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Avaliação das Necessidades de Saúde em Zonas de Baixa Densidade Populacional
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RESUMO - Introdução: O presente estudo teve como objetivo avaliar as necessidades de saúde nas zonas de baixa densidade populacional em Portugal, analisando os principais desafios e barreiras no acesso aos cuidados de saúde. Estes territórios, que representam uma parte significativa do país, caracterizam-se por densidade populacional inferior a 20 habitantes por km² e índices de envelhecimento muito superiores à média nacional, fatores que condicionam a equidade no acesso e a sustentabilidade do Serviço Nacional de Saúde.
Metodologia: Foi adotada uma abordagem mista, de carácter exploratório-descritivo, que combinou análise quantitativa de indicadores demográficos, socioeconómicos, epidemiológicos e de recursos de saúde, recolhidos em fontes oficiais (INE, DGS, ACSS, PORDATA), para o período de 2018 a 2023. A componente qualitativa consistiu na realização de quatro entrevistas semiestruturadas a profissionais de saúde de diferentes municípios, conduzidas no verão de 2025, via plataforma online, com gravação, transcrição integral e análise temática manual.
Resultados: Os resultados quantitativos revelaram densidades populacionais muito baixas, índices de envelhecimento superiores a 300, baixos níveis de poder de compra e taxas de mortalidade elevadas por doenças do aparelho circulatório, a par de rácios deficitários de médicos de família e enfermeiros. As entrevistas confirmaram estas vulnerabilidades, salientando a escassez de profissionais, as dificuldades de transporte e os custos elevados associados, a dispersão geográfica e a sobrecarga resultante do envelhecimento populacional. Apesar destas barreiras, emergiram também sinais de resiliência, como a solidariedade comunitária na partilha de transportes, a colaboração institucional em alguns concelhos e a elevada confiança da população nos profissionais de saúde.
Conclusão: Conclui-se que as necessidades de saúde em zonas de baixa densidade resultam da conjugação de fatores demográficos, socioeconómicos e organizacionais, traduzindo-se em desvantagens acumuladas para as populações. O estudo reforça a necessidade de políticas territorialmente diferenciadas, com incentivos eficazes à fixação de profissionais, soluções de transporte em saúde, modelos de cuidados integrados e estratégias de literacia em saúde adaptadas ao contexto rural.
ABSTRACT - Introduction: This study aimed to assess health needs in low-density population areas in Portugal, focusing on the main challenges and barriers to accessing healthcare services. These territories, which represent a significant part of the country, are characterized by population densities below 20 inhabitants per km² and ageing indices well above the national average, factors that strongly condition equity of access and the sustainability of the National Health Service. Methods: A mixed exploratory-descriptive design was adopted, combining quantitative analysis of demographic, socioeconomic, epidemiological, and healthcare resource indicators, collected from official sources (INE, DGS, ACSS, PORDATA) for the period 2018–2023. The qualitative component consisted of four semi-structured interviews with healthcare professionals from different municipalities, conducted in the summer of 2025 via online platform, audio-recorded, fully transcribed, and thematically analyzed manually. Results: Quantitative findings revealed very low population densities, ageing indices above 300, low purchasing power levels, and high mortality rates from circulatory diseases, alongside deficient ratios of general practitioners and nurses. The interviews confirmed these vulnerabilities, highlighting staff shortages, transportation difficulties and associated costs, geographic dispersion, and the burden of an ageing population. Nevertheless, signs of resilience also emerged, such as community solidarity through shared transport, institutional collaboration in some municipalities, and strong trust of the population in healthcare professionals. Conclusion: The study concludes that health needs in low-density population areas result from the combination of demographic, socioeconomic, and organizational factors, leading to cumulative disadvantages for local populations. The findings reinforce the need for territorially differentiated policies, including effective incentives for staff retention, healthcare transport solutions, integrated care models, and health literacy strategies adapted to rural contexts.
ABSTRACT - Introduction: This study aimed to assess health needs in low-density population areas in Portugal, focusing on the main challenges and barriers to accessing healthcare services. These territories, which represent a significant part of the country, are characterized by population densities below 20 inhabitants per km² and ageing indices well above the national average, factors that strongly condition equity of access and the sustainability of the National Health Service. Methods: A mixed exploratory-descriptive design was adopted, combining quantitative analysis of demographic, socioeconomic, epidemiological, and healthcare resource indicators, collected from official sources (INE, DGS, ACSS, PORDATA) for the period 2018–2023. The qualitative component consisted of four semi-structured interviews with healthcare professionals from different municipalities, conducted in the summer of 2025 via online platform, audio-recorded, fully transcribed, and thematically analyzed manually. Results: Quantitative findings revealed very low population densities, ageing indices above 300, low purchasing power levels, and high mortality rates from circulatory diseases, alongside deficient ratios of general practitioners and nurses. The interviews confirmed these vulnerabilities, highlighting staff shortages, transportation difficulties and associated costs, geographic dispersion, and the burden of an ageing population. Nevertheless, signs of resilience also emerged, such as community solidarity through shared transport, institutional collaboration in some municipalities, and strong trust of the population in healthcare professionals. Conclusion: The study concludes that health needs in low-density population areas result from the combination of demographic, socioeconomic, and organizational factors, leading to cumulative disadvantages for local populations. The findings reinforce the need for territorially differentiated policies, including effective incentives for staff retention, healthcare transport solutions, integrated care models, and health literacy strategies adapted to rural contexts.
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Necessidades de saúde Zonas rurais Baixa densidade populacional Acesso aos cuidados Desigualdades em saúde Health needs Rural areas Low-density population Access to care Health inequalities