HealthResJ, health, medicine, nursing, research https://ejournals.epublishing.ekt.gr/index.php/HealthResJ/sitemap

The impact of the economic crisis on mortality due to infectious diseases in Greece: An analysis of secondary data


Published: Jan 5, 2025
Keywords:
Austerity infectious diseases mortality socio-economic determinants Greece
Georgia Kourlaba
Christos Triantafyllou
https://orcid.org/0000-0002-3198-3965
Dimitrios Filippou
Vasiliki Danai Dafnomili
Giorgos Gounelas
Pavlos Myrianthefs
Abstract

Background: The economic crisis and the implementation of austere measures in Greece and other nations prompted inquiries regarding the potential impact of financial crises on the decreasing trajectory of infectious diseases. The primary aim of this study was to explore the trends of infectious diseases mortality rates in Greece from 2000 to 2019 as well as the association between infectious diseases mortality rates and socio-economic determinants.


Method and Material: An analysis of secondary data from the World Health Organization (WHO), Organization for Economic Co-operation and Development (OECD), Eurostat, and Hellenic Statistical Authority (ELSTAT) was conducted. Data on standardized death rates (SDR) (overall, by age and sex, and for administrative regions), total health spending (in US dollars per capita and as a percentage of gross domestic product (GDP)), total GDP in euros (2022 value) per capita, unemployment, long-term unemployment, and very long-term unemployment were extracted. Pearson’s or Spearman’s who was used to evaluate the association between quantitative variables.


Results: From 2011, the cut-off point between the “pre-austerity” and the “exposure to austerity” period, there had been an increasing trend in both overall SDRs and age- and`-specific SDRs of infectious diseases. The overall SDRs in Greece were statistically significantly and positively correlated with unemployment and long-term unemployment (p-value<0.05).


Conclusion: It seems that the mortality of infectious diseases was affected by the economic crisis. The present findings show significance for public health, as they assist in pinpointing populations at heightened risk during crises and devising suitable measures to safeguard their well-being.

Article Details
  • Section
  • Original Articles
Downloads
Download data is not yet available.
References
Laliotis I, Ioannidis JPA, Stavropoulou C. Total and cause-specific mortality before and after the onset of the Greek economic crisis: an interrupted time-series analysis. Lancet Public Health 2016; 1: e56–65.
Mossialos E, Allin S, Davaki K. Analysing the Greek health system: a tale of fragmentation and inertia. Health Econ 2005; 14: S151-168.
Economou C, Kaitelidou D, Kentikelenis A, Maresso A, Sissouras A. The impact of the crisis on the health sys-tem and health in Greece. In: Economic crisis, health systems and health in Europe: Country experience [In-ternet]. European Observatory on Health Systems and Policies, 2015.
Zavras D, Zavras AI, Kyriopoulos I-I, Kyriopoulos J. Economic crisis, austerity and unmet healthcare needs: the case of Greece. BMC Health Serv Res 2016; 16: 309.
Zilidis C, Stuckler D, McKee M. Use of amenable mor-tality indicators to evaluate the impact of financial cri-sis on health system performance in Greece. Eur J Pub-lic Health 2020; 30: 861–6.
Zilidis C, Hadjichristodoulou C. Economic Crisis Impact and Social Determinants of Perinatal Outcomes and Infant Mortality in Greece. Int J Environ Res Public Health 2020; 17: 6606.
Institute for Health Metrics and Evaluation (IHME). Findings from the global burden of disease study 2017. Institute for Health Metrics and Evaluation 2018.
Zilidis C, Papagiannis D, Kyriakopoulou Z. Did Eco-nomic Crisis Affect Mortality Due to Infectious Diseas-es? Trends of Infectious Diseases Mortality in Greece Before and After Economic Crisis. Cureus 2021; 13: e13621.
Bacigalupe A, Shahidi FV, Muntaner C, Martín U, Bor-rell C. Why is There so Much Controversy Regarding the Population Health Impact of the Great Recession? Reflections on Three Case Studies. Int J Health Serv 2016; 46: 5–35.
Tapia Granados JA, Rodriguez JM. Health, economic crisis, and austerity: A comparison of Greece, Finland and Iceland. Health Policy 2015; 119: 941–53.
Rechel B, Suhrcke M, Tsolova S, et al. Economic crisis and communicable disease control in Europe: a scop-ing study among national experts. Health Policy 2011; 103: 168–75.
McDaid D, Quaglio G, Correia de Campos A, et al. Health protection in times of economic crisis: chal-lenges and opportunities for Europe. J Public Health Policy 2013; 34: 489–501.
Parmar D, Stavropoulou C, Ioannidis JPA. Health out-comes during the 2008 financial crisis in Europe: sys-tematic literature review. BMJ 2016; 354: i4588.
Simou E, Koutsogeorgou E. Effects of the economic crisis on health and healthcare in Greece in the litera-ture from 2009 to 2013: a systematic review. Health Policy 2014; 115: 111–9.
Suhrcke M, Stuckler D, Suk JE, et al. The impact of economic crises on communicable disease transmis-sion and control: a systematic review of the evidence. PLoS One 2011; 6: e20724.
Kentikelenis A, Karanikolos M, Williams G, et al. How do economic crises affect migrants’ risk of infectious disease? A systematic-narrative review. Eur J Public Health 2015; 25: 937–44.
Karanikolos M, Kentikelenis A. Health inequalities after austerity in Greece. Int J Equity Health 2016; 15: 83.
Scognamiglio P, Girardi E, Fusco M, et al. Lack of im-plementation of Hepatitis B Virus (HBV) vaccination policy in household contacts of HBV carriers in Italy. BMC Infect Dis 2009; 9: 86.
Gyarmathy VA, Neaigus A, Ujhelyi E. Vulnerability to drug-related infections and co-infections among in-jecting drug users in Budapest, Hungary. Eur J Public Health 2009; 19: 260–5.
Rafiq SM, Banik GR, Khan S, Rashid H, Khandaker G. Current Burden of Hepatitis C Virus Infection Among Injecting Drug Users: A Mini Systematic Review of Prevalence Studies. Infect Disord Drug Targets 2014; 14: 93–100.
Bryla M, Dziankowska-Zaborszczyk E, Bryla P, Pikala M, Maniecka-Bryla I. Years of life lost due to infectious diseases in Poland. PLoS One 2017; 12: e0174391.
Toffolutti V, Suhrcke M. Does austerity really kill? Eco-nomics & Human Biology 2019; 33: 211–23.
WHO European Region. European Health Information Gateway. https://gateway.euro.who.int/en/datasets/ (accessed Feb 1, 2023).
Eurostat. Causes of death - standardised death rate by NUTS 2 region of residence, 3 year average. https://ec.europa.eu/eurostat/databrowser/view/HLTH_CD_YSDR2/default/table?lang=en&category=hlth.hlth_cdeath.hlth_cd_gmor (accessed Feb 1, 2023).
OECD. OECD database. theOECD. http://data.oecd.org (accessed Feb 1, 2023).
Hellenic Statistical Authority (ELSTAT). Gross Domestic Product. https://www.statistics.gr/en/statistics/-/publication/SEL15/- (accessed Feb 1, 2023).
WHO European Region. SDR, infectious and parasitic diseases, all ages, per 100 000. https://gateway.euro.who.int/en/indicators/hfa_203-1820-sdr-infectious-and-parasitic-diseases-all-ages-per-100-000/ (accessed April 24, 2023).
OECD. Health resources - Health spending - OECD Da-tabase. theOECD. http://data.oecd.org/healthres/health-spending.htm (accessed April 24, 2023).
OECD. GDP and spending - Gross domestic product (GDP) - OECD Data. theOECD. http://data.oecd.org/gdp/gross-domestic-product-gdp.htm (accessed April 24, 2023).
Karanikolos M, Mackenbach JP, Nolte E, Stuckler D, McKee M. Amenable mortality in the EU-has the crisis changed its course? Eur J Public Health 2018; 28: 864–9.
Loopstra R, McKee M, Katikireddi SV, Taylor-Robinson D, Barr B, Stuckler D. Austerity and old-age mortality in England: a longitudinal cross-local area analysis, 2007-2013. J R Soc Med 2016; 109: 109–16.
Axelrad H, Sabbath EL, Hawkins SS. The impact of the 2008 recession on the health of older workers: data from 13 European countries. Eur J Public Health 2017; 27: 647–52.
Hunter PR, Colón-González FJ, Brainard J, et al. Can economic indicators predict infectious disease spread? A cross-country panel analysis of 13 European coun-tries. Scand J Public Health 2020; 48: 351–61.
Castro M, Mattos E, Patriota F. The effects of health spending on the propagation of infectious diseases. Health Econ 2021; 30: 2323–44.
World Economics. Italy’s Median Age. World Econom-ics. 2023. https://www.worldeconomics.com/Demographics/Median-Age/Italy.aspx (accessed April 27, 2023).
Minnai F, De Bellis G, Dragani TA, Colombo F. COVID-19 mortality in Italy varies by patient age, sex and pandemic wave. Sci Rep 2022; 12: 4604.
Wickham RJ. Secondary Analysis Research. J Adv Pract Oncol 2019; 10: 395–400.
Ioannidis JPA. Exposure-wide epidemiology: revisiting Bradford Hill. Stat Med 2016; 35: 1749–62.
Most read articles by the same author(s)