On most indices of social modernization, Portugal ranked at or near the bottom for all of Western Europe. Even in the early 1990s, despite some significant economic growth in the second half of the 1980s, Portugal remained relatively poor by West European standards. Although its range of public welfare programs was extensive, it lacked the funds to fully implement them and to pay substantial benefits.

Charity and alms-giving were traditionally thought to be the responsibility of the church. It provided welfare to the poor and took care of the sick, widows, and orphans. In addition, landowners and employers fulfilled their obligations of Christian charity by aiding the less fortunate through gifts, assistance, patronage, and benefits. The charitable institution established by Queen Leonor in the late fifteen century, Santa Casa de Misericórdia, had, even in the early 1990s, offices all through Portugal. Its charitable operations were financed by the national lottery. This system of charity provided by the church and the elite probably worked tolerably well through the 1920s, as long as Portugal remained a rural and Roman Catholic society. But urbanization, secularism, and large-scale impersonal organizations rendered the old system inadequate.

Salazar's corporative system attempted to fill the void but did so poorly. Only in the 1960s, far later than in other countries, were the first steps taken toward a modern state-run welfare system. As could be expected, the services this system provided were incomplete, irregular, and woefully underfunded. Urban centers received some benefits, but almost none went to the countryside. During the revolutionary 1970s, numerous health and social welfare programs were established, but only in the 1980s did Portugal have the stability and the resources to begin their implementation.

Social Welfare Programs

Portugal had a fairly elaborate social welfare system, including programs that provided benefits for the elderly and the seriously ill or disabled. However, the benefits paid by these programs were still quite low in the early 1990s, and an estimated 3 million Portuguese lived below the EC poverty line.

The programs' benefits were financed by employee and employer contributions (roughly 10 and 25 percent, respectively). Most of the programs were the responsibility of the Ministry of Employment and Social Security and were administered by regional social security centers. The Ministry of Health was involved in programs concerned with medical care.

As of the early 1990s, men and women could retire at sixtyfive and sixty-two years of age, respectively, and be eligible for old-age pensions. Miners were eligible at fifty and merchant sailors at fifty-five years of age. Benefits ranged from 30 to 80 percent of recent average wages. Permanent disability and survivor benefits were also paid. Unemployment benefits could be paid from ten to thirty months and amounted to 65 percent of earnings, with a maximum of three times the national minimum wage of about US$300 a month in the early 1990s.

As of 1991, maternity benefits amounted to 100 percent of the mother's pay for a period of three months, one month before and two months after the birth. Sickness benefits amounted to 65 percent of wages for up to 1,095 days; after this period, the benefit was converted to a permanent disability benefit. Accidents at work were covered by private insurance carried by employers; payments could amount to two-thirds of basic earnings. Small family allowances were paid to help rear children until they reached the age of fifteen or the age of twenty-five if they were students.

Health Care

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.

Housing

Much Portuguese housing was substandard, both in rural and in urban areas. Many rural villages were not electrified even by the early 1990s, and villagers often had to carry water from a common source. The influx of rural migrants to urban centers in recent decades intensified demand on an already inadequate housing supply. Although 60 percent of Portuguese rented their houses (80 percent in Lisbon and Porto), rigid rent control laws in effect between 1948 and 1985 had discouraged the construction of apartments, as did a sluggish bureaucracy. As a result, in the late 1980s an estimated 700,000 illegally constructed dwellings existed in Portugal, 200,000 of which were located in the Lisbon area. Some were built on public or unused private lands. The resulting urban shantytowns (bairros da lata) often lacked electricity, running water, or sewage systems.

In Lisbon's suburbs, gigantic apartment houses were built for the more affluent new city-dwellers, but the supply of decent, affordable housing lagged far behind the demand, estimated at 800,000 dwellings for the entire country. A succession of Portuguese governments recognized this severe housing problem and sought to do something about it. For example, the National Housing Institute planned to build 70,000 dwellings a year during the 1990s, and various programs to help people become homeowners had been put into practice.

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Source: U.S. Library of Congress