Social integration is necessary to reduce health disparities of Roma people in Europe
A traditionally migratory population originating in northern India, the Roma people make up a sizeable minority population in Eastern Europe countries including Slovakia, Croatia, Romania, Serbia, and Macedonia. The Roma people preserve a strong sense of identity, culture, and language, but integration into their respective countries is an ongoing challenge. They have historically faced, and continued to face, wide discrimination and marginalization, which is reflected in segregated housing, high rates of poverty, and lower education rates. Unsurprisingly, Roma people are found to have lower health outcomes across the board than their non-Roma counterparts. A 2011 United Nations Development Programme (UNDP) survey compared Roma vs. non-Roma health data to find that access to health services and maternal and child health were main areas with large disparity (UNDP, 2016).
The survey results credit physical access and financial limitations as main barriers of access to services such as specialty care. For example, when non-Roma and Roma adults living in the same area were asked whether they had had access to a doctor during the past year, 42% of Roma said they had not, whereas only 26% of non-Roma respondents said the same. 55% of Roma respondents said they could not afford to buy prescription medication in the past year, whereas only 25% of non-Roma people said the same. 74% of Roma respondents said they had access to medical insurance whereas 90% of non-Roma from the same region reported having medical insurance (Mihailov 2013, UNDP 2016).
Roma respondents also reported weaker maternal and child health outcomes than non-Roma counterparts: fewer Roma people give birth in delivery facilities, and Roma people have much lower rates of routine childhood vaccination than non-Roma. The largest disparity between vaccination rates was for the measles, mumps, and rubella shot, where 81% of Roma children aged 0-6 were vaccinated compared to a 90% vaccination rate for non-Roma children (Mihailov 2013). This indicates a disparity in education and awareness of vaccines, and a lack of access.
Understanding why these health disparities persist requires an understanding of a long history of persecution – including slavery in Romania and mass killings during World War II – that led to the Roma people’s current state of marginalization. Today, Roma people are often viewed as inferior and misunderstood, which is compounded by the rising tide of nationalism in Europe. Solutions and interventions to these health disparities must focus on continued integration in society rather than new health frameworks, so that Roma people can more fully benefit from the same services that their neighbors enjoy. Improving employment and education outcomes is key, as socioeconomic status and health are intertwined. Such initiatives have and continue to exist, such as the multinational “Decade of Roma Inclusion”, but efforts must continue to challenge systemic oppression and combat biases and prejudice with education. Furthermore, societal and resource integration must be a cooperative, two-way initiative between governments and representatives of Roma communities.
References:
Mihailov, D. (2013). The Health Situation of Roma Communities: Analysis of the UNDP/World Bank/EC Regional Roma Survey Data Policy Brief. Retrieved November 29, 2016, from https://www.scribd.com/document/154052699/Policy-brief-Roma-health UNDP. (2016).
Roma data. Retrieved November 29, 2016, from http://www.eurasia.undp.org/content/rbec/en/home/ourwork/sustainable-development/development-planning-and-inclusive-sustainable-growth/roma-in-central-and-southeast-europe/roma-data.html