Recent evidence of deteriorating health indicators in mental health and infectious diseases (Box 2.6) highlight the need for maintaining critical preventive public health services, which will tend to benefit more the low-income groups who are likely to be more prone to these diseases (Karanikolos et al., Widespread tax evasion, however, distorts its distributional effects and reduces its effectiveness in terms of tax collection (Chapter 1). Based on micro-simulation analysis, Leventi and Matsaganis (2013b) conclude that the extended income underreporting (at an average rate of 12.2% in 2009), incurred mainly among self-employment, increases inequality and makes the tax system considerably more regressive (by around 32% on the basis of the difference in the value of redistribution indices under tax evasion and full compliance).