Social Exclusion as a Determining Health Factor of the Roma Population

Sivic, Suad; Huremovic, Adin; Djerzic, Haris

doi:10.5455/medarh.2013.67.60-62

Cited by 16 publications

(17 citation statements)

References 8 publications

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“…Across the six Traveller communities, the Romanian Roma (and to a lesser extent Slovakian Roma) families appeared to live with the highest levels of socioeconomic deprivation, which is well documented. 21,23,73 In contrast, the Glasgow Scottish Showpeople and their service providers spoke much less about these challenges, again resonating with existing reports. 18 Showpeople generally run businesses, live in permanent homes in privately owned or leased yards and travel out to set up and run fairground attractions.…”

Section: Access To Health and Immunisation Servicesmentioning

confidence: 57%

“…These identify multiple issues reflecting the difficulties in accessing wider health services experienced by marginalised, socially excluded communities. [17][18][19][20][21]24,[73][74][75] Issues particular to immunisation include barriers to accessing primary care services (e.g. the absence of a permanent postal address for recall letters), 45 parental concerns about the safety of vaccines 46,76 and objection to immunisation arising from strongly held cultural beliefs and traditions.…”

Section: Factors Influencing the Uptake Of Immunisationmentioning

confidence: 99%

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UNderstanding uptake of Immunisations in TravellIng aNd Gypsy communities (UNITING): a qualitative interview study

Jackson

Dyson

Bedford

et al. 2016

Health Technol Assess

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Background: Gypsies, Travellers and Roma (referred to as Travellers) are less likely to access health services, including immunisation. To improve immunisation rates, we need to understand what helps and hinders individuals in these communities in taking up immunisations. Aims: (1) Investigate the barriers to and facilitators of acceptability and uptake of immunisations among six Traveller communities across four UK cities; and (2) identify possible interventions to increase uptake of immunisations in these Traveller communities that could be tested in a subsequent feasibility study. Methods: Three-phase qualitative study underpinned by the social ecological model. Phase 1: interviews with 174 Travellers from six communities: Romanian Roma (Bristol); English Gypsy/Irish Traveller (Bristol); English Gypsy (York); Romanian/Slovakian Roma (Glasgow); Scottish Showpeople (Glasgow); and Irish Traveller (London). Focus on childhood and adult vaccines. Phase 2: interviews with 39 service providers. Data were analysed using the framework approach. Interventions were identified using a modified intervention mapping approach. Phase 3: 51 Travellers and 25 service providers attended workshops and produced a prioritised list of potentially acceptable and feasible interventions. Results: There were many common accounts of barriers and facilitators across communities, particularly across the English-speaking communities. Scottish Showpeople were the most similar to the general population. Roma communities experienced additional barriers of language and being in a new country. Men, women and service providers described similar barriers and facilitators. There was widespread acceptance of childhood and adult immunisation, with current parents perceived as more positive than their elders. A minority of English-speaking Travellers worried about multiple/combined childhood vaccines, adult flu and whooping cough. Cultural concerns about vaccines offered during pregnancy and about human papillomavirus were most evident in the Bristol English Gypsy/Irish Traveller community. Language, literacy, discrimination, poor school attendance, poverty and housing were identified by Travellers and service providers as barriers for some. Trustful relationships with health professionals were important and continuity of care was valued. A few English-speaking Travellers described problems of booking and attending for immunisation. Service providers tailored their approach to Travellers, particularly the Roma. Funding cuts, NHS reforms and poor monitoring challenged their work. Five ‘top-priority’ interventions were agreed across communities and service providers to improve the immunisation among Travellers who are housed or settled on an authorised site: (1) cultural competence training for health professionals and frontline staff; (2) identification of Travellers in health records to tailor support and monitor uptake; (3) provision of a named frontline person in general practitioner practices to provide respectful and supportive service; (4) flexib...

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Section: Access To Health and Immunisation Servicesmentioning

confidence: 57%

Section: Factors Influencing the Uptake Of Immunisationmentioning

confidence: 99%

UNderstanding uptake of Immunisations in TravellIng aNd Gypsy communities (UNITING): a qualitative interview study

Jackson

Dyson

Bedford

et al. 2016

Health Technol Assess

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“…There were other examples of difficulties in using immunisation services which were associated with broader, inter-related, socio-economic barriers that exist for Travellers and are known to impact on their access to health services more widely [1, 4, 38, 66]. We learnt from the interviews with Service Providers [42] that across the six Traveller communities, the Romanian Roma (and to a lesser extent Slovakian Roma) families appeared to live with the highest levels of socio-economic deprivation, which is well documented [5, 7, 30]. In contrast, the Glasgow Scottish Showpeople spoke much less about these challenges, again resonating with existing reports [2].…”

Section: Discussionmentioning

confidence: 99%

“…They identify multiple issues reflecting the difficulties in accessing wider health services experienced by marginalised, socially excluded communities [1–5, 8, 30–32]; for example a history of discrimination leading to mistrust of ‘non Traveller’ people and official institutions, poverty, low health literacy and language barriers [5]. Issues particular to immunisation include barriers to accessing primary care services (e.g.…”

Section: Introductionmentioning

confidence: 99%

Needles, Jabs and Jags: a qualitative exploration of barriers and facilitators to child and adult immunisation uptake among Gypsies, Travellers and Roma

et al. 2017

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BackgroundGypsies, Travellers and Roma (referred to as Travellers) are less likely to access health services including immunisation. To improve immunisation rates, it is necessary to understand what helps and hinders individuals in these communities in taking up immunisations. This study had two aims.Investigate the views of Travellers in the UK on the barriers and facilitators to acceptability and uptake of immunisations and explore their ideas for improving immunisation uptake;Examine whether and how these responses vary across and within communities, and for different vaccines (childhood and adult). MethodsThis was a qualitative, cross-sectional interview study informed by the Social Ecological Model. Semi-structured interviews were conducted with 174 Travellers from six communities: Romanian Roma, English Gypsy/Irish Travellers (Bristol), English Gypsy (York), Romanian/Slovakian Roma, Scottish Show people (Glasgow) and Irish Traveller (London). The focus was childhood and selected adult vaccines. Data were analysed using the Framework approach.ResultsCommon accounts of barriers and facilitators were identified across all six Traveller communities, similar to those documented for the general population. All Roma communities experienced additional barriers of language and being in a new country. Men and women described similar barriers and facilitators although women spoke more of discrimination and low literacy. There was broad acceptance of childhood and adult immunisation across and within communities, with current parents perceived as more positive than their elders. A minority of English-speaking Travellers worried about multiple/combined childhood vaccines, adult flu and whooping cough and described barriers to booking and attending immunisation. Cultural concerns about antenatal vaccines and HPV vaccination were most evident in the Bristol English Gypsy/Irish Traveller community. Language, literacy, discrimination, poor school attendance, poverty and housing were identified as barriers across different communities. Trustful relationships with health professionals were important and continuity of care valued.ConclusionsThe experience of many Travellers in this study, and the context through which they make health decisions, is changing. This large study identified key issues that should be considered when taking action to improve uptake of immunisations in Traveller families and reduce the persistent inequalities in coverage.Trial registrationCurrent Controlled Trials ISRCTN20019630.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-017-4178-y) contains supplementary material, which is available to authorized users.

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“…Their poor social conditions and low educational level surely have negative effects on their health. Chronic diseases caused by stress, inadequate nutrition and poor housing conditions were five to twenty times more frequent than in the general population in a study carried out in Bosnia and Herzegovina (36) . In addition to these numerous cultural (lifestyle) factors contributing to their increased risk of CVD, they are genetically predisposed to obesity (37) and abdominal fat distribution, as recently provided by quantitative genetic methods applied to anthropometric characteristics (33) .…”

Section: Discussionmentioning

confidence: 99%

Anthropometric parameters in relation to glycaemic status and lipid profile in a multi-ethnic sample in Italy

Gualdi‐Russo

Zaccagni

Dallari³

et al. 2014

Public Health Nutr.

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Objective: To examine the health status of ethnic minorities in Italy. Furthermore, we aimed to assess the association between anthropometric and blood parameters connected with health status. Design: A cross-sectional study. Anthropometric data were collected by direct measurements and blood glucose, total cholesterol and TAG were analysed. Setting: Bologna, northern Italy. Subjects: A multi-ethnic sample of adult immigrants and Roma. Results: Significant correlations between anthropometric and blood parameters were found. Among the ethnic groups, Roma males had the highest values of glucose, total cholesterol and TAG. In the females the situation was more balanced among ethnic groups. Conclusions: The data from this survey indicate that poor health status is a very common problem among ethnic groups living in Italy, especially the Roma. The use of anthropometric parameters as rapid indicators of health status in screenings of a large number of subjects could be an effective and cheap method to provide preliminary indications on individuals or ethnic groups at greater risk of poor health.

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Social Exclusion as a Determining Health Factor of the Roma Population

Cited by 16 publications

References 8 publications

UNderstanding uptake of Immunisations in TravellIng aNd Gypsy communities (UNITING): a qualitative interview study

UNderstanding uptake of Immunisations in TravellIng aNd Gypsy communities (UNITING): a qualitative interview study

Needles, Jabs and Jags: a qualitative exploration of barriers and facilitators to child and adult immunisation uptake among Gypsies, Travellers and Roma

Anthropometric parameters in relation to glycaemic status and lipid profile in a multi-ethnic sample in Italy

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