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Life expectancy in Portugal is slightly higher than the EU average, but it fell by nearly a year in 2020 because of deaths due to Covid-19.
While the Portuguese health system provides universal access to high-quality care, the Covid-19 pandemic highlighted some structural weaknesses, including low investment in the health workforce and equipment. However, the pandemic also stimulated several innovative practices that could be expanded to build a more resilient health system in the future.
Portugal’s health status
Life expectancy in Portugal in 2020 was half a year higher than the EU average, although it fell temporarily by 0.8 years between 2019 and 2020 because of deaths due to Covid-19 – a reduction close to the EU average. Before the pandemic, life expectancy in Portugal had increased by more than five years between 2000 and 2019. The burden of non-communicable diseases is high, and cardiovascular diseases and cancer are the leading causes of death.
Risk factors
Approximately one third of all deaths in Portugal in 2019 can be attributed to behavioural risk factors. Overweight and obesity are growing public health issues among adults and young people. In 2018, 22% of 15-year-olds were overweight or obese, which is higher than the EU average. Low physical activity is one factor contributing to increasing rates of overweight and obesity
Portugal’s health system
Spending on health per capita and as a share of GDP has been lower in Portugal than the EU average for many years. In 2019, Portugal spent €2,314 per capita on health, which is one third less than the EU average of €3,521, and health spending accounted for 9.5% of GDP (lower than the 9.9% EU average). The Covid-19 pandemic led to increased public spending on health in 2020, while the GDP fell sharply.
Effectiveness
Mortality from preventable and treatable causes was lower in Portugal than the EU average in 2018. However, Portugal lagged behind some EU countries (such as Italy, Spain and France) on preventable mortality, suggesting that more could be done to save lives by reducing risk factors for leading causes of death such as cancer and cardiovascular diseases.
Accessibility
In 2019, a very small proportion of people reported some unmet medical needs due to cost, distance or waiting time, although this proportion was higher among those in the lowest quintile. Unmet medical care needs were much higher for all population groups during the Covid-19 pandemic. However, rapid expansion of teleconsultations helped maintain access to care during the pandemic.
Resilience
Portugal was among the EU countries hardest hit by the Covid-19 pandemic. A broad testing strategy was supported by sufficient laboratory capacity, but containment of community transmission proved challenging. As of the end of August 2021, 74% of the Portuguese population had received two doses (or equivalent) of a Covid-19 vaccine.
OECD/European Observatory on Health Systems and Policies (2021), Portugal: Country Health Profile 2021, State of Health in the EU, OECD Publishing, Paris/European Observatory on Health Systems and Policies, Brussels.
