[Energy poverty and self-rated health among Roma population and general population in Spain]

OBJECTIVE

To quantify energy poverty in Roma population and in general population in Spain, in 2016, as well as to observe the association of this phenomenon with self-rated health, adjusted according to the main socio-economic determinants.

METHOD

Energy poverty has been defined as the financial inability to keep a home warm, the presence of dampness in the dwelling and falling into arrears in utility bills, using data from two European surveys from Spain in 2016: the Survey on Income and Living Conditions (EU-SILC) and the Second Survey on Minorities and Discrimination (EU-MIDIS II). Hierarchical logistic regression models were estimated with self-rated health as the outcome variable, progressively adjusted according to demographic (gender and age), environmental (household temperature, humidity and arrears in utility bills) and socio-economic (level of education, marital status and employment status) variables.

RESULTS

Our results show that 45% of the Roma population had moderate or high levels of energy poverty. The odds ratio (OR) of poor self-rated health was higher in the Roma population (OR: 3.11; 95% confidence interval [95% CI]: 2.59-3.74). The inability to maintain an adequate indoor temperature significantly increased the risk of poor health (OR: 2.10; 95% CI: 1.90-2.32). After adjusting according to demographic, environmental and socio-economic variables, no association was observed between the population of ascription and self-rated health.

CONCLUSIONS

Taking into account the main social determinants, including energy poverty indicators, being Roma is not associated with reporting poor health. This result points to the importance of tackling socio-economic factors, including energy poverty, to reduce health inequalities.

[Repercussions of COVID-19 in a participatory action-research process with adolescent Roma women]

The objective of this article is to describe the impact of the COVID-19 pandemic on the implementation of the RoMoMatter project, using a community-based participatory action research methodology, in Córdoba (Spain). Five academic researchers and 30 community members participated. Individual interviews, focus groups and field notes were used as data collection techniques. The interviews were audio-recorded with the consent of the participants and transcribed verbatim. The information collected was coded using Atlas Ti software. The efforts of adaptation to the new pandemic scenario made by the participants and the technical and emotional support role played by the adaptation team are highlighted. It is concluded that the main impact of the pandemic was evidenced in the participatory process of all the people involved, and in the format and number of activities.

[Dietary patterns of Roma population and total population in Spain]

OBJECTIVE

The NAOS (Nutrición, Actividad Física y Prevención de la Obesidad) strategy implemented by Spanish Ministry of Health proposes a range of healthy dietary guidelines. The objective of this article is to analyze the degree these nutritional patterns are monitored by the Roma population, compared to the rest of the population, compared to the total Spanish population.

METHODS

Data from the 2012 National Health Survey and the 2014 Roma Health Survey were compared. Sex, age and socio-occupational scale were used as independent variables, applying a logistic regression analysis to assess their degree of influence.

RESULTS

There was less monitoring carried out by the Roma population of the dietary plans recommended by the Ministry of Health and differences of more of 20 percentage points were found in some of them. In both populations, age was the variable with the greatest influence, but even more so in the Roma population, while sex did not show statistical among Roma people. The follow-up data of these dietary patterns in the Roma population were lower in comparison with any of the socio-occupational groups of the rest of the population.

CONCLUSIONS

The Roma population is in a situation of inequality as regards the levels of adherence of the healthy dietary guidelines proposed by the Spanish NAOS strategy. The distance from these healthy eating habits is even greater among the younger Roma population.

[Training for Roma health advocacy: a case study of Torreblanca, Seville]

OBJECTIVE

The objective of this study is to build advocacy capacity among a group of gipsy Roma neighbours living in contexts of risk of social exclusion.

METHODS

A Community Based Participatory Action Research design was used, in which 4 members of the community participated in the process of collecting evidence by photo-voice, analysing it using the ReACT method and disseminating the results.

RESULTS

A total of 96 pieces of evidence were collected and analysed for qualitative data analysis. These were categorised according to (a) the type of unhealthy conditions and (b) the area of the neighbourhood where they were located. The subsequent thematic grouping made it possible to identify the causes: (a) the abandonment of public services; (b) discrimination; and (c) the lack of Roma presence in community spaces. The consequences identified were (a) mental and physical health problems and (b) the normalisation of undignified living conditions. The plan was designed to advocate for the presence of Roma in community spaces.

CONCLUSIONS

Our study highlighted the relevance of the photo-voice to transcend the biomedical perspective and develop advocacy actions based on the knowledge created by the community. Future research should look more deeply into the impact of health advocacy on reducing inequalities and consider the importance of involving researchers, public health professionals and the community in addressing it.

[Knowledge, beliefs and attitudes of the Roma population regarding colorectal cancer screening]

OBJECTIVE

To identify predisposing, inhibitory and facilitating factors that may affect participation in colorectal cancer screening programs in the Roma population.

METHOD

Qualitative and exploratory study by focus group technique. Three focus groups of men and three groups of women were carried out, with a total of 16 men and 18 women from the Roma population, aged 50-69 years, from the province of Alicante. A discourse analysis was performed with the PRECEDE model as an analysis framework.

RESULTS

Several barriers to participation were identified, such as the aversion of the Roma population to talk about cancer, refusal to anticipate a diagnosis that can cause suffering to the person and their family, poor knowledge of the disease and the preventive programmes, refusal to collect and handle samples, fear and shame about the colonoscopy, acceptance of divine will, difficulties in understanding and reading, and the perception of being discriminated by their ethnicity in the health sector. However, predisposing factors to participate in the screening programme also were identified, for example willingness to receive relevant information through more appropriate pathways, as well as their confidence in professional counselling.

CONCLUSION

A willingness to receive the recommendation to participate and understanding information from health professionals have been identified. This will enable us to envisage potential strategies for approaching this population group. This could contribute to improved participation of the Roma population in colorectal cancer screening programmes and to open up new ways to promote preventive behaviours.