Growing old in Portugal: Challenges for health and social support services

Abstract

Portugal is one of the most aged countries in Europe, with a rapidly growing proportion of people aged 65 and older, particularly concentrated in rural and interior regions. This demo- graphic shift poses major challenges for health and social support services, already under pressure from limited resources, workforce shortages, and increasing demand for long-term care. The high prevalence of chronic diseases such as hypertension, diabetes, osteoarthritis, and cardiovascular conditions, combined with low levels of health literacy and persistent social inequalities, amplifies the risk of dependency, multimorbidity, and social isolation among older adults. The reorganization of the Portuguese health system, including the creation of new Local Health Units (ULS), seeks to improve coordination across primary care, hospitals, and com- munity services. However, gaps remain in ensuring equitable access, integrated care path- ways, and effective support for family and informal caregivers. Innovation is urgently need- ed to move beyond fragmented, hospital-centered care models toward community-based, preventive, and person-centered approaches. Promising strategies include strengthening health literacy, deploying digital and telemonitoring tools, co-creating interventions with older adults and caregivers, and promoting active and healthy ageing through intersectoral collaboration. This presentation will highlight the structural, demographic, and cultural factors shaping the ageing experience in Portugal, discuss ongoing reforms and their implications, and show- case innovative community-based initiatives. By addressing these challenges through inte- grated and participatory approaches, Portugal can better respond to the needs of its older population while building more resilient and sustainable health and social support systems.