THE
SOCIO-ECONOMIC DETEREMINANTS OF ROMA HEALTH STATUS IN COMPARISON WITH NON-ROMA
IN BULGARIA, HUNGARY AND ROMANIA:
The
welfare of the Roma population has been an interest of case studies over the
recent years. It has been estimated that 12-15million (Program, Open Society
Institute Network Public Health, 2005)Roma minorities live in
Europe. This has reflected decades of Roma Inclusion’ (2005-15), harmonizing
with the entry of several Central and Eastern European (CEE) countries into the
European Union. The Roma
minorities within the CEE countries are subjected to poor living conditions.
They live in poor regions with lack or no access to education (Centre for Documentation and Research, 1994).
Historically,
the Roma have been perceived and often discriminated as a source of
contamination in Central and Eastern European countries (Martin McKee, 2004). This was a result of the
health literacy of the Roma population which focused on infectious diseases,
and genetic disorders as the main caused of Roma health differences (Steve Hajioff). Although many
studies have failed to state the extent of the Roma inequalities and its
association to health (Jeremiah A. Barondess, 1998), multiple data have
indicated that the Roma population are limited to health literacy and access to
medical care. Among most of the population in Central, and Eastern Europe, it
is estimated that the Roma has 10 years of life expectancy (Braham M, 1993). It was concluded by a rare study which
was conducted in 1989, that in Czechoslovakia, the Roma men and women have a
life span of 12.1 and 14.4 years lower than the country’s entire population (Ferák V, 1987).
Recent
studies have proven that there is an increased rate of chronic diseases and
related risk factors compared to most population among the Roma minorities.
High levels of insulin, hypertension and obesity were found among the Roma’s
than the majority population in Slovakia. Due to the lifestyle and low level of
education among the young Roma population, there is a higher prevalence rate of
cardiovascular diseases risk factors and metabolic syndrome (Krajcovicova-Kudlackova
M, 2004).
Studies have shown a decrease in Vitamin C, and other antioxidant
vitamins and higher levels of inadequate nutrition, and smoking among the Roma
minority groups in Czech (Jan Dejmek, 2013) and Slovakia republics (Philipa Mladovsky, 2007). The prevalence of
underweight among the Roma population was high than that of the entire
population in Croatia (Domagoj Šegregur, 2017). The sanitary
conditions pose to be a policy objective and initiatives to improve sanitation
of the Roma society. Policies on Roma health should be multi-sectoral,
considering the economic, social and cultural crisis. The main determinants of
inequalities in health status among the Roma population in Bulgari, Romania and
Hungary were education and wealth. The study indicated that the Roma population
experienced specific health inequalities after determining for education,
expenditure and wealth.
The
Romanian society has one of the worst cases of social stigma in Europe. This
resulted from the reluctance and refusal of important public personalities of
Romani origin to declare their membership or links to Romania’s Romani minority
(Valeriu Nicolae and Hannah Slavik, 2003). Even though the
Roma population has the biggest minority groups in Europe, they face extreme
negligence and racism. Discrimination among the Roma population started from
the 16th century of nationalism, which rendered them one of the most
socially and financially excluded groups in Europe (Wilkin A, Derrington C, Foster B, 2009).
The significance of identifying the
health inequalities among Roma and Non-Roma communities is reflected by a huge
difference in their hygienic lifestyle (Hajioff S, 2000). According to WHO, sanitation is the
provision of facilities and services for the safe removal of human faeces (WHO, 2010). Different
backgrounds in cultures play a significant role in health inequalities. For
example; since the Roma population are situated in poorer regions, with low
access to medical care, the non-Roma are more likely to perform a chronic
illness diagnosis just simply because they have access to medical care than the
Roma.
THE STRUCTURE OF ETHNIC INEQUALITIES IN
HEALTH: ECONOMIC POSITION, RACIAL DISCRIMINATION, AND RACISM:
According to a US study, the nature of
racial prejudice changes over time in such a way that experience of
discrimination maybe hard to recognize. Davidio and Gaertner defined “aversive
racism”, as people characterized by “endorse egalitarian values, who consider
themselves as non-prejudiced, yet discriminate in a rationalized way. Thus,
making it hard to measure the health effects (Dovidio JF, Gaertner S, 2000).
The Forth
National Survey of Ethnic Minorities discovered an association between racial
discrimination experience, perceptions of racial harassment, and different
health risks across ethnic groups (Cooper RS, 1993). The study shows that racial
discrimination experience against minority groups were independently linked to
the likelihood of reporting fair or poor health, and the socioeconomic effects
on occupational class which includes; economic disadvantage, the feeling of low
self-esteem or devalued, minor status group, and personal insult and stress of
being a victim of racism (Kaufman JS, 1998).
Although, data have shown that socioeconomic inequalities cannot
explain the ethnic inequalities in health, it has proven that it contributes to
health inequalities among different ethnic groups across different countries.
Forth National Survey of Ethnic Minorities have illustrated that ethnic
differences differed from each ethnic group. Example, the minority people had a
smaller income compared to the whites (James Y. Nazroo and Saffron Karlsen, 1997). Similar study in the US, according to Oliver
and Shapiro, white people have more income than black peoples and, the black
are most likely to remain in that situation among those below the poverty line (James SA, 1987). Black people are
unlikely to own houses due to their low level of wealth (Melvin L,
1997).
Studies
conducted in the US have indicated the relationship between self-reported
experiences of racial discrimination and different health outcomes such as,
hypertension, psychological distress, poorer self-rated health, and days spent
ill in bed (Krieger N, 1990).
According to the National Survey of
Ethnic Minorities in the UK, ethnic inequalities increase with age, with slight
differences in younger age, and huge differences surfacing from mid-30s and
above (Nazroo J, 2001). Increase in health inequalities among
ethnic minorities at a certain age reflects on the range of health risks over
the life span, and long-term outcomes of exposure to health hazards at an early
age.
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