Policy brief - Roma health

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THE HEALTH SITUATION OF ROMA COMMUNITIES

THE HEALTH SITUATION OF ROMA COMMUNITIES ANALYSIS OF THE UNDP/WORLD BANK/EC REGIONAL ROMA SURVEY DATA

Policy brief

Dotcho Mihailov

Introduction

Context

This brief is based on a broader analysis of Roma health issues, developed as a UNDP Roma inclusion working paper. In addition to health, this series includes thematic reports on employment, education, poverty, gender, migration, and civil society. These papers, which are being released during December 2012 – February 2013, are available at http://europeandcis.undp.org/ourwork/roma/.

There is general agreement (Doyle, 2004) among health and policy experts that Roma suffer from poorer health than the general populations in the Central and Southeast European countries in which they are most numerous. Various studies since the mid-1990s have shown that Roma display greater incidence of vitamin deficiencies, malnutrition, anaemia, dystrophy, and infectious diseases than majority populations (Save the Children, 1998). Ginter et al (2001) found that Roma mortality rates at the turn of the millennium were three times national averages in Slovakia. Combinations of socio-economic deprivation and unhealthy lifestyles in Roma communities are usually blamed for these outcomes.

The brief and the paper behind it analyze health data from the 2011 UNDP/World Bank/EC regional Roma survey, which compared the living standards of Roma and Non-Roma communities living in close proximity in 12 Central and East European countries. The survey was conducted in Romania, Slovakia, Croatia, Bosnia and Herzegovina, Serbia, Montenegro, the Former Yugoslav Republic of Macedonia,1 Albania, Bulgaria, the Czech Republic, Hungary, and Moldova. It was based on representative samples of 750 Roma households in each country, as well as control samples of 350 non-Roma households living in close proximity. The survey generated data concerning Roma in three main public health areas: perception of health status, access to health services, and maternity and child health (which is a particularly sensitive Roma issue). As the survey data reflect respondents’ personal perceptions, they cannot be directly compared with epidemiological or other data collected by public health services or health care providers. Also, while the survey data are representative for the Roma population in the sampled countries, the data for non-Roma populations are only indicative (samples of non-Roma living nearby the Roma sample are not representative), and are not strictly comparable with national averages.2

While Roma health indicators deteriorated in all countries of the region in the early 1990s, this trend to some extent mirrored general declines in life expectancy and health conditions during the first years of transition. Fortunately, the health situation in Central and Southeast Europe underwent subsequent improvement—particularly when compared to some former Soviet republics. Still, general improvements during the past 15 years can mask differentiated health outcomes even within successful countries—and Roma are usually among the groups not (fully) benefiting from these improvements. Coverage and “disparities in equity of access” remain an issue for Roma and other ethnic minorities (Figueras, McKee, Cain, Lessof, 2004). The health data from the 2011 UNDP/World Bank/EC regional Roma survey provide an important opportunity to update this picture. While some improvements are apparent compared with the health data produced by UNDP’s 2004

1/ Hereafter: “Macedonia” or “MK”. 2/ They would only be comparable with national averages if official surveys had been carried out in the in the same period, applying the same methodology.

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