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Fernández-Feito A, Pesquera-Cabezas R, González-Cobo C, Prieto-Salceda MD. What do we know about the health of Spanish Roma people and what has been done to improve it? A scoping review. ETHNICITY & HEALTH 2019; 24:224-243. [PMID: 28398074 DOI: 10.1080/13557858.2017.1315373] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2016] [Accepted: 03/18/2017] [Indexed: 06/07/2023]
Abstract
Objectives: This study aims to review the published literature on the health of the Roma population in Spain, particularly that which describes health interventions and outcomes. Design: A scoping review of published articles/reports on Roma population health was carried out in Spain for publications between 2002 and 2014. Articles in Spanish or English were identified from Pubmed, Scopus, Science Direct, Web of Science, Scielo, IBECS, MEDES, Dialnet, Index Foundation, a database of theses and Google Scholar. After an initial assessment of the article title and summary, genetic studies, editorials, reviews and grey literature with incomplete data were excluded. Two independent researchers followed a protocol to analyze the selected papers in terms of general information, methodology, themes, and results or conclusions. Results: Forty studies were selected for inclusion, primarily located through PubMed and Google Scholar. Most of the papers were scientific articles, published after 2007 in Spanish scientific journals (70.0%) followed by institutional reports (20.0%). The main language was Spanish (84.2%). The studies were carried out mainly by public institutions (35.0%) or universities (22.5%). Most (67.5%) followed a descriptive design and nearly half (47.5%) were concerned only with the Roma population. The main thematic areas were: child health (25%), infectious diseases (25%), health and social education context (20%), perceived health and lifestyle (15%), sexual and reproductive health (7,5%) and health services use (7,5%). We found seven intervention studies related to health, educational environment, or social services. Conclusions: There are few publications related to the health of the Roma community in Spain and even fewer related to health interventions and outcomes. Those that are available have focused on areas such as child health or infectious disease outbreaks. It is important to promote health interventions in Roma communities and longitudinal studies that include a comprehensive vision and account for the social determinants of health.
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Affiliation(s)
- Ana Fernández-Feito
- a Department of Medicine, Nursing Area , School of Medicine and Health Sciences, University of Oviedo , Oviedo , Spain
| | - Raúl Pesquera-Cabezas
- b Basic Health Zone Pisueña-Cayon, Primary Health Care of Cantabria , Santander , Spain
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Powell Doherty R, Telionis PA, Müller-Demary D, Hosszu A, Duminica A, Bertke A, Lewis B, Eubank S. A survey of quality of life indicators in the Romanian Roma population following the 'Decade of Roma Inclusion'. F1000Res 2017; 6:1692. [PMID: 30774929 PMCID: PMC6357989 DOI: 10.12688/f1000research.12546.3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/07/2018] [Indexed: 11/20/2022] Open
Abstract
Background: This study explores how the Roma in Romania, the EU's most concentrated population, are faring in terms of a number of quality of life indicators, including poverty levels, healthcare, education, water, sanitation, and hygiene. It further explores the role of synthetic populations and modelling in identifying at-risk populations and delivering targeted aid. Methods: 135 surveys were conducted across five geographically diverse Romanian communities. Household participants were selected through a comprehensive random walk method. Analyses were conducted on all data using Pandas for Python. Combining land scan data, time-use survey analyses, interview data, and ArcGIS, the resulting synthetic population was analysed via classification and regression tree (CART) analysis to identify hot-spots of need, both ethnically and geographically. Results: These data indicate that the Roma in Romania face significant disparities in education, with Roma students less likely to progress beyond 8 th grade. In addition, the Roma population remains significantly disadvantaged with regard to safe and secure housing, poverty, and healthcare status, particularly in connection to diarrheal disease. In contrast, however, both Roma and non-Roma in rural areas face difficulties regarding full-time employment, sanitation, and water, sanitation, and hygiene infrastructure. In addition, the use of a synthetic population can generate information about 'hot spots' of need, based on geography, ethnicity, and type of aid required. Conclusions: These data demonstrate the challenges that remain to the Roma population in Romania, and also point to the myriad of ways in which all rural Romanians, regardless of ethnicity, are encountering hardship. This study highlights an approach that combines traditional survey data with more wide-reaching geographically based data and CART analysis to determine 'hot spot' areas of need in a given population. With the appropriate inputs, this tool can be extrapolated to any population in any country.
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Affiliation(s)
- Rebecca Powell Doherty
- Biocomplexity Institute of Virginia Tech, Blacksburg, VA, USA.,Population Health Sciences, Virginia Tech, Blacksburg, VA, USA
| | - Pyrros A Telionis
- Biocomplexity Institute of Virginia Tech, Blacksburg, VA, USA.,Department of Geography, Virginia Tech, Blacksburg, VA, USA
| | | | | | | | - Andrea Bertke
- Population Health Sciences, Virginia Tech, Blacksburg, VA, USA
| | - Bryan Lewis
- Biocomplexity Institute of Virginia Tech, Blacksburg, VA, USA
| | - Stephen Eubank
- Biocomplexity Institute of Virginia Tech, Blacksburg, VA, USA
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Powell Doherty R, Telionis PA, Müller-Demary D, Hosszu A, Duminica A, Bertke A, Lewis B, Eubank S. A survey of quality of life indicators in the Romanian Roma population following the 'Decade of Roma Inclusion'. F1000Res 2017; 6:1692. [PMID: 30774929 PMCID: PMC6357989 DOI: 10.12688/f1000research.12546.1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/07/2018] [Indexed: 01/10/2024] Open
Abstract
Background: This study explores how the Roma in Romania, the EU's most concentrated population, are faring in terms of a number of quality of life indicators, including poverty levels, healthcare, education, water, sanitation, and hygiene. It further explores the role of synthetic populations and modelling in identifying at-risk populations and delivering targeted aid. Methods: 135 surveys were conducted across five geographically diverse Romanian communities. Household participants were selected through a comprehensive random walk method. Analyses were conducted on all data using Pandas for Python. Combining land scan data, time-use survey analyses, interview data, and ArcGIS, the resulting synthetic population was analysed via classification and regression tree (CART) analysis to identify hot-spots of need, both ethnically and geographically. Results: These data indicate that the Roma in Romania face significant disparities in education, with Roma students less likely to progress beyond 8 th grade. In addition, the Roma population remains significantly disadvantaged with regard to safe and secure housing, poverty, and healthcare status, particularly in connection to diarrheal disease. In contrast, however, both Roma and non-Roma in rural areas face difficulties regarding full-time employment, sanitation, and water, sanitation, and hygiene infrastructure. In addition, the use of a synthetic population can generate information about 'hot spots' of need, based on geography, ethnicity, and type of aid required. Conclusions: These data demonstrate the challenges that remain to the Roma population in Romania, and also point to the myriad of ways in which all rural Romanians, regardless of ethnicity, are encountering hardship. This study highlights an approach that combines traditional survey data with more wide-reaching geographically based data and CART analysis to determine 'hot spot' areas of need in a given population. With the appropriate inputs, this tool can be extrapolated to any population in any country.
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Affiliation(s)
- Rebecca Powell Doherty
- Biocomplexity Institute of Virginia Tech, Blacksburg, VA, USA
- Population Health Sciences, Virginia Tech, Blacksburg, VA, USA
| | - Pyrros A. Telionis
- Biocomplexity Institute of Virginia Tech, Blacksburg, VA, USA
- Department of Geography, Virginia Tech, Blacksburg, VA, USA
| | | | | | | | - Andrea Bertke
- Population Health Sciences, Virginia Tech, Blacksburg, VA, USA
| | - Bryan Lewis
- Biocomplexity Institute of Virginia Tech, Blacksburg, VA, USA
| | - Stephen Eubank
- Biocomplexity Institute of Virginia Tech, Blacksburg, VA, USA
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Cook B, Wayne GF, Valentine A, Lessios A, Yeh E. Revisiting the evidence on health and health care disparities among the Roma: a systematic review 2003-2012. Int J Public Health 2013; 58:885-911. [PMID: 24096986 DOI: 10.1007/s00038-013-0518-6] [Citation(s) in RCA: 113] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2013] [Revised: 09/16/2013] [Accepted: 09/23/2013] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES To conduct a systematic review of the epidemiological and health service utilization literature related to the Roma population between 2003 and 2012. METHODS Systematic review of empirical research related to Roma health and health care utilization published between 2003 and 2012 identified through electronic databases (PsycInfo, Medline, Google Scholar). Methodological rigor was evaluated using a six-point set of design criteria. RESULTS We found evidence for lower self-reported health and significantly higher mortality risk for Roma compared to non-Roma, and greater prevalence of health risk factors for Roma children, including environmental risks, low birth weight, and lower vaccination coverage. Studies of non-communicable and infectious disease remain insufficient to make firm conclusions on disparities. Barriers to care include lack of documentation and affordability of care, though more studies on health care utilization are needed. CONCLUSIONS Roma youth and adults are in need of programs that reduce health disparities and their increased mortality risk. Reducing exposure to risk factors such as smoking, obesity, and poor living conditions may be a target for interventions. More intervention studies and rigorous evaluations are needed.
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Affiliation(s)
- Benjamin Cook
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA,
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