Eduarda Marques da Costa, born in Lisbon in 1966, is associate professor of the Institute of Geography and Spatial Planning of University of Lisbon. She teaches Geography and Spatial Planning since 1990, she is researcher in the Centre of Geographical Studies, since 1987 and since 2009 that is coordinator of Modelling and Spatial Planning Research Group. Between 2010-2020, was coordinator of the graduation in Spatial Planning (2010-2020) and since 2020 the co-coordination of the master on Spatial Planning and Urbanism. The main scientific areas of their interest are Regional, Urban and Local Planning, Urban Geography, Health cities, Cohesion Policy and Evaluation of Public Policies. https://orcid.org/0000-0001-5070-3562
Marques da Costa, E.
Elderly patterns of access to primary health care services – when inequities come from urbanization model
Eduarda Marques da Costa, Universidade de Lisboa, Center of Geographical Studies-Institute of Geography and Spatial Planning
Marcela Barata, Universidade de Lisboa, Lisboa
Nuno Marques da Costa, Universidade de Lisboa, Lisboa
Changes in demographic and family structures have been reflected in an increased need for public strategies to monitor and respond to aging process in Portuguese society. Portugal emphasizes the attention to “proximity services”, traduced in the formal support network (Order nº 407/98) which includes: Day Centers, Social Centers, Social Services Home Support (SAD) and Residential Structures for the Elderly (ERPI). The increasing demand for this type of support responds to the need for a better quality of life, fighting the loss of neighborhood relationships and the separation of families, especially in rural areas. From another perspective, its inclusion in urban policies is highlighted, namely by the World Health Organization (WHO), which brought the concept of “An age-friendly city” in 2008. In this context, the availability and physical accessibility to this type of services are fundamental for their access.
This study aims to identify the potential coverage of formal support services in view of the aging framework that characterizes our territory, taking Aveiro, Coimbra, Faro (3 medium-sized cities) and Lisbon (the capital of Portugal) as case studies. The methodology used includes the collection and georeferentiation of formal support equipment, with the determination of their coverage potential through the application of a network analysis, values that are compared with the distribution of the elderly population.
The results show a dysfunction between the demand and the offer of these services, especially because their geographical location not fulfil the proximity concept. This pattern is not exclusive of Lisbon city but also in medium-sized cities of Portugal, putting the relation between health and urban planning in the core of municipal action. Which services were provided? Which new need emerged in pandemic times? What new services emerged? The pandemic times put a large pressure in these services, but also male evident that a strategic answer in terms of service provision represents the guarantee of equal access and a large contribution to active ageing support measures.
The paper also concludes on the need for municipalities to develop monitoring of these services, finding territorially appropriate responses, “adapting their structures and services so that they include and are accessible to older people with different needs and capacities”.