The 2015 Italian Cash Transfer Reform and Population Health: Evidence from Municipal Panel Data

Background: Cash transfer programs are widely used to support household income and improve socioeconomic well-being. We examine the health impact of a nationwide transfer introduced in Italy in 2015, targeted at middle-income groups and providing up to €960 annually per beneficiary. Objective: To assess the effect of the program on municipal all-cause mortality. Methods: Leveraging panel data for all municipalities from 2010 to 2019, we exploit variation in treatment intensity induced by eligibility rules. Intensity is measured via per capita disbursements and share of beneficiaries. We estimate fixed-effects regressions with socio-demographic and economic covariates, regional time trends, and controls for spatial dependence. Results: Increased transfer intensity is significantly associated with lower mortality: an additional €1 per capita corresponds to 0.004 fewer deaths per 1,000 residents, while a one-percentage-point increase in the beneficiary share corresponds to a 0.03 decrease in the same outcome. Heterogeneity analyses suggest stronger effects in municipalities with higher education levels and better healthcare access, indicating that these factors enhance the translation of income support into health gains. Conclusions: Although not designed with health objectives, broad-based income support programs can yield measurable improvements in population health, particularly when complemented by education and healthcare investments.