Trends in mortality from respiratory diseases in Greece during the financial crisis

Abstract

Introduction: During the ongoing financial crisis, the smoking prevalence in Greece, and emissions from vehicles and industrial activity have declined; barriers to healthcare access have increased and expenditure on healthcare has decreased by 25%.

Aim: To assess trends in standardised mortality from respiratory diseases in Greece before and during the financial crisis.

Methods: We calculated standardised mortality –by gender and 5-year age groups- from selected diseases (ICD-9 codes), using mortality data from the Hellenic Statistical Authority. We also calculated the average annual change in standardised mortality before (2001-2009) and during (2010-2013) the crisis.

Results: Standardised mortality from all diseases of the respiratory system decreased at an average rate of 3.2% per year during the crisis, in contrast to an average annual increase of 3.3% in the pre-crisis period. The trends of the standardised mortality from tuberculosis and from malignant neoplasms of respiratory and intrathoracic organs were quite similar before and during the crisis (-2.4% vs. -2.9% and 0.2% vs. 0.6% respectively). However, the annual increase in mortality from malignant neoplasms of lip, oral cavity and pharynx was 4.5% during the crisis, compared to 0.1% before the crisis.

Discussion: Standardised mortality from diseases of the respiratory system decreased during the crisis, despite barriers to healthcare access, highlighting the importance of factors such as smoking and air quality. However, these favourable trends have not been observed in respiratory cancers, which have longer natural history and are more reliant to expensive treatments that may not be widely available in times of financial hardship.