The health of the Roma people: a review of the published literature

Abstract

Background-The Roma people originated in northern India and have been known in Europe for nearly a thousand years. For much of that time they have been the subjects of discrimination and oppression, culminating in the extermination of half a million Roma in the Nazi death camps. While it is widely believed that the health of Roma people is often poorer than the majority population, these inequalities remain largely unresearched. Methods-Published literature on the health of the Roma people was identified using Medline. Opinion pieces were excluded, as were papers relating to anthropometry and to genetic markers. The resultant papers were analysed by country of study and by disease type or care group. Results-Some 70% of papers identified related to just three countries; Spain and the Czech and Slovak Republics. Much literature concentrates upon communicable disease or reproductive health. The limited evidence suggests increased morbidity from non-communicable disease, but there is little published on this topic. Evidence on health care, though fragmentary, suggests poorer access to health services and uptake of preventative care. Discussion-Published research on the health needs of the Roma population is sparse. The topics that have received attention suggest a focus on concepts of contagion or social Darwinism, indicating a greater concern with the health needs of the majority populations with which they live. There is a need for both further research into the health of Roma people; with particular emphasis on noncommunicable disease; and also for interventions that improve Roma health. Such research must, however, be handled with sensitivity, recognising the social and political context of the society concerned.

Socioeconomic indicators and ethnicity as determinants of regional mortality rates in Slovakia

“…Results from published literature on Roma health in Central Europe show several differences between the Roma population and the general population. Among the Roma higher birth and fertility rates are found, but also higher death rates, earlier start of reproductive activity and longer reproduction period, lower life expectancy and higher rates of illness [36][37][38] . The Roma population is also disadvantaged by lower education levels and greater illiteracy, which represent a major barrier to successful involvement in the labour market 36 .…”

“…It has furthermore been argued that unemployment may be a health hazard, and many studies have shown that unemployed persons have poorer health and higher mortality than employed people. It is generally recognised that those who are unemployed have lower quality of life and probably worse health and shorter life, particularly for males [36][37][38][39] . For this study, socioeconomic indicators were chosen from official statistics available in the Slovak Republic on the district level.…”

Roma coronary heart disease patients have more medical risk factors and greater severity of coronary heart disease than non-Roma

“…Rosicova et al (2011) found Roma ethnicity as a predictor of regional infant mortality rate in Slovakia. This is likely to contribute to the poorer CHD outcomes among Roma (Ginter 1998;McKee 1997;Hajioff and McKee 2000), but evidence on this is lacking.…”

Mass immunisation campaign in a Roma settled community created an opportunity to estimate its size and measles vaccination uptake, Poland, 2009

“…This figure was mainly based on settled communities that the census could reach. The real number of Roma residents in Poland is probably higher, as illustrated in review published in 2000 [8]. The Roma ethnic group is the largest minority in several central and eastern European countries, comprising approximately seven million people [7].…”