public health


The continuing worldwide economic crisis and austerity measures have raised concerns about the impact of economic conditions on public health.

An article published in the American Journal of Public Health, co-authored by a Queen Mary, University of London Research Fellow, shows that economic recession and austerity policies imposed in Greece have had detrimental effects on health services and health outcomes.

The study, led by researchers at the Aristotle University of Thessaloniki in Greece and the University of New Mexico in the United States , analysed current data on economic and social conditions, use of health services, and health outcomes.

Key public health indicators were found to have deteriorated in association with economic crisis and austerity policies that reduced public services. After 14 years of continuous economic expansion since 1994, Greece’s gross domestic product (GDP) started showing zero or close to zero growth rates since the fourth quarter of 2007 and negative growth rates from the fourth quarter of 2008 onwards.

Between 2007 and 2009, suicide and homicide mortality rates among men increased by 22.7 per cent and 27.6 per cent. Mental disorders, substance abuse, and infectious diseases showed deteriorating trends during 2010 and 2011.

Despite worsening health conditions the Ministry of Health’s total expenditures fell by 23.7 per cent between 2009 and 2011. Meanwhile, due to unemployment and loss of personal income, patients decreased their use of private medical facilities, and use of already stressed public inpatient and primary care services rose by 6.2 per cent and 21.9 per cent between 2010 and 2011.

Dr. Elias Kondilis, lead author of the study and a Research Fellow at Queen Mary’s Global Health, Policy and Innovation unit, said:  “We were expecting that these austerity policies would negatively affect health services and health outcomes, but the results were much worse than we imagined.”*

Based on their findings, the authors criticize austerity policies that are likely to cause deteriorating health conditions in other European countries and in the United States.

“Economic crisis, restrictive policies, and the population’s health and health care: The Greek case” Elias Kondilis, M.D., Ph.D., Stathis Giannakopoulos, M.D., Ph.D., Magda Gavana, M.D., Ph.D., Ioanna Ierodiakonou, M.D., Ph.D., Howard Waitzkin, M.D., Ph.D., and Alexis Benos, M.D., Ph.D., American Journal of Public Health, Published online ahead of print April 18, 2013: e1–e8. doi:10.2105/ AJPH.2012.301126

Economic Crisis, Restrictive Policies, and the Population Health Care The Greek cases

source: Queen Mary University of London

Health effects of Greece’s austerity measures are “worse than imagined,” report researchers

Sophie Arie

Greece’s severe economic crisis has had a substantially negative effect on public health that provides a warning for other countries faced with similar challenges, the authors of a report published in the American Journal of Public Health have said.1

Researchers at the Aristotle University of Thessaloniki in Greece and the University of New Mexico in the United States said that
a sharp deterioration in major indicators of public health had accompanied the worsening of the Greek economy over recent years, as incomes fell and unemployment soared. Suicide and murder rates rose by 22.7% and 27.6%, respectively, between 2007 and 2009, while deaths from infectious diseases rose by 13.2% in the same period. Sharp increases in substance abuse and mental health problems were also recorded.

The authors said that evidence from Greece and from previous economic crises elsewhere implied that reduced household incomes and purchasing power, as a result of unemployment and cuts in real wages, could lead to reduced health expenditure by households, lower use of private health services, and greater use of public sector services, especially those that are free or low cost at the point of delivery.

In Greece, these trends have happened at a time when government spending on healthcare has been slashed. Compared with 2010, use of public inpatient and primary care services in 2011 rose by 6.2% and 21.9%, respectively. Meanwhile, government health spending was cut by 23.7% between 2009 and 2011, with many services being privatised and staff levels in the public sector being cut dramatically.

Elias Kondilis of Aristotle University, lead author of the study, said: “We were expecting that these austerity policies would negatively affect health services and health outcomes, but the results were much worse than we imagined.”

The authors said their findings indicated that austerity policies were likely to cause deteriorating health conditions elsewhere in Europe and also in the US. They argued that past resistance to pressure from international financial institutions to reduce public investment in health services in Latin American countries—such as Argentina, Venezuela, and Ecuador—had been followed by improvements in health and economic indicators that may otherwise not have occurred.

1 Kondilis E, Giannakopoulos E, Gavana M, Ierodiakonou I, Waitzkin H, Benos A. Economic
crisis, restrictive policies, and the population’s health and health care: the Greek case.

Am J Public Health 2013, doi:10.2105/AJPH.2012.301126.

Cite this as: BMJ 2013;346:f2740

© BMJ Publishing Group Ltd 2013

“Troika”-Mandated Austerity and the Emerging Health Care Crisis in Greece: An Open Letter to the Greek Government


“Troika”-Mandated Austerity and the Emerging Health Care Crisis in Greece: An Open Letter to the Greek Government


To the Prime Minister of Greece and President of New Democracy Party, Mr. Antonis Samaras

To the President of PASOK, Mr. Evangelos Venizelos

To the President of the Democratic Left, Mr. Fotis Kouvelis,

To the Minister of Health, Mr. Andreas Lykouretzos,

This letter is an attempt by Greek scholars and physicians to express their concern regarding the current, dire state of Health Care services in Greece.

Our country has fallen into a dismal state, and it is constantly challenged by extrinsic and intrinsic pressures, while the economic and social climate deteriorates further day by day. The Greek government, in total obedience to the irrational demands of the Troika, focuses on the obligations of the citizens towards the state, and seems to forget or ignore its own obligations towards its citizens. The Government has imposed a brutal and self-defeating fiscal austerity; in a confiscatory manner, it tries to collect extra revenue from an already impoverished and afflicted populace, while it neglects its main role, as specified by the Constitution: The Protection of the Rights and the Welfare of the Citizen Body.

In three short years, governments comprised of the current coalition parties have managed to reduce the country’s GDP by 25%, leading Greece to the deepest and longest-lasting economic depression in the history of the modern Western world. During the same period of time, the public debt expanded from 109% GDP to 170% GDP, unemployment rose from 8% to 27%, and youth unemployment now holds the world record at 58%.  Incomes have been reduced by more than 40%, leading to a record number of families and individuals living below the poverty line. It is worth noting that the famous “haircut” (PSI), presented by the Government as a notable achievement, ultimately increased the public debt, while raiding the reserves of pension funds, reserves that were gathered painstakingly by the contributions of workers and pensioners.  (more…)

Greek unemployed cut off from medical treatment

ATHENS — As the head of Greece’s largest oncology department, Dr. Kostas Syrigos thought he had seen everything. But nothing prepared him for Elena, an unemployed woman whose breast cancer had been diagnosed a year before she came to him.

By that time, her cancer had grown to the size of an orange and broken through the skin, leaving a wound that she was draining with paper napkins. “When we saw her we were speechless,” said Dr. Syrigos, the chief of oncology at Sotiria General Hospital in central Athens. “Everyone was crying. Things like that are described in textbooks, but you never see them because until now, anybody who got sick in this country could always get help.”