The deteriorating global economic outlook is increasing worries among health experts about the effects that the economic crises will have on people’s health. As the World Health Organization stated in 2009, “It is not yet clear what the current financial crisis will mean for low-income and emerging economies, but many predictions are highly pessimistic.”

A strong correlation has been found between job loss and clinical and subclinical depression, substance abuse, anxiety and antisocial behavior.

In low-income countries, economic crises lead to reduced demand for imports (including medicines and medical supplies and technology), tighter access to capital and falling remittances from family members working outside the country. In addition, there are less government revenues to finance health and social services.

A recent article in Lancet highlights those effects in Greece, one of the European countries most affected by the ongoing global economic crisis. As a result, there has been a significant increase in unemployment, which rose from 6.6% in May 2008 to 16.6% in May 2011. Even more troublesome, youth unemployment rose in the same period from 18.6% to 40.1%.

Several studies have shown that unemployment increases both the risk of psychiatric and somatic disorders. For example, a strong correlation has been found between job loss and clinical and subclinical depression, substance abuse, anxiety and antisocial behavior. In addition, several studies have shown that prolonged unemployment increases mortality rates.

In Greece, there has been a 17% increase in suicides between 2007 and 2009. During that same period, homicide and theft rates almost doubled. One-quarter of callers to a national suicide help line reported financial difficulties in 2010. The inability to pay high levels of personal debt may be one of the explanations behind the increase in the number of suicides, which had a 40% increase in the first six months of 2011 compared to the same period in 2010.

By many accounts, Greece’s public healthcare system is riddled with corruption and inefficiencies.

Also, a surge in intravenous drug users may explain a rise in HIV infections of more than 1000% among them. In addition to intravenous drug use, prostitution and unsafe sex are also responsible for the increase in HIV infections in the general population, estimated to be 52% higher in 2011 than in 2010.

Although in Greece patients with social insurance may visit general practitioners (GPs) free of charge or attend outpatient clinics for a very low fee, there was a reduction of those visits in 2009 compared to 2007. At the same time, there was a 24% rise of public hospital admissions in 2010 compared to 2009, while admission to private hospitals declined by 25-30% during the same period. This situation may be a result of a 40% cut in hospital budgets, resulting in understaffing and occasional shortages of medicines and medical supplies.

Another example of the effect of the economic crisis in Greece on vulnerable groups is the increased use of street clinics run by NGOs, such as the Greek chapter of Médecins du Monde, which report an increase in those seeking medical attention from their street clinics from 3-4% before the crisis started to about 30% now.

The inability to pay high levels of personal debt may help explain the increase in the number of suicides.

That their health situation has worsened as a result of the crisis is demonstrated by the number of Greeks who consider their health to be “bad” or “very bad,” which has increased by 14% from 2007 to 2009. To make matters worse, a third of the country’s outreach programs have been eliminated as a result of budget cuts in 2009 and 2010.

By many accounts, Greece’s public healthcare system is riddled with corruption and inefficiencies. Oftentimes, patients offer doctors informal payments to receive treatment, particularly when they are not covered by their social insurance fund. In addition, hospitals frequently face shortages of materials and equipment.

The situation in Greece may be a harbinger of what may happen — or is happening — in countries with similar social and healthcare systems and which may go through similarly difficult economic situations. And it is up to the governments in those countries to provide necessary resources, increase efficiency and protect their most valuable asset: the health of their citizens.