October 10, 2011 — The Greek financial crisis has led to worsened health outcomes, according to a study published as a letter online October 10 in The Lancet.
Since 2007, Greece has experienced more financial turmoil than other European countries, with an increase in adult unemployment from 6.6% in May 2008 to 16.6% in May 2011. Unemployment among youth rose from 18.6% to 40.1% over the same period. The national debt rose from 105.4% of gross domestic product (GDP) to 142.8% of GDP between 2007 and 2010. Other European Union (EU) countries averaged debts from 66.2% to 85.1% of GDP during the same time frame.
To evaluate the effects of this crisis on health, a team led by David Stuckler of the University of Cambridge, United Kingdom, analyzed data from the European Union Statistics on Income and Living Conditions, a database of cross-sectional and longitudinal information about social characteristics, economic characteristics, and living conditions in the EU.
They incorporated 12,346 samples from Greece in 2007 (before the crisis) and 15,045 samples from 2009. Other sources include information from medical research institutes, health prefectures, and nongovernment organizations (NGOs).
The researchers found a significant increase in the number of people who reported that they did not visit a doctor or dentist, despite believing that a visit was necessary (odds ratio [OR] for doctors' visits, 1.15; 95% confidence interval [CI], 1.02 - 1.30; OR for dentists' visits, 1.14; 95% CI, 1.01 - 1.28).
The reasons appeared to be less associated with cost barriers (OR, 0.87; 95% CI, 0.74 - 1.02) and more to do with long waiting times (OR, 1.83; 95% CI, 1.26 - 2.64), travel distance to care (OR, 2.50; 95% CI, 1.35 - 4.63), waiting to feel better (OR, 1.93; 95% CI, 1.26 - 2.96), and other reasons that the survey did not measure (OR, 1.54; 95% CI, 1.05 - 2.27).
Greek citizens and residents with social insurance can visit general practitioners and hospital outpatient clinics for free, which suggests that the reduction in visits represents a supply-side problem, probably caused by cuts in hospital budgets, understaffing, and shortages of medical supplies.
Despite fewer visits to general practitioners and outpatient facilities, public hospitals saw increases in admissions of 24% between 2009 and 2010 and 8% between the first half of 2010 and the first half of 2011. Admissions to private hospitals, however, declined by 25% to 30% in 2010.
After the crisis, more people described their health as "bad" or "very bad" (OR, 1.14; 95% CI, 1.02 - 1.28). There was a 17% increase in suicides between 2007 and 2009, and 25% of callers to the national suicide helpline reported financial difficulties in 2010.
Other trends included a decline in the number of people able to obtain sickness benefits (OR, 0.61; 95% CI, 0.38 - 0.98) between 2007 and 2009; a predicted rise in HIV infections of 52% between 2010 and 2011 (with many cases due to infections among intravenous drug users); and a 20% increase in heroine use in 2009. The rise in HIV cases is also attributable to increased prostitution and the resulting unprotected sexual practices.
Social services have been reduced. Street clinics run by NGOs, which traditionally serve immigrants, saw the proportion of Greeks served increase from 3% - 4% before the financial crisis to about 30%.
On a positive note, the researchers identified significant reductions in alcohol consumption and a reduction in drunk driving.
"Overall, the picture of health in Greece is concerning. It reminds us that, in an effort to finance debts, ordinary people are paying the ultimate price,” the authors conclude. “Greater attention to health and health-care access is needed to ensure that the Greek crisis does not undermine the ultimate source of the country’s wealth — its people."
The authors have disclosed no relevant financial relationships.
Lancet. Published online October 10, 2011. Full Text
Since 2007, Greece has experienced more financial turmoil than other European countries, with an increase in adult unemployment from 6.6% in May 2008 to 16.6% in May 2011. Unemployment among youth rose from 18.6% to 40.1% over the same period. The national debt rose from 105.4% of gross domestic product (GDP) to 142.8% of GDP between 2007 and 2010. Other European Union (EU) countries averaged debts from 66.2% to 85.1% of GDP during the same time frame.
To evaluate the effects of this crisis on health, a team led by David Stuckler of the University of Cambridge, United Kingdom, analyzed data from the European Union Statistics on Income and Living Conditions, a database of cross-sectional and longitudinal information about social characteristics, economic characteristics, and living conditions in the EU.
They incorporated 12,346 samples from Greece in 2007 (before the crisis) and 15,045 samples from 2009. Other sources include information from medical research institutes, health prefectures, and nongovernment organizations (NGOs).
The researchers found a significant increase in the number of people who reported that they did not visit a doctor or dentist, despite believing that a visit was necessary (odds ratio [OR] for doctors' visits, 1.15; 95% confidence interval [CI], 1.02 - 1.30; OR for dentists' visits, 1.14; 95% CI, 1.01 - 1.28).
The reasons appeared to be less associated with cost barriers (OR, 0.87; 95% CI, 0.74 - 1.02) and more to do with long waiting times (OR, 1.83; 95% CI, 1.26 - 2.64), travel distance to care (OR, 2.50; 95% CI, 1.35 - 4.63), waiting to feel better (OR, 1.93; 95% CI, 1.26 - 2.96), and other reasons that the survey did not measure (OR, 1.54; 95% CI, 1.05 - 2.27).
Greek citizens and residents with social insurance can visit general practitioners and hospital outpatient clinics for free, which suggests that the reduction in visits represents a supply-side problem, probably caused by cuts in hospital budgets, understaffing, and shortages of medical supplies.
Despite fewer visits to general practitioners and outpatient facilities, public hospitals saw increases in admissions of 24% between 2009 and 2010 and 8% between the first half of 2010 and the first half of 2011. Admissions to private hospitals, however, declined by 25% to 30% in 2010.
After the crisis, more people described their health as "bad" or "very bad" (OR, 1.14; 95% CI, 1.02 - 1.28). There was a 17% increase in suicides between 2007 and 2009, and 25% of callers to the national suicide helpline reported financial difficulties in 2010.
Other trends included a decline in the number of people able to obtain sickness benefits (OR, 0.61; 95% CI, 0.38 - 0.98) between 2007 and 2009; a predicted rise in HIV infections of 52% between 2010 and 2011 (with many cases due to infections among intravenous drug users); and a 20% increase in heroine use in 2009. The rise in HIV cases is also attributable to increased prostitution and the resulting unprotected sexual practices.
Social services have been reduced. Street clinics run by NGOs, which traditionally serve immigrants, saw the proportion of Greeks served increase from 3% - 4% before the financial crisis to about 30%.
On a positive note, the researchers identified significant reductions in alcohol consumption and a reduction in drunk driving.
"Overall, the picture of health in Greece is concerning. It reminds us that, in an effort to finance debts, ordinary people are paying the ultimate price,” the authors conclude. “Greater attention to health and health-care access is needed to ensure that the Greek crisis does not undermine the ultimate source of the country’s wealth — its people."
The authors have disclosed no relevant financial relationships.
Lancet. Published online October 10, 2011. Full Text
Δεν υπάρχουν σχόλια:
Δημοσίευση σχολίου