Health Systems in Transition

Health systems in transition

Portugal

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The recent National Health Survey with Physical Examination (INSA, 2016)

identified that the prevalence of high blood pressure, diabetes and overweight

was higher among men than women, whereas obesity affected more women

than men (see section 1.4). However, comparing regions and removing the

effects of sex and age, the Survey found that standardized prevalence:

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for high blood pressure and obesity was highest in the North Region;

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for diabetes was highest in Azores;

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for dyslipidaemia was highest in the Centre Region.

Also, age- and sex-standardized prevalences for high blood pressure,

diabetes, overweight, obesity and dyslipidaemia were higher among those with

low or no education, and among those with unpaid occupations (INSA, 2016).

The population with the highest educational level (i.e. tertiary education)

showed higher prevalence of fruit and vegetable consumption (81.5% and

80.%, respectively), whereas the unemployed had the lowest prevalence of

fruit and vegetable consumption (71.5% and 68.5%, respectively) (INSA, 2016).

Sedentary lifestyle was also high among the unemployed (46.9%), those with low

education (51.6%) and those living in the Azores (52.5%), whereas the highest

levels of physical exercise were recorded among those living in the Region of

Lisbon and the Tagus Valley (40.3%), those with higher education (49.6%) and

those in employment (38.4%) (INSA, 2016).

Regarding smoking, Azores (42.8%) and Algarve (22.2%) recorded the

highest rates of smoking among men and women, respectively in 2014. Among

women, tobacco consumption increased with education level; whereas among

men, smoking was more prevalent among those with mid-education (e.g. men

with primary education and tertiary education are less likely to smoke than

those with secondary education) (INSA, 2016). The unemployed population

recorded the highest prevalence of smoking for both sexes (43.0% males and

27.0% females) (INSA, 2016). Finally, Alentejo and Madeira showed the

highest prevalence of binge drinking in both sexes: Alentejo – 51.6% men and

11.3% women; Madeira – 49.9% men and 10.8% women.

These differences are important in the analysis of mortality data across

regions in Portugal (see section 1.4). In 2014, standardized death rate (SDR) for

malignant neoplasms was higher in Madeira and Azores (INE, 2016c). However,

Azores recorded the highest SDR for the following (INE, 2016a):

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trachea, bronchus and lung cancer (43.3 per 100 000 population), both for

men (82.3/100 000) and women (12.2/100 000);