The course aims to: 1) frame and explain the main demographic trends taking place in the advanced economies: 2) analyse the consequences of these trends on the health systems. With regard to population trends, particular attention will be paid to evolution and determinants of migratory flows and of the natural balance, i.e. population ageing and the trend of births. The course then compares demographic trends, health expenditure and the major reforms of health systems, drawing considerations on the critical issues and on possible reforms. After an overview of global migratory and demographic trends, the course will focus on the Italian case, analysing the evolution of demographic trends and the national health system, comparing the main regional health systems and the limits that have emerged during the pandemic. At the end of the course, the students will be able to analyse, also from a statistical point of view, the main demographic trends and characterize the health systems at both international and regional level. In addition, they will be able to assess the relationships between the performance of the health systems and demographic trends and discuss the main policy implications.