Mental health, health-related quality of life, and material and social deprivation: A hierarchical analysis of their relationships and determinants in people attending a Greek public hospital.
Palermos D, Briasoulis A, et al. • Maturitas • 2026
Material and social deprivation was highly prevalent (46.3%) among patients and accompanying persons attending a Greek public hospital cardiology clinic, almost double national estimates, and was closely linked to adverse sociodemographic and lifestyle characteristics, physical morbidity, and impaired mental health and HRQoL.
Key Findings
Results
The prevalence of deprivation among hospital attendees was 46.3%, with 28.5% experiencing severe deprivation, almost double national estimates for 2024.
Study conducted at a public hospital cardiology clinic in Athens, Greece in 2024
456 participants were included (59% female; 25% aged ≥65 years; 40% with ≤12 years of education)
46.3% of participants experienced deprivation overall
28.5% experienced severe deprivation specifically
These rates were described as almost double the national estimates for Greece in 2024
Results
Lower educational attainment, older age, and unemployment were significant determinants of deprivation.
These associations were identified through univariate and multivariate logistic regression analyses guided by a hierarchical framework
Participants with ≤12 years of education comprised 40% of the sample
Participants aged ≥65 years comprised 25% of the sample
These sociodemographic factors were independently associated with deprivation in multivariate models
Results
Smoking, sleep duration, and presence of physical health conditions were independently associated with deprivation.
These lifestyle and health factors were identified as independent determinants of deprivation after controlling for sociodemographic variables
Associations were established using multivariate logistic regression within a hierarchical analytical framework
Physical health conditions were part of participants' self-reported medical history
These findings suggest a clustering of adverse lifestyle and health characteristics among deprived individuals
Results
Deprived individuals reported substantially worse health-related quality of life, higher depressive symptoms, clinically significant anxiety, and lower life satisfaction compared to non-deprived individuals.
HRQoL, mental health indicators, and life satisfaction were all self-reported by participants
Both depressive symptoms and clinically significant anxiety were more prevalent among deprived participants
Material and social deprivation was measured using the European Union Material and Social Deprivation Index
These mental health and HRQoL differences persisted as part of the hierarchical multivariate analysis
Methods
The study population attending a public hospital cardiology clinic showed a concentration of vulnerability, with nearly half experiencing deprivation.
Cross-sectional design was used, conducted in 2024 in Athens, Greece
Both patients and accompanying persons aged over 30 years were included
The sample had notable proportions of older adults (25% aged ≥65 years) and those with lower educational attainment (40% with ≤12 years of education)
The authors concluded that routine assessment of deprivation in clinical care and targeted support programs for vulnerable populations are warranted
What This Means
This research suggests that people attending a public hospital cardiology clinic in Athens, Greece face very high rates of financial and social hardship. Nearly half (46.3%) of the 456 participants were classified as deprived, and more than one in four (28.5%) were severely deprived — roughly double what would be expected based on national figures for Greece in 2024. The people most likely to be deprived were older, had less education, and were unemployed. Smoking, poor sleep, and having physical health problems were also linked to higher rates of deprivation.
The study also found that people who were deprived had noticeably worse outcomes across multiple measures of wellbeing. They reported lower quality of life related to their health, more symptoms of depression, higher rates of clinically significant anxiety, and less satisfaction with life overall. This suggests that economic and social hardship does not exist in isolation — it tends to cluster together with poor physical health and poor mental health, creating compounding disadvantages for vulnerable individuals.
The researchers argue that hospitals and clinics should routinely screen patients for signs of material and social deprivation, not just physical illness. This research suggests that identifying deprived patients in clinical settings could open doors to targeted support programs that address the broader social conditions affecting health. The findings are particularly relevant given that this population — people seeking care at a public hospital — may already represent some of the more vulnerable members of society.
Palermos D, Briasoulis A, Ntanasis-Stathopoulos I, Titsi K, Tsakliadou C, Charalampopoulou A, et al.. (2026). Mental health, health-related quality of life, and material and social deprivation: A hierarchical analysis of their relationships and determinants in people attending a Greek public hospital.. Maturitas. https://doi.org/10.1016/j.maturitas.2026.108939