Zilidis C, Angelopoulos N V
General Department, University of Thessaly, Larissa, Greece.
Department of Psychiatry, Faculty of Medicine, University of Thessaly, Larissa, Greece.
J Public Health (Oxf). 2022 Mar 7;44(1):92-99. doi: 10.1093/pubmed/fdab129.
The financial crisis affected several aspects of health. The aim of this study is to explore the impact of the crisis on mortality of mental illnesses in Greece and the socioeconomic determinants of mortality trends.
Mortality data of 2000-16 were analyzed and sex-and-age-standardized death rates (SDRs) were calculated. The Average Annual Percent Change (AAPC) before and after the time point of slope change was computed. The crisis impact on SDRs was explored with interrupted time series analyses and standardized rate ratios (SRRs). The correlation of mortality with socioeconomic and healthcare-related variables was investigated with correlation and regression analyses.
A significant change in SDR trend was observed after 2012. The AAPC reversed from -2.9% to 94.5%, while the SRR was calculated at 6.1 (5.5-6.7). Income reduction, unemployment rise and health budget cuts were found to be significantly correlated with mortality rise.
Financial crisis had a significant impact on mortality due to mental illnesses, especially in females and elderly. The findings indicate that mortality increase is more driven by socioeconomic and healthcare-related factors that affect access to appropriate healthcare than by morbidity trends. The findings have implications in planning interventions to provide appropriate healthcare to patients living with mental illness.
金融危机影响了健康的多个方面。本研究的目的是探讨危机对希腊精神疾病死亡率的影响以及死亡率趋势的社会经济决定因素。
分析2000 - 2016年的死亡率数据并计算性别和年龄标准化死亡率（SDRs）。计算斜率变化时间点前后的平均年变化百分比（AAPC）。采用中断时间序列分析和标准化率比（SRRs）探讨危机对SDRs的影响。通过相关性和回归分析研究死亡率与社会经济及医疗相关变量的相关性。
2012年后观察到SDR趋势有显著变化。AAPC从-2.9%转变为94.5%，而SRR计算为6.1（5.5 - 6.7）。发现收入减少、失业率上升和卫生预算削减与死亡率上升显著相关。
金融危机对精神疾病导致的死亡率有显著影响，尤其是对女性和老年人。研究结果表明，死亡率增加更多是由影响获得适当医疗服务的社会经济和医疗相关因素驱动，而非发病率趋势。这些发现对规划干预措施以向精神疾病患者提供适当医疗服务具有启示意义。
