Is the Definition of Roma an Important Matter? The Parallel Application of Self and External Classification of Ethnicity in a Population-Based Health Interview Survey

Abstract

The Roma population is typified by a poor and, due to difficulties in ethnicity assessment, poorly documented health status. We aimed to compare the usefulness of self-reporting and observer-reporting in Roma classification for surveys investigating differences between Roma and non-Roma populations. Both self-reporting and observer-reporting of Roma ethnicity were applied in a population-based health interview survey. A questionnaire was completed by 1849 people aged 18–64 years; this questionnaire provided information on 52 indicators (morbidity, functionality, lifestyle, social capital, accidents, healthcare use) indicators. Multivariate logistic regression models controlling for age, sex, education and employment were used to produce indicators for differences between the self-reported Roma (N = 124) and non-Roma (N = 1725) populations, as well as between observer-reported Roma (N = 179) and non-Roma populations (N = 1670). Differences between interviewer-reported and self-reported individuals of Roma ethnicity in statistical inferences were observed for only seven indicators. The self-reporting approach was more sensitive for two indicators, and the observer-reported assessment for five indicators. Based on our results, the self-reported identity can be considered as a useful approach, and the application of observer-reporting cannot considerably increase the usefulness of a survey, because the differences between Roma and non-Roma individuals are much bigger than the differences between indicators produced by self-reported or observer-reported data on individuals of Roma ethnicity.

Prevalence of Chronic Diseases and Activity-Limiting Disability among Roma and Non-Roma People: A Cross-Sectional, Census-Based Investigation

“…Although this validity issue has to be acknowledged [48,49,50], the results from parallel applications of self-report and interviewer classifications in health surveys suggest that this validity issue has minor importance in the investigation of population-level health status differences between Roma and non-Roma people. It is a likely consequence of the fact that the self-declared Roma subjects tended to live in more segregated circumstances, have worse health status, and be less educated than those that did not declare Roma identity [21,51].…”

Taste and Food Preferences of the Hungarian Roma Population

“…To address the latter issue, Roma field workers were involved in our study; however, higher response rates were not achieved. Although the response rate of Roma individuals in our study was lower than that of the reference sample, it is quite high if we compare it with the majority of Roma studies (75)(76)(77). Furthermore, sweet, fat, and salt preference was investigated by applying only single questions, whereas bitter preference was assessed with questions for six bitter-tasting food items individually.…”

“…The response rate of the Hungarian sample was 91%, while it was less favorable (77.4%) among the Roma population. Survey response rates of Roma surveys differ to a great extent (28-96.9%) (3,27,(75)(76)(77)(78), and can be lower among Roma populations than among the majority populations included in research (27,75,78). This phenomenon can be due to the lack of financial incentives for participation and motivation of Roma to be involved in free medical examinations and to the existing mistrust of segregated Roma toward interviewers.…”

“Do my Roma and non-Roma patients need different care?” A brief step-by-step guideline for clinical practitioners

“…1A step-by-step guideline for dealing with apparent differences in Roma and non-Roma patientsAre the seeming differences in outcomes real?Do the studied differences remain statistically significant after adjustments for likely differences in the demographics of the different populations the compared patient groups are supposed to represent? Until this question can be answered “yes”; there is no need to consider tailoring treatment according the given Roma and non-Roma distinction criteria Are the compared groups indeed Roma and non-Roma?Do all patients in both groups agree to being labelled as such according to a set of unambiguous criteria? Ethnicity labelling can be constructed and contested in many ways by both those labelled and those labelling (Janka et al 2018; Ladányi and Szelényi 2001). If “no”, drop the ethnic part of the hypothesis but continue with the next step (3).If “yes”, specify the ethnic aspect of your hypothesis (e.g.…”

“…Do all patients in both groups agree to being labelled as such according to a set of unambiguous criteria? Ethnicity labelling can be constructed and contested in many ways by both those labelled and those labelling (Janka et al 2018; Ladányi and Szelényi 2001).…”