Health-endangering everyday settings and practices in a rural segregated Roma settlement in Slovakia: A descriptive summary from an exploratory longitudinal case study

Abstract

BackgroundResearch into social root-causes of poor health within segregated Roma communities in Central and Eastern Europe, i.e. research into how, why and by whom high health-endangering settings and exposures are maintained here, is lacking. The aim of this study was to assess the local setup of health-endangering everyday settings and practices over the long-term in one such community. It is the initial part of a larger longitudinal study qualitatively exploring the social root-causes of poor Roma health status through the case of a particular settlement in Slovakia.MethodsThe study, spanning 10 years, comprised four methodologically distinct phases combining ethnography and applied medical-anthropological surveying. The acquired data consisted of field notes on participant observations and records of elicitations focusing on both the setup and the social root-causes of local everyday health-endangering settings and practices. To create the here-presented descriptive summary of the local setup, we performed a qualitative content analysis based on the latest World Health Organization classification of health exposures.ResultsAcross all the examined dimensions – material circumstances, psychosocial factors, health-related behaviours, social cohesion and healthcare utilization – all the settlements’ residents faced a wide range of health-endangering settings and practices. How the residents engaged in some of these exposures and how these exposures affected residents’ health varied according to local social stratifications. Most of the patterns described prevailed over the 10-year period. Some local health-endangering settings and practices were praised by most inhabitants using racialized ethnic terms constructed in contrast or in direct opposition to alleged non-Roma norms and ways.ConclusionsOur summary provides a comprehensive and conveniently structured basis for grounded thinking about the intermediary social determinants of health within segregated Roma communities in Slovakia and beyond. It offers novel clues regarding how certain determinants might vary therein; how they might be contributing to health-deterioration; and how they might be causally inter-linked here. It also suggests racialized ethnically framed social counter-norms might be involved in the maintenance of analogous exposure setups.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-017-4029-x) contains supplementary material, which is available to authorized users.

Enhancing the social integration of Roma in Slovak Republic

“…Health-care outcomes of Roma are poor and critical in some areas (Belak et al, 2017;Gatti et al, 2016). The estimated life expectancy is 6 years lower than that of the rest of the population (MoF, 2019).…”

Juvenile Idiopathic Arthritis: Roma Children Seem to Run More Risk than Non-Roma

“…Over half of Slovak Roma (current estimates of their total number is up to 450,000 persons) resides in segregated settlements [7,8], similar to the situation elsewhere in CEE. These settlements are characterized by general poverty, high rates of unemployment and low education, substandard material conditions, access barriers to health care and other public services and a generally poor health status [9][10][11]. The generally poor living conditions of Roma can be expected to lead to worse clinical consequences of JIA and to barriers that cause their entry into health care in more acute states.…”

Roma Housing and Eating in 1775 and 2013: A Comparison

“…Despite several high-quality study reports and analyses mentioned in the introduction to the paper [1,6,7], in the conditions of Slovakia there is a lack of research studies that would deal with the eating habits and nutrition values of the poor in the settlements. Therefore, future research projects, including multidisciplinary teams consisting of social scientists and health professionals, should focus on analyzing needs in the area of eating and housing in the settlements.…”

“…Roma health includes the low level of recognition and understanding of the minority by the majority, a topic very difficult to study. The very poor hygienic standards in segregated Roma settlements aggravates such a problem [6,7]. Culture should also be studied "under the surface" and history analyzed in sufficient detail [8].…”