Longevity, Healthcare and the Geography of a Longer Life

Health and wellbeing are among the themes on the agenda, alongside wealth, family and cross-border planning, in a wider conversation about how internationally minded families plan for the long term.

Speakers include Dr. Nina Patrick, a longevity researcher and entrepreneur; Cintia Mano, Chief Investment Officer at the European Longevity Hub; and Dr. Joana Costa, Clinic Director at B-life Clinic. Hosted by Global Citizen Solutions, in partnership with CNN Portugal, the Summit brings together investors, advisors, family offices, government officials and industry leaders over two days of main-stage discussions and specialist-led workshops.

Why quality of life now shapes the decision

Health, wellness and quality of life are no longer secondary considerations when families decide where to live. Where someone lives shapes what they eat, how much they move, the air they breathe, the care they can reach and the community around them, and over decades those factors compound. Increasingly, they are part of the decision itself. The InterNations Expat Insider 2025 survey found that lifestyle now edges out career as a reason for moving abroad, named by 19% of expatriates against 18% who relocate for work.

Portugal performs strongly on that measure. It ranks 11th in the world in the Quality of Life Index of Global Citizen Solutions’ Global Passport Index 2026, which assesses countries on sustainable development, cost of living, happiness, personal freedoms, environmental performance and the acceptance of migrants.

Portugal and the next Blue Zones

Blue Zones are the handful of communities, such as Sardinia in Italy, Ikaria in Greece and Okinawa in Japan, where people live measurably longer, healthier lives, sustained by simple diets, daily movement and close social ties. A Global Citizen Solutions briefing on extending the Blue Zone model looks at where similar conditions are emerging, and finds some of the strongest candidates in Portugal.

The Azores and Madeira are both rated strong candidates, alongside Galicia in Spain and Muğla on Turkey’s Aegean coast. On the island of São Miguel in the Azores, an Atlantic diet of fresh fish, seasonal vegetables and legumes goes hand in hand with an active rural life, with only 5% of the island’s land built up. On the Portuguese island of Madeira, a mild subtropical climate, steep terrain and the island’s levada trails keep older residents moving, while family ties remain strong. Portugal also recorded the cleanest air of all the emerging regions assessed, and both archipelagos are accessible through Portuguese citizenship and residency routes, including the Golden Visa.

Health moves to the front of the plan

Yet residency and citizenship decisions are still usually discussed in terms of mobility, tax, investment and security. Health is often treated as a secondary consideration, something to be arranged once the move has been made.

That ordering is starting to change. As internationally-minded families plan over longer horizons, the questions extend well beyond where they can travel or invest. They include where they will receive care in later life, where their children will raise their own families, and how their health and wealth will be managed across borders over several decades.

Those horizons are lengthening in two directions at once. Global Citizen Solutions' 2026 Global Retirement Report and Index notes that many people are aiming to step back from full-time work earlier, with research cited in the report finding that Gen Z expects to retire at 54 on average.

At the same time, people are living longer. As the report points out, someone who stops working at 40 or 45 may need to fund 50 or 60 years of life, with rising healthcare costs compounding over that span.

"Longevity is becoming part of how families think about where they want to live," said Patricia Casaburi, Founder and CEO of Global Citizen Solutions. "They want a country where the lifestyle naturally supports a long life: good food, good water and a good medical system. Healthcare is really an important part of that."

Longevity, in this sense, is not only a scientific or medical subject. It is also a planning question, and one that sits naturally alongside residency and citizenship.

Healthcare access is a jurisdictional question

Access to healthcare depends heavily on legal status. Residency, citizenship and tax residence can each affect which public systems a person can use, how private insurance is priced, and what continuity of care is possible when moving between countries.

For a family spread across several jurisdictions, these questions rarely have a single answer. A parent may spend most of the year in one country, a child may study in another, and an older relative may need long-term care somewhere else. Each arrangement carries its own rules, costs and practical limitations.

This is why healthcare belongs at the start of a residency or citizenship conversation, not at the end. The legal route chosen today can shape the options available to a family many years from now.

Longevity is also an investment theme

For many investors, longevity is not only a personal concern. It is increasingly discussed as an area of investment and innovation in its own right, spanning research, healthtech, preventive care and related services.

At the Summit, Mano brings the investor's perspective, while Patrick brings the view from science and innovation.

For internationally minded investors, the two perspectives meet. The same family may be thinking about longevity as a personal priority and as an allocation decision, sometimes in the same jurisdiction.

Planning across generations

Longer lives also change the shape of family wealth. Decisions about residency, citizenship, tax, investment and succession now often affect three generations at once, sometimes living in different countries.

For many families, the family office is where those decisions come together. Rather than a series of separate choices made by different advisors at different times, the aim is a single plan in which each part supports the others.

What this means for residency and citizenship planning

Bringing longevity into the planning process does not mean choosing a jurisdiction for its healthcare alone. It means asking a wider set of questions at the outset, such as:

· Does the country’s way of life support long-term wellbeing, from healthcare and safety to environment, community and daily routine?

· Which healthcare systems will each family member be able to access, and on what terms?

· Does the route lead somewhere: permanent residency, citizenship or the right to keep an existing nationality?

· Can the people who matter most, whether a spouse, children or parents, be included now or join later?

· How do these priorities interact with tax residence, investment decisions and succession planning?

· Is the plan flexible enough to adapt as the family’s circumstances, and the wider landscape, evolve?

“Retirement abroad is a decision measured in decades, so the later years deserve as much thought as the first. Where a visa leads matters as much as where it starts,” said Laura Madrid, Lead Researcher, Global Intelligence Unit, Global Citizen Solutions.

The answers will differ for every family. What they share is a longer horizon. A residency or citizenship decision made with longevity in mind is more likely to remain useful across decades, rather than solving only the needs of the next few years.

Residency and citizenship planning has always been about the future. As families plan for longer lives, that future extends further, and health becomes one of the factors that shapes it.

The most useful plans consider where a family can live and invest today, and where they will want to live, work and receive care in the decades ahead.

Contact: Nicholas Walker

Nicholas@globalcitizensolutions.com