-
pushers and addicts. Furthermore, in the area emerges the contradiction between the need of green
spaces and the fear that they can immediately become degraded, useless and unsafe places.
The associative fabric and the participation of the citizens, that have been traditionally strong, risk to
be weakened by the perception of the insufficient results of the last years development policies and by
the City’s lack of attention to the neighbourhood claims. This trend could also be reinforced by the
uncertainty on the realisation of those project that local residents consider as a priority.

Ongoing transformations in the area
At the borders of Barriera di Milano (and only partially within it) some important short and mid-term
urban transformations are occurring, in particular the works concerning the so called City “Backbone”
(i.e. the underground railway link that results in new available spaces on the surface). The Backbone
has been divided in four trunks and the nearest to the Barriera di Milano is the “Spina 4”, in which the
main actions regards the renewal and re-use of dismissed industrial sites for new housings, green
areas and shopping ares. Other important transformations regard: the realisation of the Line 2 of the
Underground; the re-qualification of the Scalo Vanchiglia area (ex railways area) and its
surroundings, through the realisation of an urban park, private housing estates, facilities for care
services and for services to enterprises; the regeneration of the ex–INCET industrial area, with the
realisation of a centre for different religious beliefs, warehouses for the City Cinema Museum, spaces
for local associations, a police station, a kindergarten and infant school; the renewal of the Docks
Dora buildings (also old industrial buidings) and its surroundings; the transformation of the ex-FIAT
Officine Grandi Motori industrial area to host new housing estates, facilities for commerce, tertiary,
handicraft and service activities.


Theme 4: Use of Structural Funds in designing actions to develop "health gains"

POR FESR (ERDF Regional Operational Programme)
Managing Authority: Regional Department for “Productive Activities”
Decision of approval: C(2007) 3809 del 02/08/2007
Approved measures:
Priority axis 1: Innovation and “productive transition”;
Priority axis 2: Sustainability and energy efficiency;
Priority axis 3: Territorial regeneration.

POR FSE (ESF Regional Operational Programme)
Decision of approval: C(2007)5464 del 06/11/2007
Managing Authority: Regional Department for Education, Vocational Training and Job
Approved measures:
Priority axis I: Adaptability;
Priority axis II: Employability;
Priority axis III: Social inclusion;
Priority axis IV: Human capital;
Priority axis V: Transnationality and inter-regionality.

Only the 2000-2006 programming period is considered, as the current period 2007-2013 is just at the
beginning of the implementation phase.

Docup 2000-2006 (ERDF-funded)
Priority axis 3 – Local development and enhancement of the territory: measure 3.1 – integrated
programmes.
This measure funded about 20 integrated programmes, but it is to be underlined that interventions
were mainly addressed to development issues.

Priority axis 4 – Social cohesion: measure 4.1 – social inclusion interventions.
This measure was devoted to the rehabilitation of buildings, areas, open spaces (especially in deprived
urban areas) to be dedicated to social and cultural use. About 50 projects had been funded under this
measure, in the eligible areas (in 2000-2006 not all the regional territory was eligible for ERDF –
because of the so called “zoning”).

ESF: any specific actions funded under ESF regional operational programme can be directly
connected to health and quality of life.

Only some examples are given, as the topics (especially quality of life, as it involves different policies
and a number of different target groups with dedicated policies) are very broad and it is quite an
heavy (i.e. mission impossible…) exercise to map all the different regional, national and European
policies involved.

1. Regional programme “Wi-Pie” (a programme aimed at extend ICT infrastructures and their use to
   the whole Region) is funding some pilot actions of e-health (health care for aged people,
   improving the efficiency of health examinations);
2. the Agency for Metropolitan Mobility has been recently jointly created by the Region, the
   Province of Turin, the Municipality of Turin and other municipalities of the metropolitan area, in
   order to improve the efficiency and the coordination of the mobility system;
3. e-government: different initiatives to improve efficiency of public services for citizens;
4. regional programme funding different kind of child care services and structures;
5. regional and national funds to support families with more than 3 children (services for children,
   tax reductions, …) and for the domestic care of aged people.

Health issues aren’t directly addressed by Structural Funds, a good exception being the topic of e-
health, improvement of health services by exploiting ICT potentialities, but, in the ERDF ROP, the
measure devoted to innovative ICT services is mainly addressed to SMEs. This is due to the fact that
Structural Funds for Competitiveness Regions (i.e. Objective 2 Regions) are mainly devoted to
innovation and competitiveness (75% of resources are to be allocated to actions directly linked to
Lisbon strategy).
Quality of life has a strong cross-sectoral character: different policies (e.g. health, mobility, social
policies for mothers, young and aged people, e-government, …) are involved, and an integrated
approach and coordination of policies are required.
This cause problems because of the traditional sectoral approach of public administration.
In this context the ERDF ROP of Regione Piemonte will fund, under Priority axis 3 – Territorial
regeneration, integrated plans whose aim is development and increased competitiveness of a specific
area. Within these plans some actions to support and improve quality of life could be foreseen, if
consistent with the general aim of the plan.

 Sources
 Bibliography:
 AAVV, Non c’è Barriera senza Spina. Indagine sugli insediamenti abitativi di Spina 4 a
        Torino, Cooperativa Sociale Marca, Torino, 2008
 T. Ciampolini (a cura di), Barriera Fragile, Ed. IDOS, collana Territorio, Roma, 2007
 L. Conforti, A. Mela, La configurazione sociale dei diversi ambiti spaziali nella Città di
        Torino, IRES Piemonte, Torino, 2000
 L. Conforti, A. Mela, La configurazione sociale nei diversi ambiti spaziali della Città di Torino
        e i processi di mobilità residenziale, IRES Piemonte, Torino, 2008
 S. Ronconi (a cura di), Tavolo di osservazione sulle problematiche occupazionali della Sesta
        Circoscrizione: Rapporto di ricerca e sintesi del percorso di costituzione del Tavolo,
        Città di Torino – Assessorato Lavoro Formazione Sviluppo, 2004

 Documents of analysis and planning – Projects and feasibility studies:
 PTI “Barriera mobile: infrastrutture e qualità della vita nel quadrante est- nord est di Torino”
 PISL “Ricucitura di ambiti urbani storicamente separati – Aree ricomprese nelle Circoscrizioni
        5, 6,7”
 Regione Piemonte:
  Piano socio – sanitario regionale 2007 – 2010
  Lo stato di Salute della popolazione in Piemonte
  Atlante sanitario del Piemonte
  Guida ai Servizi Sanitari per Immigrati

 Sites:
 Ministero della Salute
http://www.ministerosalute.it/cittadini/cittadini.jsp

Regione Piemonte
http://www.regione.piemonte.it/sanita/
http://www.regione.piemonte.it/sanita/program_sanita/
http://www.aress.piemonte.it/ (Agenzia Regionale per i Servizi Sanitari)
http://www.regione.piemonte.it/polsoc/ (Piemonte Sociale)
http://www.regione.piemonte.it/sanita/ep/atlante/riepilogo.htm (Atlante sanitario del Piemonte)
http://www.piemonteimmigrazione.it/ (Osservatorio sull’immigrazione in Piemonte)
http://www.regione.piemonte.it/polsoc/servizi/anziani.htm (Servizi per anziani)

IRES Piemonte
http://www.ires.piemonte.it
http://www.regiotrend.piemonte.it/

CIPES Piemonte
http://www.cipespiemonte.it/
http://www.cipespiemonte.it/piani_reg_piem.php

Provincia di Torino
http://www.provincia.torino.it/salute.htm
http://www.provincia.torino.it/speciali/fragili_orizzonti07/fragili_orizzonti.htm

Comune di Torino
http://www.comune.torino.it/relint/network/citta_sane.shtml
http://www.comune.torino.it/gga/ (pagina Giovani Genitori Anziani)
http://www.comune.torino.it/pss03-06/ (Piano dei servizi sociali 2003-2006)
http://www.comune.torino.it/aaa/ (Agenzia Anziani Attivi)

				
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