A new study by a School of Dentistry faculty member and dozens of other researchers from the University of Washington and around the world has found that Greece’s population health declined markedly and death rates rose sharply after harsh austerity measures were imposed on Greece by the European Union and the International Money Fund in 2010.
“This study is important because it provides a framework for health surveillance on a national level following major socioeconomic changes,” said Dr. Georgios Kotsakis of the School of Dentistry’s Department of Periodontics, one of the study’s authors.
The study, which was published this week in the British journal The Lancet Public Health, reported that government health spending fell sharply and that the causes of death that increased the most were largely those that could have been addressed by health care. The researchers noted that Greece’s reduced health spending, required as part of the austerity measures, had been criticized for omitting measures to protect the country’s National Health System. They said that health policymakers should place a special focus on ensuring that Greece’s health-care system is equipped to meet the needs of the country’s citizens.
The study, which was funded by the Bill & Melinda Gates Foundation, relies heavily on the UW’s 2016 Global Burden of Diseases, Injuries, and Risk Factors Study (GBD). The 2016 GBD study, conducted by the UW’s Institute for Health Metrics and Evaluation (IHME), is an outgrowth of the original 1997 GBD study. This was the world’s largest systematic effort to chart the scope of health loss from all major diseases, injuries, and risk factors by age, sex, and population.
Co-authors of the Greece study were Dr. Kotsakis, assistant professor at the School of Dentistry; Dr. Stefanos Tyrovolas, a visiting scholar at the School of Dentistry; Dr. Andy Stergachis, professor of pharmacy and global health and associate dean at the UW School of Pharmacy; and Dr. Nick Kassebaum, associate professor at IHME and in the Department of Anesthesiology and Pain Medicine at Seattle Children’s Hospital. The four were joined by 43 other GBD collaborators in a number of countries, including 15 at the UW.
The researchers identified an increase in the pace at which Greece’s population was aging as another important concern and wrote: “The increase in total deaths in children younger than 5 years and older adults with increase in causes sensitive to resource availability (e.g., access to screening and urgent care) suggest that the health system requires substantial restructuring to cope with the effects that the financial crisis has had on resource availability, resource allocation, and population structure.”
They reported that while the country’s overall death rate rose by about 5.6 percent from 2000 to 2010, it jumped by about 17.7 percent in the six years that followed, after austerity measures were imposed. The rate rose three times faster than the rate in Western Europe overall, and came at a time when mortality rates were actually declining worldwide. The largest increase came among people 70 and older, while the very young also saw a disproportionate increase.
The rise in mortality coincided with changes in causes of death, with notable increases in communicable, maternal, neonatal, and nutritional diseases.
Other findings from the study included these:
- The incidence of tuberculosis increased among native-born Greeks after austerity was imposed.
- The incidence of HIV nearly doubled from 2010 to 2012, spurring reinstatement of syringe distribution programs. After this was done, HIV rates declined.
- The period of austerity saw rises in major depression and suicide, as well as a lack of improvement in in maternal, infant, and child mortality rates.
“Notably, the number of individuals with unmet health-care needs nearly doubled since 2010, with a considerable fraction reporting health-care cost as the main reason for not receiving the recommended health-care services,” the researchers wrote.