IDEAS home Printed from https://ideas.repec.org/p/arx/papers/2407.17084.html

Effect of Austerity Measures on Infant Mortality: Evidence from Greece

Author

Listed:
  • Robert J. Kolesar
  • Rok Spruk

Abstract

This study examines the effect of fiscal austerity measures on infant mortality in Greece. Austerity measures were initiated by the tripartite committee and implemented between 2010 and 2017 to counteract deep fiscal deficit and large public debt. By comparing Greece with a plausible donor pool of OECD and Mediterranean member states in the period 1991-2020, we estimate a series of missing counterfactual scenarios to evaluate the infant mortality effects of large-scale reduction in spending on health care. A series of hybrid synthetic control and difference-in-differences estimates indicate a unique and pervasive increase in infant mortality after the implementation of austerity measures. Compared to a plausible OECD and Mediterranean counterfactual scenario, pro-cyclical austerity measures are associated with derailed and permanently increased infant mortality up to the present day. Our estimates suggest that compared to a plausible counterfactual scenario, the cumulative infant mortality cost of austerity policies exceeds 10,000 infant deaths or slightly less than 850 deaths for each year of the austerity policies. Notably, mortality increases are concentrated among boys. The estimated impacts survive a battery of rigorous robustness and placebo tests.

Suggested Citation

  • Robert J. Kolesar & Rok Spruk, 2024. "Effect of Austerity Measures on Infant Mortality: Evidence from Greece," Papers 2407.17084, arXiv.org.
  • Handle: RePEc:arx:papers:2407.17084
    as

    Download full text from publisher

    File URL: http://arxiv.org/pdf/2407.17084
    File Function: Latest version
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Itzik Fadlon & Torben Heien Nielsen, 2021. "Family Labor Supply Responses to Severe Health Shocks: Evidence from Danish Administrative Records," American Economic Journal: Applied Economics, American Economic Association, vol. 13(3), pages 1-30, July.
    2. Siddiqi, Arjumand & Jones, Marcella K. & Erwin, Paul Campbell, 2015. "Does higher income inequality adversely influence infant mortality rates? Reconciling descriptive patterns and recent research findings," Social Science & Medicine, Elsevier, vol. 131(C), pages 82-88.
    3. Bibek Adhikari & James Alm, 2016. "Evaluating the Economic Effects of Flat Tax Reforms Using Synthetic Control Methods," Southern Economic Journal, John Wiley & Sons, vol. 83(2), pages 437-463, October.
    4. Bibek Adhikari & James Alm, 2016. "Evaluating the Economic Effects of Flat Tax Reforms Using Synthetic Control Methods," Southern Economic Journal, Southern Economic Association, vol. 83(2), pages 437-463, October.
    5. Simou, Effie & Koutsogeorgou, Eleni, 2014. "Effects of the economic crisis on health and healthcare in Greece in the literature from 2009 to 2013: A systematic review," Health Policy, Elsevier, vol. 115(2), pages 111-119.
    6. Eli Ben-Michael & Avi Feller & Jesse Rothstein, 2021. "The Augmented Synthetic Control Method," Journal of the American Statistical Association, Taylor & Francis Journals, vol. 116(536), pages 1789-1803, October.
    7. Keramidou, Ioanna & Triantafyllopoulos, Loukas, 2018. "The impact of the financial crisis and austerity policies on the service quality of public hospitals in Greece," Health Policy, Elsevier, vol. 122(4), pages 352-358.
    8. Xu, Yiqing, 2017. "Generalized Synthetic Control Method: Causal Inference with Interactive Fixed Effects Models," Political Analysis, Cambridge University Press, vol. 25(1), pages 57-76, January.
    9. Tapia Granados, José A. & Rodriguez, Javier M., 2015. "Health, economic crisis, and austerity: A comparison of Greece, Finland and Iceland," Health Policy, Elsevier, vol. 119(7), pages 941-953.
    10. Dmitry Arkhangelsky & Susan Athey & David A. Hirshberg & Guido W. Imbens & Stefan Wager, 2021. "Synthetic Difference-in-Differences," American Economic Review, American Economic Association, vol. 111(12), pages 4088-4118, December.
    11. Georgia Kaplanoglou & Vassilis T. Rapanos, 2018. "Evolutions in Consumption Inequality and Poverty in Greece: The Impact of the Crisis and Austerity Policies," Review of Income and Wealth, International Association for Research in Income and Wealth, vol. 64(1), pages 105-126, March.
    12. Colombo, Emilio & Rotondi, Valentina & Stanca, Luca, 2018. "Macroeconomic conditions and health: Inspecting the transmission mechanism," Economics & Human Biology, Elsevier, vol. 28(C), pages 29-37.
    13. Pierre-Olivier Gourinchas & Thomas Philippon & Dimitri Vayanos, 2017. "The Analytics of the Greek Crisis," NBER Macroeconomics Annual, University of Chicago Press, vol. 31(1), pages 1-81.
    14. Gabriel Chodorow-Reich & Loukas Karabarbounis & Rohan Kekre, 2023. "The Macroeconomics of the Greek Depression," American Economic Review, American Economic Association, vol. 113(9), pages 2411-2457, September.
    15. Abadie, Alberto & Diamond, Alexis & Hainmueller, Jens, 2010. "Synthetic Control Methods for Comparative Case Studies: Estimating the Effect of California’s Tobacco Control Program," Journal of the American Statistical Association, American Statistical Association, vol. 105(490), pages 493-505.
    16. Martha J. Bailey & Andrew Goodman-Bacon, 2015. "The War on Poverty's Experiment in Public Medicine: Community Health Centers and the Mortality of Older Americans," American Economic Review, American Economic Association, vol. 105(3), pages 1067-1104, March.
    17. Ifanti, Amalia A. & Argyriou, Andreas A. & Kalofonou, Foteini H. & Kalofonos, Haralabos P., 2013. "Financial crisis and austerity measures in Greece: Their impact on health promotion policies and public health care," Health Policy, Elsevier, vol. 113(1), pages 8-12.
    18. Rauch Bernhard & Göttsche Max & Engel Stefan & Brähler Gernot, 2011. "Fact and Fiction in EU-Governmental Economic Data," German Economic Review, De Gruyter, vol. 12(3), pages 243-255, August.
    19. T. Efthimiadis & S. Papaioannou & P. Tsintzos, 2013. "Economic growth in Greece: the cost of a failed adjustment programme," Applied Economics Letters, Taylor & Francis Journals, vol. 20(11), pages 1076-1080, July.
    20. Charis E. Kubrin & Bradley J. Bartos & Richard McCleary, 2022. "The debt crisis, austerity measures, and suicide in Greece," Social Science Quarterly, Southwestern Social Science Association, vol. 103(1), pages 120-140, January.
    21. Theodore Mitrakos, 2014. "Inequality, poverty and social welfare in Greece: distributional effects of austerity," Working Papers 174, Bank of Greece.
    22. Daron Acemoglu & Simon Johnson, 2007. "Disease and Development: The Effect of Life Expectancy on Economic Growth," Journal of Political Economy, University of Chicago Press, vol. 115(6), pages 925-985, December.
    23. Alberto Abadie, 2021. "Using Synthetic Controls: Feasibility, Data Requirements, and Methodological Aspects," Journal of Economic Literature, American Economic Association, vol. 59(2), pages 391-425, June.
    24. David Gilchrist & Thomas Emery & Nuno Garoupa & Rok Spruk, 2023. "Synthetic Control Method: A tool for comparative case studies in economic history," Journal of Economic Surveys, Wiley Blackwell, vol. 37(2), pages 409-445, April.
    25. Ioannides, Yannis & Philippon, Presenter Thomas & Gourinchas, Pierre-Olivier & Blanchard, Olivier & Steinsson, Jon & Uhlig, Harald & Alvarez, Fernando & Reis, Ricardo & Klein, Michael, 2017. "The Analytics of the Greek Crisis Discussion," Department of Economics, Working Paper Series qt4z39g6vx, Department of Economics, Institute for Business and Economic Research, UC Berkeley.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Mohammad Reza Farzanegan, 2023. "Years of life lost to revolution and war in Iran," Review of Development Economics, Wiley Blackwell, vol. 27(4), pages 2061-2103, November.
    2. Garoupa, Nuno & Spruk, Rok, 2025. "Populist constitutional backsliding and judicial independence: Evidence from Türkiye," International Review of Law and Economics, Elsevier, vol. 84(C).
    3. David Gilchrist & Thomas Emery & Nuno Garoupa & Rok Spruk, 2023. "Synthetic Control Method: A tool for comparative case studies in economic history," Journal of Economic Surveys, Wiley Blackwell, vol. 37(2), pages 409-445, April.
    4. Nuno Garoupa & Rok Spruk, 2025. "Revolutions as structural breaks: the long-term economic and institutional consequences of the 1979 Iranian Revolution," Constitutional Political Economy, Springer, vol. 36(3), pages 273-301, September.
    5. Aleksandar Keseljevic & Stefan Nikolic & Rok Spruk, 2025. "Ethnic Conflicts, Civil War and Economic Growth: Region-Level Evidence from former Yugoslavia," Papers 2505.02431, arXiv.org.
    6. Pekka Malo & Juha Eskelinen & Xun Zhou & Timo Kuosmanen, 2024. "Computing Synthetic Controls Using Bilevel Optimization," Computational Economics, Springer;Society for Computational Economics, vol. 64(2), pages 1113-1136, August.
    7. Bilbao-Goyoaga, Eugenia, 2023. "Perceptions Matter: Quasi-Experimental Evidence on the Effects of Minimum Income on Objective and Subjective Financial Wellbeing in Spain," SocArXiv wv7xt, Center for Open Science.
    8. Aleksandar Kešeljević & Rok Spruk, 2024. "Estimating the effects of Syrian civil war," Empirical Economics, Springer, vol. 66(2), pages 671-703, February.
    9. repec:osf:socarx:wv7xt_v1 is not listed on IDEAS
    10. Luis Costa & Vivek F. Farias & Patricio Foncea & Jingyuan (Donna) Gan & Ayush Garg & Ivo Rosa Montenegro & Kumarjit Pathak & Tianyi Peng & Dusan Popovic, 2023. "Generalized Synthetic Control for TestOps at ABI: Models, Algorithms, and Infrastructure," Interfaces, INFORMS, vol. 53(5), pages 336-349, September.
    11. S. V. Doroshenko & R. I. Vasileva & V. P. Litvinets, 2024. "The Far Eastern Development Program and Effectiveness for Regions: Case-Study Assessment," Studies on Russian Economic Development, Springer, vol. 35(2), pages 237-245, April.
    12. Chiara Natalie Focacci & Mitja Kovac & Rok Spruk, 2022. "The perils of Kremlin's influence: evidence from Ukraine," Papers 2206.04950, arXiv.org.
    13. Taehyeon Koo & Zijian Guo, 2025. "Distributionally Robust Synthetic Control: Ensuring Robustness Against Highly Correlated Controls and Weight Shifts," Papers 2511.02632, arXiv.org, revised Jan 2026.
    14. Mohammad Reza Farzanegan & Nader Habibi, 2024. "The Effect of International Sanctions on the Size of the Middle Class in Iran," CESifo Working Paper Series 11175, CESifo.
    15. Li, Xingyu & Shen, Yan & Zhou, Qiankun, 2024. "Confidence intervals of treatment effects in panel data models with interactive fixed effects," Journal of Econometrics, Elsevier, vol. 240(1).
    16. Maximiliano Marzetti & Rok Spruk, 2023. "Long-Term Economic Effects of Populist Legal Reforms: Evidence from Argentina," Comparative Economic Studies, Palgrave Macmillan;Association for Comparative Economic Studies, vol. 65(1), pages 60-95, March.
    17. Dennis Shen & Peng Ding & Jasjeet Sekhon & Bin Yu, 2022. "Same Root Different Leaves: Time Series and Cross-Sectional Methods in Panel Data," Papers 2207.14481, arXiv.org, revised Oct 2022.
    18. Zhentao Shi & Jin Xi & Haitian Xie, 2025. "A Synthetic Business Cycle Approach to Counterfactual Analysis with Nonstationary Macroeconomic Data," Papers 2505.22388, arXiv.org.
    19. Robert Messerle & Jonas Schreyögg, 2024. "Country-level effects of diagnosis-related groups: evidence from Germany’s comprehensive reform of hospital payments," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 25(6), pages 1013-1030, August.
    20. Andrii Melnychuk, 2024. "Synthetic Controls with spillover effects: A comparative study," Papers 2405.01645, arXiv.org.
    21. Liang, Yufan & He, Xiaolong, 2024. "Does the cross-border e-commerce comprehensive pilot area policy help to improve the level of urban technological innovation?," Economic Analysis and Policy, Elsevier, vol. 84(C), pages 1258-1271.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:arx:papers:2407.17084. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: arXiv administrators (email available below). General contact details of provider: http://arxiv.org/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.