The paper aims to measure the health status of adults in Italy by considering and measuring the mediating effect of what we refer to as Health Capability (HC). This refers to an individual's ability to make informed decisions based on their knowledge and skills, to enhance their health. The study also focuses on regional factors, including the effects of income inequality and life expectancy between regions. The analysis was carried out using data from the European Health Interview Survey (EHIS) for the year 2019, collected for Italy, on a subsample of individuals aged 50 and over, divided into poor and non-poor groups. The empirical results showed that HC is differentiated between social groups, and it was better both for well-off and poor individuals in contexts with low-income inequality. Life expectancy is significant and positively affects HC in both poor and non-poor groups. The region of residence plays an essential role in influencing health status, with adverse health outcomes being more prevalent in southern regions.