A Greek tragedy in health?

The Greek debt crisis threatens not just its economy, but the health of its people, according to a new report which shows a significant rise in homicides, suicides, heroin use, HIV infections, and people losing access to healthcare.

Writing in the journal The Lancet, Cambridge University researchers Alex Kentikelenis and Dr David Stuckler report a marked decline in the health of Greece’s population since 2007, with the most vulnerable groups in society suffering the most.

The study combined authoritative Greece healthcare reports with an analysis of representative household surveys of over 10,000 people, taken in 2007, before the economic crisis began, and again in 2009.

“The trends in Greece are deeply disturbing,” Dr Stuckler, senior author of the report, said. “They pose a warning for hard-hit European countries like Spain, Ireland and Portugal.”

New HIV infections in Greece have risen by a third in 2011 and are projected to be over 50% higher than in 2010 by the year’s end. Cases of HIV from injection drug use rose 10-fold during 2010 and account for half the rise in HIV. The rest of the increases appear to be linked to prostitution and unsafe sex. Expert reports also suggest that some cases of deliberate self-infection may have occurred among poorer groups so as to obtain public welfare benefits of 700 Euros per month.

The researchers also found that there was a 14% rise in the number of Greeks reporting that their health was “bad” or “very bad”. They also found that when Greek citizens felt it was necessary to see a doctor or dentist, they were 15% less likely to do so in 2009 than in 2007. The researchers suggest this may reflect 40% cuts to hospital budgets and a 40% decline in access to sickness benefits.

Alexander Kentikelenis, lead author on the report and a PhD researcher at the University of Cambridge’s Department of Sociology, said: “Public hospitals have less money to deal with growing care needs. This creates backlogs in healthcare delivery, rising waiting times, staff shortages and limited medical supplies.”

In spite of this, admission to public hospitals increased by 24% in 2010 compared with the previous year – which researchers argue is probably a reflection of fewer people being able to afford private care.

Homicides and theft rates doubled between 2007 and 2009. Heroin use rose by 20% in 2009. Suicides also rose by 17% between 2007 and 2009, and unofficial data quoted in the country’s Parliament mentions a 25% rise in 2010. Calls to the Greek national suicide helpline reported in 2010 that approximately 25% of its callers were facing financial difficulties.

Despite many adverse signs, the report identifies some areas of improvement, such as a decline in alcohol use and drink-driving, which is most likely a reflection failing income.

Overall, the report concludes that the data places a much needed “human face” on the economic crisis. “The picture of health in Greece is concerning,” the researchers write. “It reminds us that, in an effort to finance debts, ordinary people are paying the ultimate price: losing access to care and preventative services, facing higher risks of HIV and sexually transmitted diseases, and in the worst cases losing their lives. 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.”