Learn Hardcore Portuguese (Portugal): A Ana está preocupada com a sua saúde mental e física este ano. - Ana is worried about her mental and physical health this year.

This sounds completely normal and neutral in Portugal. Omitting the article (Ana está preocupada…) is also possible, but it can sound a bit more formal, written, or careful.

So:

A Ana está preocupada… – the most natural everyday version in Portugal.
Ana está preocupada… – fine, but a bit more “bookish” or formal-sounding in many contexts.

In direct address (when you are speaking to Ana), you normally drop the article:

Ana, estás preocupada com a tua saúde? – Ana, are you worried about your health?

Why is it está preocupada and not é preocupada?

Portuguese uses estar for temporary states and ser for more permanent characteristics.

A Ana está preocupada…
= Ana is (currently) worried; this is how she feels now / this year.
A Ana é preocupada.
= Ana is a worrier / a generally worried or anxious person (a personality trait).
This is much less common and sounds like you are describing her character.

In your sentence, we are clearly talking about how Ana feels this year, so está preocupada (with estar) is the correct choice.

Why does preocupada end in -a? Would a man say preocupada too?

No. The ending -a shows that the adjective is feminine singular, agreeing with Ana, which is a feminine noun.

A Ana está preocupada. – Ana is worried.
O João está preocupado. – João is worried.

General pattern:

masculine singular: preocupado
feminine singular: preocupada
masculine plural: preocupados
feminine plural: preocupadas

Adjectives in Portuguese usually agree in gender and number with the noun they refer to.

Is está preocupada a sort of continuous tense, like is worrying, or is it more like is worried?

Here preocupada is functioning as an adjective, not as a verb form in a progressive tense.

So:

A Ana está preocupada…
is best understood as Ana is worried… (a state), not Ana is worrying… (an ongoing action).

If you wanted to express the action to worry, Portuguese would normally use the reflexive verb preocupar-se:

A Ana preocupa-se com a sua saúde. – Ana worries about her health.
A Ana anda a preocupar-se muito com a sua saúde. – Ana has been worrying a lot about her health.

Your sentence focuses on her state (she is in a worried condition), not on the ongoing action of worrying.

Why is the preposition com used after preocupada? Could I use por or sobre instead?

With preocupado / preocupada, the natural preposition in Portuguese is com:

estar preocupado com algo – to be worried about something
preocupar-se com algo – to worry about something

So:

A Ana está preocupada com a sua saúde… – Ana is worried about her health…

You would not normally say:

✗ preocupada por a sua saúde
✗ preocupada sobre a sua saúde

Those sound unnatural in standard Portuguese. Treat preocupado com as a fixed combination.

Why do we say com a sua saúde and not just com sua saúde?

In European Portuguese, possessive adjectives (meu, teu, seu, nossa, etc.) are normally used with the definite article:

a minha saúde – my health
a tua casa – your house
o seu carro – his / her / your car (formal)

So the most natural form is:

com a sua saúde – with her health / about her health

Without the article (com sua saúde) is possible in some very formal or fixed expressions, but in everyday modern European Portuguese it usually sounds odd or old-fashioned.

Therefore:

com a sua saúde mental e física – the normal, idiomatic structure.

Does sua necessarily refer to Ana here? Could it be someone else’s health?

By default, in a sentence like:

A Ana está preocupada com a sua saúde…

Portuguese speakers will interpret sua as referring back to Ana (the subject).

However, in a longer context with several third-person people, seu/sua can become ambiguous. To avoid confusion, Portuguese often uses dele / dela (of him / of her):

A Ana está preocupada com a saúde mental e física dela.
= Ana is worried about her (some other woman’s) mental and physical health.
A Ana está preocupada com a saúde mental e física da mãe.
= Ana is worried about her mother’s mental and physical health.

In everyday European Portuguese, because você is much less frequent, sua is usually understood as his/her (referring to the subject), not your, so here it is naturally Ana’s own health.

Why is it a sua saúde and not o seu saúde? How do I know the gender?

The possessive agrees with the gender and number of the noun possessed, not with the owner.

saúde is a feminine noun in Portuguese: a saúde.
Therefore the possessive must also be feminine: a sua saúde.

Examples:

a minha saúde – my health
a tua saúde – your health
a nossa saúde – our health

For a masculine noun:

o meu carro – my car
o teu livro – your book
o seu problema – his / her problem

So: a sua saúde, never o seu saúde.

Why is it saúde mental e física and not mental e física saúde?

In Portuguese, the normal order is:

noun + adjective(s)

So you say:

saúde mental – mental health
saúde física – physical health
água fria – cold water
carro novo – new car

Putting the adjectives before the noun (mental e física saúde) is ungrammatical in this case.

You can, however, have multiple adjectives after the noun and link them with e:

saúde mental e física – mental and physical health

This matches the typical noun-first pattern of Portuguese.

Could I say saúde física e mental instead of saúde mental e física? Does the order change the meaning?

Yes, you can say:

saúde mental e física
or
saúde física e mental

Both are grammatically correct and mean the same thing: mental and physical health.

The difference is mostly stylistic:

Many people naturally say saúde mental e física, because mental health is often mentioned first in modern discussions.
Reversing them to saúde física e mental is also fine; it may just reflect what you want to emphasize or your personal rhythm when speaking.

There is no grammatical rule that one must come before the other here.

Why is there no article before este ano? Should it be neste ano or este ano?

With demonstratives like este, esse, aquele, you normally do not use a separate definite article:

este ano – this year
esse mês – that month
aquele dia – that day

So este ano is perfectly correct as a time expression.

You can also use the contracted form with a preposition:

neste ano = em + este ano – in this year
este ano – this year (as a simple adverbial phrase)

In your sentence:

A Ana está preocupada com a sua saúde mental e física este ano.

este ano works as a time adverbial (when she is worried), so no article is needed, and you do not need em before it.

Can este ano appear in a different position in the sentence? Does the meaning change?

Yes, este ano is quite flexible in position. All of these are possible:

Este ano, a Ana está preocupada com a sua saúde mental e física.
A Ana, este ano, está preocupada com a sua saúde mental e física.
A Ana está, este ano, preocupada com a sua saúde mental e física.
A Ana está preocupada, este ano, com a sua saúde mental e física.
A Ana está preocupada com a sua saúde mental e física este ano. (your version)

They all mean essentially the same thing: that this year is the time frame for her worrying.

Nuance:

Putting este ano at the beginning (1) slightly emphasises the time frame: As for this year, Ana is worried…
Keeping it at the end (5) is neutral and very common in speech and writing.

None of these word orders is ungrammatical; it is mostly a question of emphasis and style.

Could I say A Ana anda preocupada com a sua saúde mental e física este ano? How is that different from está preocupada?

Yes, you can say that, and it adds a nuance:

A Ana está preocupada…
= Ana is worried (describes her current state at this time).
A Ana anda preocupada…
literally “Ana goes around worried” and is best translated as:
= Ana has been worried / has been going around worried (for some time recently).

In European Portuguese, andar + past participle/adjective often suggests:

a repeated or ongoing situation
something that has been happening lately / these days

Since you already have este ano, anda preocupada… este ano implies that throughout this year she has been in a worried state, not just at a single moment.

How is this sentence pronounced in European Portuguese? Are there any tricky sounds?

Here is a rough pronunciation guide using English-like approximations (not exact IPA):

A Ana – ah AH-nuh
está – shtah (the e is very short; es- often sounds like sh in Portugal: shtá)
preocupada – preh-oo-koo-PAH-duh (stress on -pa-)
com a – kõ mah (the om is nasal, like French on)
sua – SOO-uh (two syllables)
saúde – sah-OOD(uh) (the final e is very short, almost like a little grunt)
mental – men-TAL (clear l at the end)
e – ee (like English ee in see)
física – FEE-zee-kuh (stress on FÍ-)
este – EESH-t(ee) (in most of Portugal: es → eesh)
ano – AH-noo (final o often reduced and not too strong)

Spoken relatively naturally:

A Ana está preocupada com a sua saúde mental e física este ano.
ah AH-nuh shtah preh-oo-koo-PAH-duh kõ mah SOO-uh sah-OOD(uh) men-TAL ee FEE-zee-kuh EESH-t(ee) AH-noo

Main tricky points for English speakers learning European Portuguese:

The sh/tch-like sound at the start of está and este.
The nasal vowel in com (kõ).
The very short final vowels (saúde, física, ano) compared to English.