The number of doctors, dentists, and nurses increased greatly between 1960 and the early 1990s. At 26,400 in 1987, the number of physicians actively practicing medicine in Portugal represented a fourfold increase over the total in 1960. The number of dentists expanded even more dramatically, from 120 in 1960 to 5,700 in 1986. As of 1987, the number of medical personnel per occupied hospital bed was 1.7, compared with 0.24 in 1960. By 1990 there were 2.9 doctors per 1,000 Portuguese, a ratio higher than that found in most West European countries. However, most medical personnel were concentrated in urban centers, to the detriment of those needing health care in rural areas. In the latter areas, folk health practitioners were not uncommon, even in the early 1990s. Their medical practices were often fused with magical, religious, and superstitious elements.