Psychiatric Annals, April 19, 2013
The economic recession and subsequent austerity measures in Greece were associated with a significant deterioration in public health services and mental and physical health outcomes, according to a new report by Greek and US researchers.
“We were expecting that these austerity policies would negatively affect health services and health outcomes, but the results were much worse than we imagined,” study researcher Elias Kondilis, PhD, of Aristotle University of Thessaloniki in Greece, said in a press release.
Kondilis and colleagues examined data on economic and social conditions, the utilization of health services, and health outcomes in Greece during the 2008-2012 recession. Between 2009 and 2011, there was a 23.7% reduction in the Ministry of Health’s expenditures, and the overall expenses of public hospitals fell by 12.5% during the same period. To address the growing economic crisis, the government deregulated private health services.
A number of adverse health outcomes coincided with these events, according to the researchers.
The all-cause mortality rate continued to decline during the economic crisis, but suicide, homicide and infectious disease rates increased by 16.2%, 25.5% and 13.2%, respectively.
Specifically, the suicide and homicide rates among men increased by 22.7% and 27.6%, respectively, between 2007 and 2009. The 1-month prevalence of major depression doubled between 2008 and 2009 from 3.3% to 6.8%, and the number of people with problematic drug use — primarily heroin — increased 11.6% from 2008 to 2010. Among those aged 35 to 64 years, the increase in the prevalence of drug use was even more significant, at 88.2% in 2010.
Greece experienced three outbreaks of infectious disease in a period of less than 18 months. There were 197 reported cases of neuroinvasive disease and 35 related deaths in October 2010; 63 cases of malaria between May and October 2011; and a 57.2% increase in newly diagnosed cases of HIV-1 infection from 2010 to 2011. Among injection drug users, there was a 1,506.7% increase in newly diagnosed HIV-1 infections.
Although the increased prevalence of infectious disease in Greece was initially attributed to environmental risk factors and migrant populations, the researchers said cutbacks in public health services were to blame, as well. Preventive services such as mosquito- and vector-control programs and the distribution of condoms and clean needles had been dismantled.
The recession in Greece and its economic policies to address the crisis also had an effect on the utilization of health care services, the researchers said. The use of private medical facilities decreased, and the use of public inpatient and primary care services increased by 6.2% and 21.9%, respectively, between 2010 and 2011.
Study researcher Howard Waitzkin, PhD, MD, of the University of New Mexico, said severe economic cutbacks in the United States could lead to health outcomes similar to those in Greece.
“Instead of austerity policies, we need increased public health sector spending to stimulate our failing economy and to protect the health of our people,” he said in the press release.
Disclosure: The researchers report no relevant financial disclosures.
Kondilis E. Am J Public Health. 2013;doi:10.2105/AJPH.2012.301126.
http://www.healio.com/psychiatry/suicide/news/online/%7B69483171-C5EB-4FE8-8DF2-D4BA6B5DB576%7D/Austerity-in-Greece-linked-to-serious-mental-physical-health-decline