Gypsies and American Medical Care

Abstract

Gypsies are a cohesive cultural group who may have difficult relations with the American medical community. There are several hundred thousand Gypsies in this country; they maintain a private society with an internal moral code and legal system. There is a strong cultural basis for obesity, tobacco use, fatty diet, and inbreeding among Gypsies. These traits predispose them to hypertension, diabetes, hyperlipidemia, and occlusive vascular disease. When ill they present a striking dichotomy of primitive fears of disease process with surprising sophistication for medical terms and the workings of the hospital hierarchy. Specific recommendations are made for more effective and compassionate relations with Gypsy patients.

“CEM” risk factors and severity of obstructive sleep apnoea in central European Roma and non-Roma patients referred for a diagnostic polysomnography

“…Of interest, our findings of increased abdominal obesity and higher proportion of patients with type 2 diabetes among Romanies support previous reports on cardiovascular risk profile in central European Roma population (Krajcovicova-Kudlackova et al 2002;Vozarova de Courten et al 2003). Interestingly, similarly to Slovakian Roma subjects, Romanies residing in the USA have also higher prevalence of obesity, type 2 diabetes, and dyslipidemia compared to the majority population (Thomas 1985). In addition, Asian Indians have high incidence of obesity, insulin resistance, and are at high risk for developing diabetes and coronary heart disease (Raji et al 2001).…”

“…Indeed, significant health inequalities exist between the Roma and non-Roma subjects in England ): being a Roma was associated with poorer health outcomes than the non-Roma residents (Peters et al 2009). In Roma subjects residing in the USA, high prevalence of hypertension, diabetes, and dyslipidemia (Thomas 1985), in association with short-life expectancy have been observed (Thomas 1987). Similar health inequalities have been described in Slovakian Roma residents who have a higher prevalence of type 2 diabetes, metabolic syndrome and cardiovascular mortality when compared with the majority population (Vozarova de Courten et al 2003).…”

“…These differences were paralleled by higher prevalence of cardiovascular risk factors, such as hyperlipidemia, insulin resistance and obesity among Roma subjects. Similarly, higher prevalence of obesity in the Roma as compared to the non-Roma population was reported in USA (Thomas 1985). Because obesity, and central obesity in particular, represents one of the major risk factors for the development of OSA, and OSA severity is tightly linked to the severity of obesity (Patil et al 2007), we hypothesised that a higher proportion of Roma subjects referred for a diagnostic sleep study will suffer from severe OSA as compared to non-Roma individuals.…”

“…About 1,000 years ago, Romanies moved westward from India. Roma people constitute one of the few ethnic groups that has not adequately adapted to European or western societies in general, including countries such as Sweden (Lehti and Mattson 2001), England Van Cleemput et al 2007) or USA (Thomas 1985(Thomas , 1987Sutherland 1992). Their first language is ''Romany'' that is similar to Sanskrit.…”

A congenital myasthenic syndrome refractory to acetylcholinesterase inhibitors

“…The inability to definitively explain this phenomenon may reflect the limitations imposed on this study by the inherent distrust of Gypsies for guje (non-Gypsy) physicians. 21 Our patients refused requests for further study, including motorpoint biopsy and direct muscle fiber stimulation. Because previous muscle biopsy was not evaluated with electron microscopy, we cannot completely exclude myopathy as a cause for our patients' symptoms.…”