Increased Employment for Segregated Roma May Improve Their Health: Outcomes of a Public–Private Partnership Project

Bosakova, Lucia; Gecková, Andrea Madarasová; Dijk, Jitse P. van; Reijneveld, Sijmen A.

doi:10.3390/ijerph16162889

Cited by 10 publications

(18 citation statements)

References 21 publications

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“…However, the low competitiveness of segregated Roma is not the only barrier to employment. Better employability does not always increase their employment opportunities, because other factors, such as anti-Gypsyism, also affect their chances of getting a job [8][9][10]. Because of these discriminatory practices, Roma often have access only to unstable jobs with low wages [11].…”

Section: Introductionmentioning

confidence: 99%

Appropriate Employment for Segregated Roma: Mechanisms in a Public–Private Partnership Project

Bosakova

Gecková

Dijk

et al. 2020

IJERPH

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Our earlier article showed that increased employability of segregated Roma may improve their well-being and health. To achieve that, appropriate employment based on a public–private partnership could be the key. For optimal design of such a partnership, we need insight into its potential mechanisms. Evidence on this is lacking, however. This paper builds on the previously published article by focusing on mechanisms for achieving better health. Therefore, our aim was to identify the potential mechanisms by which a public–private Roma employment project could increase employability. We investigated a Roma employment project called Equality of Opportunity established by a private company, U.S. Steel Kosice in eastern Slovakia. We conducted a multi-perspective qualitative study to obtain key stakeholders’ perspectives on the potential mechanisms of a public–private Roma employment project in terms of increased employability. We found three types of mechanisms. The first type regarded formal job mechanisms, such as an appropriate employment and salary offer and a bottom-up approach in capacity building. The second type involved sustainability mechanisms, such as the personal profile of project and work-shift coordinators, the continuous offer of training and cooperation with relevant stakeholders (municipalities, community centers, etc.). The third type was cultural mechanisms, such as personal contact with project participants, attention to less-voiced groups like children, the motivation of project participants, a counter-value reciprocity approach and respect for the specifics of Roma history. Our findings imply that policymakers could consider public–private partnerships for increasing the employability of segregated Roma, as they have the potential to address a wider range of social needs simultaneously.

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Section: Introductionmentioning

confidence: 99%

Appropriate Employment for Segregated Roma: Mechanisms in a Public–Private Partnership Project

Bosakova

Gecková

Dijk

et al. 2020

IJERPH

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“…Many studies have been conducted to understand the mechanism by which Roma ethnicity leads to misuse of health facilities [50,51] and health loss [47,49,52], but our knowledge is still insufficient. This limitation is reflected in the hardly detectable impact of Roma targeted health policies in European countries [10,53,54]. To conclude, the full effect of the Roma population on the use of different health care services and financing is still not sufficiently documented.…”

Section: Introductionmentioning

confidence: 97%

“…Spontaneous market-based processes without strategic planning and purposeful execution of interventions cannot control for risks of inequality [7,8]. Effective public policy is required to counterbalance the inequality generated by technological development, incorporating community needs in planning, training programs, material aids, and grants for long term sustainability [9,10]. At present, there are striking inequalities in health spending in many respects, including individual, social, and healthcare system related determinants [11,12].…”

Section: Introductionmentioning

confidence: 99%

Self-Declared Roma Ethnicity and Health Insurance Expenditures: A Nationwide Cross-Sectional Investigation at the General Medical Practice Level in Hungary

Kasabji

Alrajo

Vincze

et al. 2020

IJERPH

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The inevitable rising costs of health care and the accompanying risk of increasing inequalities raise concerns. In order to make tailored policies and interventions that can reduce this risk, it is necessary to investigate whether vulnerable groups (such as Roma, the largest ethnic minority in Europe) are being left out of access to medical advances. Objectives: The study aimed to describe the association between general medical practice (GMP) level of average per capita expenditure of the National Health Insurance Fund (NHIF), and the proportion of Roma people receiving GMP in Hungary, controlled for other socioeconomic and structural factors. Methods: A cross-sectional study that included all GMPs providing care for adults in Hungary (N = 4818) was conducted for the period 2012–2016. GMP specific data on health expenditures and structural indicators (GMP list size, providing care for adults only or children also, type and geographical location of settlement, age of GP, vacancy) for secondary analysis were obtained from the NHIF. Data for the socioeconomic variables were from the last census. Age and sex standardized specific socioeconomic status indicators (standardized relative education, srEDU; standardized relative employment, srEMP; relative housing density, rHD; relative Roma proportion based on self-reported data, rRP) and average per capita health expenditure (standardized relative health expenditure, srEXP) were computed. Multivariate linear regression model was applied to evaluate the relationship of socioeconomic and structural indicators with srEXP. Results: The srEDU had significant positive (b = 0.199, 95% CI: 0.128; 0.271) and the srEMP had significant negative (b = −0.282, 95% CI: −0.359; −0.204) effect on srEXP. GP age > 65 (b = −0.026, 95% CI: −0.036; −0.016), list size <800 (b = −0.043, 95% CI: −0.066; −0.020) and 800–1200 (b = −0.018, 95% CI: −0.031; −0.004]), had significant negative association with srEXP, and GMP providing adults only (b = 0.016, 95% CI: 0.001;0.032) had a positive effect. There was also significant expenditure variability across counties. However, rRP proved not to be a significant influencing factor (b = 0.002, 95% CI: −0.001; 0.005). Conclusion: As was expected, lower education, employment, and small practice size were associated with lower NHIF expenditures in Hungary, while the share of self-reported Roma did not significantly affect health expenditures according to our GMP level study. These findings do not suggest the necessity for Roma specific indicators elaborating health policy to control for the risk of widening inequalities imposed by rising health expenses.

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“…However, the low competitiveness of segregated Roma is not the only barrier to employment. Better employability does not always increase their employment opportunities, because other factors, such as anti-Gypsyism in the majority population, also affect their chances of getting a job (Bosakova et al 2019a;). Because of these discriminatory practices, Roma often have access only to unstable jobs with low wages ).…”

Section: Chaptermentioning

confidence: 99%

“…The private sector may help provide employment and training opportunities for Roma, whereas the public and third sector can be helpful in providing adequate potential employees to employers together with various types of support within the process. Such a partnership could have a huge potential to increase employability by combining their assets, offering appropriate and equal work opportunities, initiating a dialogue within the business community regarding zero tolerance to discrimination (Bosakova et al 2019a) and developing and enforcing laws and workplace policies against discrimination.…”

Section: Social Policies and Public-private Partnerships To Tackle Inequalitiesmentioning

confidence: 99%

Breaking the cycle of poverty: routes to counteract intergenerational transmission of socioeconomic health differences

Bosakova¹

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Increased Employment for Segregated Roma May Improve Their Health: Outcomes of a Public–Private Partnership Project

Cited by 10 publications

References 21 publications

Appropriate Employment for Segregated Roma: Mechanisms in a Public–Private Partnership Project

Appropriate Employment for Segregated Roma: Mechanisms in a Public–Private Partnership Project

Self-Declared Roma Ethnicity and Health Insurance Expenditures: A Nationwide Cross-Sectional Investigation at the General Medical Practice Level in Hungary

Breaking the cycle of poverty: routes to counteract intergenerational transmission of socioeconomic health differences

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