Gaining health : analysis of policy development in European ...

Greece
Anna Ritsatakis
1. Country profile
Greece is bordered to the north by Albania, Bulgaria and
the former Yugoslav Republic of Macedonia and to the east
by Turkey, and is surrounded in the west by the Ionian Sea
and in the east by the Aegean Sea. Much of the mainland
is mountainous and there are numerous inhabited small
islands.
Greece is a presidential republic and the official language is
Greek.
There are 13 geographical and administrative regions and
52 prefectures or counties (nomos, pl. nomoi). The prefects,
who until 1994 were appointed by the Government, are
now elected officials but the nomos is not hierarchically
superior to the communes and municipalities.
Greece is a member of the EU and maintains close relations
with the Balkan countries.
1.1. Socioeconomic development
When Greece joined the European Community in 1981, it
did so with a dominant public sector and little preparation
for membership (1). Although the economy is now more
balanced, the public sector remains comparatively large
with the Government retaining a large stake in major public
utilities. A place in the civil service is still a main aim of
young people entering the labour market.
Unemployment has been high over the past decade, particularly
for young people. In 2001, it was 21.0% for men
aged 15–24 years and a huge 35.7% for women in the same
age group. It is now slowly falling and reached 9.6% in 2005,
which is still higher than the average for EU countries prior
to 2004. A severe problem is the number of “educated
unemployed”: young people with university education who
are jobless, or in jobs with low skill requirements, unrelated
to their field of study.
GNP per capita rose rapidly from US$ 4299 in 1980 to US$
16 610 in 2004, a rise in real GDP (PPP) per capita of from
US$ 5277 to US$ 22 205. There is a relatively high level of
income inequality and a more imbalanced distribution of
wealth than the average for the EU15 countries. 6 The first
survey on poverty, carried out on behalf of the Ministry of
the Economy in 2007, indicated that poverty has begun to
threaten social cohesion and that 60% of the population
feared that they might fall beneath the poverty line.
1.2. The people and their health
The birth rate in Greece is one of the lowest in Europe,
with a resulting natural population growth of zero (2). Reversing
the trends of the mid-20th century, when thousands
of Greeks left to find work abroad and migrants’ remittances
were one of the mainstays of the economy, the recent
positive net migration has slightly increased the population
to just over 11 million.
The aging of the population is one of its main characteristics.
As the large birth cohorts of the first half of the 20th
century reach retirement age, the proportion of people 65
years and over is estimated to grow from about 17.5% in
2003 to 25.9% in 2030 (3).
Overall life expectancy at birth reached 79.3 years in
2005 (76.9 for men and 81.8 for women). For many years,
Greece enjoyed one of the longest life expectancies in
the world, which may have led to some complacency. In
6
EU15: the EU prior to the accession of 10 candidate countries on 1 May
2004. It comprised the following 15 countries: Austria, Belgium, Denmark,
Finland, France, Germany, Greece, Ireland, Italy, Luxembourg, the Netherlands,
Portugal, Spain, Sweden and the United Kingdom.
Chapter 4
99
Case studies: policy development in countries for tackling noncommunicable diseases