Kostas Rontos

The study examined the extent of bribery within the public healthcare system in Greece and the influence of its determinants at the macro-, meso-, and micro-levels, highlighting institutional and cultural influences, systemic weaknesses, inequalities, and high-risk groups. Structured questionnaires were administered to a representative sample of adult users of healthcare services in public hospitals located in urban areas. The analysis included descriptive statistics to examine variable distributions and trends, bivariate non-parametric tests to assess associations between informal payments and selected demographic and socioeconomic characteristics, as well as binary logistic regression modelling to estimate the probability of exposure to informal payments based on specific individual characteristics. The study sample comprised 2072 adults, of whom 59.5% were female and 40.5% male, with the largest age group being 36–55 years. A proportion of 23.2% resided outside the metropolitan areas of Athens and Thessaloniki, while nearly 50% reported a monthly household income of up to €1500, indicating a substantial representation of socio-economically disadvantaged groups. The large size of the sample, the fact that the residence place of the responders is spread all over the country, the stratified procedure for the hospitals selected and the fact that sampling method used is a typical one in the case of sample frame lack, ensure the greatest achievable representation of the Greek population. The analysis revealed the existence of a significant problem of informal payments within the Greek public healthcare system and identified specific institutional, cultural, and organizational determinants, as well as demographic and socioeconomic groups that are particularly vulnerable to such practices. The phenomenon disproportionately affects economically, educationally, and geographically disadvantaged populations. Addressing informal payments in healthcare is essential to preventing the erosion of the social fabric of the country and requires comprehensive transparency-oriented policies, the strengthening of equitable access to services, and targeted interventions for high-risk groups, in order to ensure the sustainability of the public healthcare system and the promotion of equitable and healthy living conditions for the population.

The mass arrival of Asia Minor refugees following the events of 1922 profoundly altered the demographic and social structure of Greece, but its effects were geographically uneven. Despite extensive scholarship on refugee settlement at the national level, less attention has been given to its demographic consequences in the Eastern Aegean islands, which received particularly large refugee populations relative to their pre-existing populations. This study examines the scale and demographic effects of the refugee influx in Lesvos, Samos, and Chios, compares them with national patterns, and considers local responses and institutional measures related to integration. The study adopts a quantitative historical-demographic approach, complemented by qualitative archival and historical evidence. It draws primarily on the 1920 and 1928 Population Censuses and the 1923 Refugee Census, conducting comparative analyses at national, prefectural, and selected municipal levels. Population change and density are examined with and without refugees, while age and sex structures, sex ratios, dependency and aging indices, marital status, literacy, and population pyramids are used to assess changes in population composition. Archival and historical sources contextualize local responses and settlement and integration processes. The results show that in 1928 refugees represented 20.2% of the population of Lesvos, 17.0% of Chios, and 9.0% of Samos, compared with 17.2% nationally. Refugee settlement reversed otherwise negative population-growth trends in Lesvos and Chios and substantially increased population density. It also altered age and sex structures, although these effects varied among the three prefectures. Historical evidence indicates that initial tensions between refugees and local populations coexisted with socioeconomic integration and institutional support. Overall, national aggregates alone cannot adequately capture the demographic consequences of the 1922 refugee influx, as the Eastern Aegean islands experienced distinct patterns shaped by the scale, composition, and spatial distribution of refugee settlement.

The study examined the extent of bribery within the public healthcare system in Greece and the influence of its determinants at the macro-, meso-, and micro-levels, highlighting institutional and cultural influences, systemic weaknesses, inequalities, and high-risk groups. Structured questionnaires were administered to a representative sample of adult users of healthcare services in public hospitals located in urban areas. The analysis included descriptive statistics to examine variable distributions and trends, bivariate non-parametric tests to assess associations between informal payments and selected demographic and socioeconomic characteristics, as well as binary logistic regression modelling to estimate the probability of exposure to informal payments based on specific individual characteristics. The study sample comprised 2,072 adults, of whom 59.5% were female and 40.5% male, with the largest age group being 36–55 years. A proportion of 23.2% resided outside the metropolitan areas of Athens and Thessaloniki, while nearly 50% reported a monthly household income of up to €1,500, indicating a substantial representation of socio-economically disadvantaged groups. The analysis revealed the existence of a significant problem of informal payments within the Greek public healthcare system and identified specific institutional, cultural, and organizational determinants, as well as demographic and socioeconomic groups that are particularly vulnerable to such practices. The phenomenon disproportionately affects economically, educationally, and geographically disadvantaged populations. Addressing informal payments in healthcare is essential to preventing the erosion of the social fabric of the country and requires comprehensive transparency-oriented policies, the strengthening of equitable access to services, and targeted interventions for high-risk groups, in order to ensure the sustainability of the public healthcare system and the promotion of equitable and healthy living conditions for the population.

The contemporary evolution of scientific thought and research is increasingly characterized by efforts to investigate and address problems whose origins extend over long historical periods, often spanning several decades

Climate warming, agricultural intensity, and urban growth are main forces triggering land degradation in advanced economies. Being active over different spatial and temporal scales, they usually reflect—at least indirectly—the impact of additional factors, such as wellbeing, demographic dynamics, and social development, on land quality. Using descriptive statistics and a multiple regression analysis, we analyzed the impact of these three processes comparatively over a decadal scale from 1960 to 2020 at the provincial level (Nuts-3 sensu Eurostat) in Italy. We enriched the investigation with a short-term forecast for 2030, based on four simplified assumptions grounded on a purely deterministic approach. Land degradation was estimated adopting the Environmental Sensitive Area Index (ESAI) measured at the spatio-temporal scale mentioned above. Computing on multiple observations at nearly 300,000 locations all over Italy, provinces were regarded as representative spatial units of the territorial pattern of land degradation. Between 1960 and 1990, the three predictors (climate, agriculture, and urbanization) explained a relatively high proportion of variance, suggesting a modest role for any other (unobserved) factor. All of these factors were found to be highly significant predictors of land degradation intensity across provinces, the most impactful being farming intensity. The highest adjusted-R² coefficient was observed in both 1990 and 2000, and suggests that the three predictors still reflect the most powerful drivers of land degradation in Italy at those times, with a marginal role for additional (unobserved) factors. The impact of farming intensity remained high, with the role of urbanization increasing moderately, and the role of climate aridity declining weakly between 2000 and 2010. In more recent times (2010 and 2020), and in future (2030) scenarios, the adjusted R² diminished moderately, suggesting a non-negligible importance of external (unobserved) factors and the rising role of spatial heterogeneity. The climate factor became progressively insignificant over time, while increasing the role of urbanization systematically. The impact of farming intensity remained high and significant. These results underlie a latent shift in the spatial distribution of the level of land vulnerability in Italy toward a spatially polarized model, influenced primarily by human pressure and socioeconomic drivers and less intensively shaped by biophysical factors. Climate aridity was revealed to be more effective in the explanation of land degradation patterns in the 1960s rather than in recent observation times.

Geographic data quality is a complex issue requiring continuous operational improvements. Considering this to be one of the most topical research and technical issues in official statistics and environmental monitoring, this study re-connects the operational dimension of ‘geographic data quality’ with the broader issue of monitoring the quality of official statistics. By estimating the accuracy of public (spatially explicit) data, this study illustrates an operational framework with an exploratory exercise in estimating the geographic data quality characteristic of a specific information source within the official statistical system (i.e., building registry) in a given European country, namely, Italy. The results of this exercise provide a paradigmatic example of profound innovation in the activities of statistical services in Europe and specifically the Italian National Statistical Institute (Istat), transitioning from independent (and poorly connected) field surveys to an integrated system of registries. Since several studies are based on spatially explicit survey units, it is essential to estimate the quality of geographical data, especially those derived from information sources where space is topical information, such as (local, regional, or national) building registers. Thanks to the results of an empirical exercise applied to Italian building registers, the present article will discuss the issue of data accuracy, considered the main issue related to monitoring geographic data quality, from an official statistics’ perspective. Statistical indicators will be proposed for the assessment of systematic and random errors of spatially explicit measures, possibly enabling a quali-quantitative improvement in the semantic content of building registers that address the inherent requirements of official statistics. Such indicators have some positive implications for the entire system of official statistics in Italy and, for generalization, within the European Statistical System.

Being intertwined with economic development, urbanization determines the present and future development path of regions and countries. The intimate relationship between urban expansion and economic development is of particular interest in the case of large regions with complex (and mostly non-linear) socio-demographic dynamics and a relevant primacy in the metropolitan system of a given country. Typical examples of advanced economies with settlement systems characterized by a high degree of city primacy are peripheral and disadvantaged European countries such as Portugal and Greece. For instance, the administrative region of Attica—centered on Athens, the Greek capital city—represents the largest metropolitan area of the country, hosting almost 3.8 million inhabitants in 2021 (36.2% of the Greek population). In this context, this study investigates the internal redistribution of the resident population in metropolitan Athens and the progressive development of satellite cities over a relatively longtime interval, testing the assumptions of the Spatial Cycle Theory (SCT) between 1951 and 2021 and predicting future development paths up to 2051. To investigate past, present, and future intra-regional population trends, we used data released from decadal (1951–2021) censuses and demographic forecasts for the years 2031, 2041, and 2051. Being in line with the SCT, the empirical results of our study document how demographic dynamics of individual centers influence largely—and independently—the long-term development of metropolitan regions, both with policy/planning regulation and in conditions of non-intervention (spontaneous urban growth).