The observed pattern shows that most deaths occurred among people aged 75 or older, with a predominance of circulatory, respiratory and neoplastic causes.
Portugal has so far recorded three periods of excess mortality from all causes during the summer of 2026, totaling 680 deaths above the expected number, according to estimates from the National Institute of Health Ricardo Jorge (INSA).
According to data provided to the Lusa news agency by INSA and the Directorate-General of Health (DGS), updated as of July 30, the first period occurred on June 16, with an estimated excess of 62 deaths (+22.4% compared to expected), coinciding with an episode of high temperatures.
The second period, “of greater magnitude,” occurred between July 2 and 8, with an estimated 555 excess deaths, 29% above expected mortality. “This period coincided with an episode of extreme and prolonged heat, and the possible influence of high temperatures in the immediately following days should also be considered,” they state in an assessment requested by Lusa.
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The third occurred on July 23, with an estimated excess of 63 deaths (+23.5% compared to expected), mainly among those over 75. “This is a single day and the most recent data may still undergo adjustments as records are updated, so only with consolidated information will it be possible to assess the significance of this increase,” the entities caution.
INSA and DGS explain that these estimates correspond to excess mortality from all causes, obtained through statistical models that compare observed mortality with the mortality expected for the time of year. The observed pattern shows that most deaths occurred among people aged 75 or older, with a predominance of circulatory, respiratory and neoplastic causes.
According to the entities, deaths whose underlying cause of death was coded as exposure to excessive heat represent only a small part of the impact of heat on mortality, since, in most cases, heat acts as a triggering or aggravating factor for other conditions rather than as the underlying cause of death recorded on the death certificate.
On the other hand, in younger age groups, observed mortality was mainly due to external causes, not showing a pattern directly compatible with an association with heat. The observed values were below the mortality impact estimated by the ÍCARO Index, a predictive model that assesses the risk associated with observed or forecast temperatures.
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Health authorities note that this difference may be related to the effectiveness of preparedness and response measures implemented by Public Health and other entities, to the thermal exposure experienced, to the phenomenon of temporal displacement of mortality (“harvesting”), and to the degree of consolidation of death records.
They explain that the magnitude of the impact of each episode depends on the intensity and duration of the heat and the effectiveness of the protective measures adopted, especially for the most vulnerable groups.
They add that, in the absence of competing explanatory causes for excess mortality, such as respiratory viruses, this is mostly attributable to extreme temperatures. According to INSA and DGS, the observed pattern is similar to that seen in previous episodes in Portugal and in other European countries, such as Spain and France, where higher excess mortality than Portugal’s was recorded.
They also note that heat frequently acts as a precipitating or aggravating factor for pre-existing conditions, especially cardiovascular and respiratory diseases, increasing the risk of acute events and death, particularly among elderly, frail people or those with multiple comorbidities.
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The DGS continues to monitor the weather situation and health and mortality indicators in coordination with INSA, IPMA and other entities of the Ministry of Health, adjusting the measures set out in the National Seasonal Health Preparedness and Response Plan whenever necessary.
