The State of Web Accessibility for Italian Local Health Authorities

Digital accessibility is a fundamental right that ensures that all people, regardless of their abilities, have equal access to online information and services. Ensuring equitable access to digital services is a fundamental principle of inclusive public administration. In this study, we investigate the state of web accessibility of the websites of Italian Local Health Authorities, focusing on their compliance with WCAG 2.1 Level AA requirements, as required by European and national regulations, including the Stanca Law and Legislative Decree no. 106/2018. A total of 103 institutional websites were evaluated using MAUVE++, a tool aligned with regulatory standards. The analysis, conducted on each homepage, reveals considerable heterogeneity in accessibility performance. Although the average accessibility score reached 81\%, the evaluation completeness was lower (71.62\%), revealing critical gaps in the coverage of advanced criteria. Particularly, many websites fail to meet essential requirements related to perceivability and robustness, especially those affecting users with visual or cognitive disabilities. The most frequently violated criteria include semantic structure, keyboard operability, and sufficient color contrast. The results suggest that while minimum compliance with Level A is often pursued, more demanding Level AA requirements are largely neglected. This study highlights the urgent need for improved training, comprehensive evaluation strategies, and inclusive design practices across public health digital services.