Since the end of the 1950s drastic transformations have occurred in the Portuguese economy and society. There have been large political, social, technological and economic changes: the establishment of a democratic political system, a redefined relationship between the State and the Catholic Church, the end of the colonial empire, the growth of the middle class, better school education, and ‘open frontiers’ to people and goods. In addition to these changes, in 1986 Portugal joined the European Union. These developments also influenced, and were influenced by public health, for example, a decrease in the fertility rate and in child mortality, changes in consumption patterns, improved health care and social security services (e.g., Barreto, 1996).