I've been wondering about the relative importance of better medical care too. I'm sure it's a factor, but it's definitely not the only factor. Denmark and big parts of Germany have a projected longevity of around 81. Southern Italy, which has worse health care than Northern Italy, is still around 82-83. Northern Italy is around 84, 85.
There does seem to be a slight drop in longevity in some data from 2017, but it's about 3 months, and unfortunately most of the drop stems from decreases in the south. Again, I think that can be attributed in part to a lower standard of living and worse health care.
https://www.thelocal.it/20170411/life-expectancy-in-italy-has-fallen
I personally think that it's probable that if incomes and health care in the south were better, their life expectancy would equal or exceed that of the North, mostly, I think, because their diet falls more within the parameters of the "Mediterranean" diet, and their family units are even stronger and more supportive than what I see in certain parts of the north. The people of my own Emilia Romagna, for example, have a diet very heavy in butter and cheese and consume more meat than the Southerners. They don't call Bologna "La Grassa" or fat for nothing, and yes, with age the people tend to become a bit "portly", although genetics could be a factor too.
Oh, as for the really old, "
The number of centenarians, or people that are over the age of 100, has tripled in Italy over the last 15 years."