Health conditions in Portugal were long among the poorest in Western Europe. Recent decades saw substantial improvements, however, although Portugal still lagged behind most of the continent in some categories of health care. Portuguese life expectancy at birth rose from sixty-two years for men and sixtyseven for women in 1960 to seventy-one and seventy-eight, respectively, in 1992. The country's infant mortality rate in 1970 was 58 deaths per 1,000--one of the highest in Europe and close to Third World levels--but by 1992 it had dropped to 10 per 1,000. However, the chief causes of death among the young were infectious and parasitic diseases and diseases of the respiratory system, a Third World pattern found in rural areas, as well as in city slums. Malnutrition and related diseases were also widespread. The chief cause of deaths among adults was thrombosis, followed by cancer. About 400 Portuguese died each year from tuberculosis.

The number of doctors, dentists, and nurses increased greatly between 1960 and the early 1990s. At 26,400 in 1987, the number of physicians actively practicing medicine in Portugal represented a fourfold increase over the total in 1960. The number of dentists expanded even more dramatically, from 120 in 1960 to 5,700 in 1986. As of 1987, the number of medical personnel per occupied hospital bed was 1.7, compared with 0.24 in 1960. By 1990 there were 2.9 doctors per 1,000 Portuguese, a ratio higher than that found in most West European countries. However, most medical personnel were concentrated in urban centers, to the detriment of those needing health care in rural areas. In the latter areas, folk health practitioners were not uncommon, even in the early 1990s. Their medical practices were often fused with magical, religious, and superstitious elements.

Portuguese were able to take advantage of a national health system that, since the second half of the 1970s, paid 100 percent of most medical and pharmaceutical expenses. The system, managed by the Ministry of Health, offered care at large urban hospitals, several dozen regional hospitals, and numerous health centers. The health centers specialized in providing primary care. Care provided by the national system ranged from the most sophisticated to basic preventive medicine.

The national health system's overriding problems were the long waits, frequently months in duration, for medical care, that resulted from shortages of financial resources, lack of personnel, and inadequate facilities. Medical facilities in Portugal ranged from those of centuries past to the ultramodern. Partly as a result of these inadequacies, there was a substantial private medical sector that offered better care. Many doctors and other medical personnel worked in both the public and private system, often because of the low salaries paid by the national system.

Data as of January 1993