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Int J Cardiol. 2013 Oct 9;168(4):4497-9.

Mortality and the economic crisis in Greece

The 201112 increased mortality in people

older than 55 years (about 2200 excess deaths)
probably constitutes the first evident shortterm consequence of austerity on mortality in
Greece.

The Lancet
Volume 383, Issue 9918, Page 691 (February 2014)
DOI: 10.1016/S0140-6736(14)60250-6

The Lancet
Volume 383, Issue 9918, Page 691 (February 2014)
DOI: 10.1016/S0140-6736(14)60250-6

Int J Cardiol. 2013 Oct

12;168(5):4886-7.

Trends in cardiovascular risk factors in Greece before and

during the financial crisis: the impact of social disparities

BACKGROUND:
Economic crises may have a significant impact on public health. The objective of this study was to
assess trends in health-related behaviours and cardiovascular risk factors within Greece before, at
the beginning and during the current financial crisis by comparing data from three waves of the
Greek cross-sectional household 'Hellas Health' surveys.
METHODS:
Data from three waves were analysed. The first wave was conducted in 2006 (n = 1005), the
second in 2008 (n = 1490) and the third in 2011 (n = 1008). Samples were representative of the
Greek adult population in terms of age and residency. Smoking status, height, weight and fruit
and vegetable consumption were self-reported. Physical activity levels were assessed with the
International Physical Activity Questionnaire.
RESULTS:
The prevalence of smoking in Greece decreased from 42.6 to 38.1% during the crisis period 200811 (P = 0.026), but not during 2006-8. The prevalence of high levels of physical activity increased
among Greek adults (from 21.9 to 31.7%, P < 0.001) in all socio-economic and demographic
groups, with the exception of the highest socio-economic status (SES) group. On the contrary, the
consumption of at least five portions of fruit and vegetables per day significantly decreased
during the crisis among those of lower SES (from 9.0 to 4.1%, P = 0.006). Prevalence of obesity
did not show significant trends.
CONCLUSIONS:
During the economic crisis, fruit and vegetable consumption alarmingly decreased, especially
among those of lower SES, whereas trends in smoking prevalence and physical activity levels
seem favourable. These results indicate that the economic crisis may unequally impact
cardiovascular risk factors among different socio-economic groups.
Eur J Public Health. 2014 Mar 10.

Trying to treat diabetes in Greek crisis



60

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40

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0

&

Mackay and Mensah, The atlas of heart disease and stroke, WHO 2004

( LDL, DNA, )

Block G. Dietary guidelines and the results of food consumption surveys. Am J Clin Nutr 1991

,
,
.
mJMed113:13S,2002

Quick remarks on

Economics and Health

Unemployment rich countries

Increases mortality (Brenner)
Reduces mortality (Ruhm)
Less tobacco consumption and weight loss
More physical activity during free time

Russia
From 1990 to 1994
Standardized mortality increased by 30%,
particularly in men of working age (alcohol,
malnutrition, external causes ...)
Life expectancy for men dropped from 64 to
58 years (women, 74 to 71)

Russia
Gorbachev alcohol prohibition
Massive privatization: Unemployment
- Working age men increased mortality
- Reduction in life expectancy
- Social capital mitigates these effects

Finland
Severe recession in same years (1990 to
1994) than Russia: Unemployment 2 to 18%
- No adverse effects on health
- On the contray, lower alcohol consumption and
reductions of socio-economics gradient in
mortality

- Nordic welfare states

It seems that
Not all economic crises are equal and
have the same effects on health

Public policy can prevent and cure many

of the effects of the economic crisis on
health
Strong institutions are key



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Health effects of financial crisis: omens of a Greek tragedy,
Kentikelenis et al., The Lancet, 378, 9801, 1457-1458 Oct 2011