Portugal – Health Issues

What are the most common health issues and diseases in Portugal?

Cardiovascular diseases and cancer are the principal causes of both death and disability in Portugal, together responsible for close to half of all fatalities. These fall within the category of non-communicable diseases (NCDs) — conditions shaped by lifestyle choices, the ageing process, and genetic predisposition — and their dominance mirrors the situation across much of Western Europe.

By 2021, non-communicable diseases were responsible for 88% of total deaths in Portugal and 86% of total disability-adjusted life years (DALYs). Compared to data from 1990, the contribution of NCDs to deaths and DALYs has increased. This long-term trajectory closely parallels developments in comparable high-income European countries such as France, Spain, and Germany.

Among NCD-related deaths, cardiovascular diseases accounted for 26.54%, with ischaemic heart disease and stroke claiming the greatest number of lives within this category. Cardiovascular diseases also constitute a major source of disability across the country.

The most commonly diagnosed cancers estimated for 2022 were prostate, colorectal, lung, and bladder cancer in men, while for women they were breast, colorectal, lung, and thyroid cancer. Stomach cancer has also featured more prominently in Portugal’s historical cancer data than in many neighbouring European nations.

The most common chronic conditions in 2024 included lipid disorders, hypertension, obesity, and tobacco abuse. These conditions often appear together, and Portugal records high rates of multimorbidity — meaning a large proportion of the population manages two or more chronic conditions simultaneously.

Regionally, multimorbidity exceeded 65% in all zones, with the North (78.9%) and Alentejo (78.3%) regions having the highest rates. Those relocating to rural inland areas should be mindful that access to specialist services for complex health needs tends to be more restricted than in major urban centres such as Lisbon or Porto.

Among the leading causes of disability are low back and neck pain, sense organ diseases, depressive disorders, migraines, skin diseases, anxiety disorders, oral disorders, diabetes, falls, and other musculoskeletal issues. Many of these are persistent in nature and disproportionately affect older residents — a particularly relevant consideration for retirees choosing Portugal as their new home.

Is Portugal considered a healthy country? How do health outcomes compare internationally?

In 2024, life expectancy in Portugal reached 82.7 years, one year above the EU average. However, just over half of adults report good health and a notable proportion of later life is spent managing illness or disability. This distinction is meaningful: a longer life does not necessarily equate to a healthier one, and Portugal shoulders a considerable burden of years lived in poor health or with functional limitations in old age.

Life expectancy in Portugal has improved significantly over the years. WHO data indicates an average of 81.2 years for the population overall, with women living to 83.9 years and men to 78.3 years — a differential between the sexes that is broadly consistent with patterns observed throughout Europe.

Portugal records fewer deaths from preventable and treatable causes than the EU average. Preventable mortality refers to deaths mainly avoidable through public health and primary prevention interventions, while treatable mortality refers to deaths mainly avoidable through healthcare interventions, including screening and treatment. Both indicators refer to premature mortality under age 75. This is an encouraging sign, suggesting that Portugal’s healthcare system is reasonably effective at identifying and addressing conditions at an early stage.

The share of people with chronic diseases or long-standing health problems has been increasing since 2019, reaching a total of about 45% of people in 2022. This upward trend reflects, in part, an ageing population and improved diagnostic capability, and echoes developments seen in comparable European nations.

Child mortality rates have decreased over the past five decades. In 1970, 6.9% of all children died before reaching age five; by 2021, that figure had fallen to just 0.3%. This remarkable improvement is the product of sustained investment in maternal and child health services over many decades.

For the most current official figures on Portugal’s health outcomes, readers should consult the WHO Portugal country profile, the OECD’s State of Health in the EU series, or Statistics Portugal (INE).

What infectious diseases or environmental health risks should expats be aware of in Portugal?

By global standards, Portugal is a low-risk destination when it comes to infectious disease. No vaccinations are required for entry, and drinking water in urban areas is reliably safe. Nevertheless, there are several environmental and emerging health risks that are worth understanding before you make the move.

The national vaccination programme in Portugal is a universal and free initiative accessible to all the population living in Portugal. It was implemented in 1965 and was updated in September 2020. Expats who register with the public health system (SNS) can access these vaccinations. It is also worth consulting your home country’s travel health authority — such as the UK’s NHS Travel Health or the US CDC’s Traveler’s Health pages — to check whether any additional vaccinations are recommended given your personal health background.

Portugal is expected to experience more frequent and intense heatwaves, bringing significant health risks particularly for the elderly, children, and individuals with pre-existing conditions. Heat-related illnesses such as heat exhaustion and heat stroke are expected to become more prevalent. Heatwaves can also worsen cardiovascular and respiratory diseases, leading to higher hospitalisation rates. Expats arriving from cooler climates — such as northern Europe, Canada, or high-altitude countries — may require an adjustment period, especially during the summer months in the Alentejo, Algarve, or inland regions.

Warmer temperatures and shifting climate patterns are creating more favourable conditions for disease-carrying insects such as mosquitoes. Diseases like dengue fever and malaria could become more common. Portugal has already recorded localised outbreaks of dengue fever, particularly in Madeira. The Direção-Geral da Saúde (DGS) publishes updates on any active disease alerts.

High temperatures can aggravate air pollution, particularly in urban areas, as warmer weather contributes to the formation of pollutants. Lisbon and Porto periodically experience elevated particulate matter levels, particularly during the wildfire season. People with asthma or other respiratory conditions should keep track of air quality forecasts, which are published by the Portuguese Environment Agency (APA).

Wildfires represent a growing environmental health concern, especially in central and northern inland regions during the summer months. Smoke inhalation during wildfire events carries serious risks for those with respiratory or cardiovascular conditions. If you reside in a rural area, checking Portugal’s civil protection authority (ANEPC) for fire risk updates is strongly recommended.

Food and water safety is generally good on mainland Portugal. Tap water is treated and suitable for drinking in most urban settings, though rural properties relying on private wells should arrange for water quality testing. Standard food hygiene practices apply when consuming shellfish or raw seafood, both of which feature prominently in traditional Portuguese cooking.

Is smoking common in Portugal, and what are the laws around it?

Portugal has experienced a downward trend in smoking in recent years: daily smoking rates among adults declined from nearly 17% in 2014 to 14% in 2019, while among adolescents there was a reduction in reported cigarette smoking from 11% in 2018 to 9% in 2022. Despite this encouraging direction, tobacco use remains a meaningful public health challenge.

There are approximately 1,849,000 adult smokers in Portugal. Although the overall trajectory is downward, among teenagers the use of e-cigarettes increased slightly, from 12.4% to 13.4%, in the period 2015–2019. Vaping regulation has been tightened in line with broader EU directives, and e-cigarettes are subject to similar restrictions as conventional tobacco in many public settings.

Portugal introduced its first comprehensive tobacco control law (Law No. 37/2007) in 2007, which banned smoking in most enclosed workplaces, public spaces, restaurants, and bars. This framework broadly mirrors the kind of legislation introduced around the same time in countries like Ireland (2004) and France (2008). A revised law enacted in 2017 extended protections further, including restrictions near schools and healthcare facilities.

In Portugal, smoking is allowed but strictly regulated, with cigarettes permitted in the country under certain restrictions. Designated smoking rooms are still permitted in some hospitality venues, which means that visitors from countries with complete indoor smoking bans — such as the Republic of Ireland or New Zealand — may notice that smoking remains present in certain enclosed spaces.

Expats should be aware that while the legislation is well defined, enforcement in some smaller hospitality venues can be inconsistent. Outdoor café terraces, which are an integral part of Portuguese social life, are generally not covered by smoking restrictions, so non-smokers may encounter tobacco smoke when eating outside. Always check DGS guidance and any local authority updates for the most current rules.

Is obesity or poor diet a significant health concern in Portugal?

In contrast to the declining smoking rates, overweight and obesity levels have been edging upward in Portugal, with self-reported data classifying 17.1% of adults as obese in 2019 (up from 16.1% in 2014), and 20% of Portuguese 15-year-olds being either overweight or obese in 2022 (compared to 17% in 2010). Measured (rather than self-reported) rates are higher — reaching 29% among adults based on actual weight and height measurements as of 2015.

Portugal’s traditional diet is broadly Mediterranean in character — rich in fish, olive oil, legumes, vegetables, and whole grains — and is widely regarded as one of the healthier dietary patterns in the world. However, as in many European countries, eating habits have shifted over recent decades in the direction of more processed and convenience foods, which has contributed to rising rates of overweight and obesity, particularly among urban and younger populations.

In 2022, one in five people aged 15–74 drank daily or almost daily, while 3.5% reported alcohol abuse or dependence. Alcohol is deeply woven into Portuguese social and culinary life, and moderate wine consumption is widely accepted. Expats should note that alcohol-related health risks — including liver disease, cardiovascular complications, and mental health impacts — form a notable component of the broader diet and lifestyle picture.

Actions taken to improve dietary habits include measures under the National Programme for the Promotion of Healthy Eating, such as restrictions on advertising unhealthy foods to children, introducing nutrition standards in schools, no value-added sales tax on healthy foods, and a tax on sugar-sweetened beverages and high-salt/high-fat foods.

Additionally, the National Physical Activity Promotion Programme contains awareness-raising initiatives and pilot projects to encourage physical activity prescriptions in primary care, with the support of digital tools. Portugal’s outdoor lifestyle — shaped by a warm climate, an extensive coastline, and a strong walking and cycling culture in many communities — offers natural encouragement for staying active, which is a genuine advantage for health-conscious expats.

What are the mental health attitudes and services like in Portugal?

As in many Southern European countries, mental health in Portugal has historically been subject to social stigma, with a cultural tendency to interpret emotional difficulties in physical or spiritual terms rather than seeking psychological support. This dynamic is gradually shifting, especially among younger generations and residents of urban areas, where public awareness campaigns and more open dialogue are slowly reshaping attitudes.

The National Plan for Mental Health, adopted in 2016, sets out ways to ensure everyone has good mental health and helps people with mental illnesses. It creates a system where different healthcare and social services work together, and aims to ensure that mental health services are easy to access, that problems are identified early, and that the care provided is high quality.

The SNS (public health service) provides basic mental health assistance. If psychiatric or psychotherapist help is needed, a patient first visits a family doctor who can make the relevant referral. This referral-based model is similar to approaches used in countries such as the Netherlands or Australia, where a GP’s recommendation is typically required before accessing specialist mental health services within the public system.

However, the low number of mental health professionals and regional disparities in service accessibility pose obstacles to the swift implementation of mental health reforms. In practice, waiting times for public mental health appointments can be substantial, and availability outside major cities is considerably more limited. This stands in contrast to countries that have invested more heavily in public mental health infrastructure.

Private mental health services are widely available in Lisbon, Porto, and the Algarve, with many practitioners offering consultations in multiple languages — a practical consideration of considerable importance for expats. Costs vary, but therapy sessions typically range from €50–€100 per hour in private practice. International health insurance policies often provide partial or full cover for mental health consultations, and expats are strongly encouraged to clarify their policy terms before relocating.

Community support is also available through expat networks, international congregations, and organisations such as the Ordem dos Psicólogos Portugueses (the Portuguese Order of Psychologists), which maintains a searchable directory of registered professionals.

Are there any health risks specific to expats living in Portugal?

The majority of expats adapt well to life in Portugal, but there are several health considerations that deserve particular attention during the transition period and in the longer term.

Climate adjustment: Portugal is expected to experience more frequent and intense heatwaves, bringing significant health risks particularly for the elderly, children, and individuals with pre-existing conditions, with heat-related illnesses such as heat exhaustion and heat stroke expected to become more prevalent. Expats arriving from cooler climates should acclimatise at a gentle pace, maintain good hydration throughout summer, and exercise particular caution in inland regions such as the Alentejo, where summer temperatures regularly surpass 40°C.

Sun exposure and skin health: Portugal’s abundant sunshine, one of its great attractions for many incoming residents, carries an elevated risk of sunburn and cumulative skin damage. UV index readings are frequently high between April and September. Making a habit of applying high-SPF sunscreen, wearing protective clothing, and avoiding direct sun during the midday hours is especially important for those who were not previously accustomed to high-UV conditions. Scheduling regular skin checks with a dermatologist is advisable.

Registering with a GP: For foreign nationals with legal residency, obtaining a user number is the key to accessing SNS healthcare services. To secure your SNS user number, visit your local health centre (Centro de Saúde), choosing the centre nearest to your registered address, as the public healthcare system operates based on geographical areas. Completing this registration promptly on arrival gives you access to care, screening programmes, and preventive health services without unnecessary delay.

NHS family doctor shortage: Workforce pressures, including an ageing health workforce and high workloads, mean that 15% of people do not have an NHS family doctor. As a result, some newly registered expats may find themselves on a waiting list before being assigned a GP. In the meantime, private GP consultations are relatively affordable and easily accessible throughout the country.

Health insurance: Only 62% of health spending in Portugal is publicly financed, with out-of-pocket payments reaching 29% — one of the highest shares across the EU. Comprehensive private health insurance is strongly advisable for expats, particularly those who are self-employed, retired, or not yet fully integrated into the SNS, to ensure coverage for specialist consultations, dental treatment, and any shortfalls in public provision.

Preventive screenings: If you are relocating to Portugal after years within a different healthcare system, it is well worth requesting a thorough health review — covering blood pressure, cholesterol, blood glucose, and age- and sex-appropriate cancer screenings — when you register with a new GP. Portugal’s SNS runs a national preventive care programme, and getting up to date with recommended health checks is a sensible early priority.

Where can expats find reliable health information and services in Portugal?

Understanding and navigating an unfamiliar healthcare system is among the most pressing priorities for any new arrival. Portugal offers a variety of official and practical resources to help expats find their way.

1. Serviço Nacional de Saúde (SNS) — www.sns.gov.pt: The official portal for Portugal’s National Health Service. It provides information on registering with a GP, locating your nearest health centre, emergency services, and public health programmes. An English-language section is available.
2. Direção-Geral da Saúde (DGS) — www.dgs.pt: Portugal’s national public health authority, responsible for disease surveillance, vaccination programmes, health alerts, and official public health guidance. The DGS publishes regular updates on infectious diseases, seasonal health risks, and national health campaigns.
3. WHO Portugal country profile — data.who.int/countries/620: Provides regularly updated statistics on life expectancy, causes of death, and key health indicators for Portugal, useful for understanding the broader health landscape.
4. Statistics Portugal (INE) — www.ine.pt: Portugal’s national statistics agency publishes data on health trends, demographics, and chronic disease prevalence, useful for those wishing to understand longer-term patterns.
5. Your home country’s travel health authority: Before relocating, review official travel health guidance from your country of origin — such as the UK’s NHS Travel Health or equivalent national bodies — for vaccination recommendations and any health advisories relating to Portugal.
6. ANEPC (Civil Protection) — www.prociv.pt: For environmental health risks such as wildfires and heatwaves, Portugal’s civil protection authority issues real-time alerts and safety guidance.
7. Private health insurance providers: International health insurers active in Portugal, such as Allianz Care, Cigna Global, or AXA, offer expat-focused health plans and often maintain directories of English-speaking doctors and specialists.

Health guidelines, vaccination schedules, and service availability evolve over time. Always verify current requirements and procedures with official sources — particularly the DGS and SNS — both in advance of your move and after you have settled in Portugal. Information that is accurate at the time of publication may not fully reflect the situation at the point of your relocation.

Frequently Asked Questions About Health Issues in Portugal

Is Portugal a safe country from a disease perspective?

Yes, Portugal is regarded as a low-risk destination for most infectious diseases by international standards. No vaccinations are required for entry, tap water is generally safe to drink in urban areas, and food hygiene practices comply with EU regulations. The principal health concerns are non-communicable diseases such as cardiovascular disease, cancer, and diabetes — conditions that primarily affect the established resident population rather than representing an acute hazard for new arrivals.

Do I need any vaccinations before moving to Portugal?

The national vaccination programme is a universal and free initiative accessible to all the population living in Portugal. No vaccinations are required for entry into Portugal. However, it is sensible to ensure your routine vaccinations — such as MMR, tetanus, diphtheria, and polio — are current before you relocate. Consult your home country’s travel health authority for personalised advice tailored to your medical history.

Is the air quality good in Portugal?

High temperatures can aggravate air pollution, particularly in urban areas, as warmer weather can contribute to the formation of pollutants. Air quality across Portugal is generally good by European standards, though Lisbon and Porto can record higher pollution levels during hot spells and the wildfire season. Coastal and rural areas typically enjoy much cleaner air. Those with asthma or chronic respiratory conditions should monitor forecasts through the Portuguese Environment Agency (APA) at www.apambiente.pt.

How do I access mental health support as an expat in Portugal?

Within the public SNS system, mental health care is obtained through a referral from your assigned family doctor (médico de família). Waiting periods can be considerable, and availability is significantly better in urban centres than in rural areas. Many expats turn to private psychologists or therapists, particularly those who conduct sessions in multiple languages. The Ordem dos Psicólogos Portugueses maintains a searchable directory of registered practitioners throughout the country.

Is Portugal’s public healthcare system suitable for expats with chronic conditions?

Portugal’s SNS provides universal access to healthcare for legal residents, including the treatment and ongoing management of chronic conditions such as diabetes, cardiovascular disease, and cancer. However, in 2024, only 49% of Portuguese people surveyed were satisfied with their health service. Waiting times for specialist appointments can be lengthy, and out-of-pocket expenses are relatively elevated by EU standards. Expats managing pre-existing chronic conditions are strongly encouraged to obtain comprehensive private health insurance to complement public coverage.

What is the biggest lifestyle-related health risk in Portugal?

The most common chronic conditions in 2024 included lipid disorders, hypertension, obesity, and tobacco abuse. For expats, the interplay of a rich culinary culture, widespread alcohol consumption, and ready access to tobacco products creates conditions in which lifestyle-related health risks are genuinely present. Maintaining regular physical activity, eating a balanced diet, attending recommended health screenings, and keeping alcohol intake in check are among the most effective approaches to staying well.

Are wildfires a health risk in Portugal?

Yes, wildfires represent a growing environmental health concern, especially in inland central and northern areas during summer. Prolonged exposure to smoke from wildfire events can exacerbate respiratory and cardiovascular conditions and may affect otherwise healthy individuals. Expats living in rural or forested settings should sign up for alerts from ANEPC and ensure they have a personal emergency plan ready for the fire season, which typically runs from June through October.

Where can I find an English-speaking doctor in Portugal?

As an expatriate in Portugal, you have access to both public and private healthcare services. While the public system maintains a commendable standard, many expatriates choose private healthcare for reasons such as prompt service and the availability of multilingual medical professionals. Private hospitals and clinics in Lisbon, Porto, and the Algarve — such as Hospital da Luz, Hospital CUF, and the Hospital Particular do Algarve — routinely employ multilingual staff. Your international health insurer can also supply a list of approved practitioners in your area.