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Why don’t segregated Roma do more for their health? An explanatory framework from an ethnographic study in Slovakia

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  • Andrej Belak

    (P.J. Safarik University
    P.J. Safarik University
    University Medical Center Groningen
    Charles University)

  • Andrea Madarasova Geckova

    (P.J. Safarik University
    P.J. Safarik University
    Palacky University Olomouc)

  • Jitse P. van Dijk

    (P.J. Safarik University
    University Medical Center Groningen
    Palacky University Olomouc)

  • Sijmen A. Reijneveld

    (University Medical Center Groningen)

Abstract

Objectives The health status of segregated Roma is poor. To understand why segregated Roma engage in health-endangering practices, we explored their nonadherence to clinical and public health recommendations. Methods We examined one segregated Roma settlement of 260 inhabitants in Slovakia. To obtain qualitative data on local-level mechanisms supporting Roma nonadherence, we combined ethnography and systematic interviewing over 10 years. We then performed a qualitative content analysis based on sociological and public health theories. Results Our explanatory framework summarizes how the nonadherence of local Roma was supported by an interlocked system of seven mechanisms, controlled by and operating through both local Roma and non-Roma. These regard the Roma situation of poverty, segregation and substandard infrastructure; the Roma socialization into their situation; the Roma-perceived value of Roma alternative practices; the exclusionary non-Roma and self-exclusionary Roma ideologies; the discrimination, racism and dysfunctional support towards Roma by non-Roma; and drawbacks in adherence. Conclusions Non-Roma ideologies, internalized by Roma into a racialized ethnic identity through socialization, and drawbacks in adherence might present powerful, yet neglected, mechanisms supporting segregated Roma nonadherence.

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  • Andrej Belak & Andrea Madarasova Geckova & Jitse P. van Dijk & Sijmen A. Reijneveld, 2018. "Why don’t segregated Roma do more for their health? An explanatory framework from an ethnographic study in Slovakia," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 63(9), pages 1123-1131, December.
    • Handle: RePEc:spr:ijphth:v:63:y:2018:i:9:d:10.1007_s00038-018-1134-2
    DOI: 10.1007/s00038-018-1134-2
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    1. Pavol Jarcuska & Daniela Bobakova & Jan Uhrin & Ladislav Bobak & Ingrid Babinska & Peter Kolarcik & Zuzana Veselska & Andrea Madarasova Geckova, 2013. "Are barriers in accessing health services in the Roma population associated with worse health status among Roma?," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 58(3), pages 427-434, June.
    2. Kolarcik, Peter & Geckova, Andrea Madarasova & Orosova, Olga & van Dijk, Jitse P. & Reijneveld, Sijmen A., 2009. "To what extent does socioeconomic status explain differences in health between Roma and non-Roma adolescents in Slovakia?," Social Science & Medicine, Elsevier, vol. 68(7), pages 1279-1284, April.
    3. Benjamin Cook & Geoffrey Wayne & Anne Valentine & Anna Lessios & Ethan Yeh, 2013. "Revisiting the evidence on health and health care disparities among the Roma: a systematic review 2003–2012," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 58(6), pages 885-911, December.
    4. P. Kolarcik & A. Geckova & S. Reijneveld & J. Dijk, 2012. "Social support, hopelessness and life satisfaction among Roma and non-Roma adolescents in Slovakia," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 57(6), pages 905-913, December.
    5. Sijmen Reijneveld, 2010. "Ethnic differences in health and use of health care: the questions to be answered," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 55(5), pages 353-355, October.
    6. Singh-Manoux, Archana & Marmot, Michael, 2005. "Role of socialization in explaining social inequalities in health," Social Science & Medicine, Elsevier, vol. 60(9), pages 2129-2133, May.
    7. Teresa Janevic & Janko Jankovic & Elizabeth Bradley, 2012. "Socioeconomic position, gender, and inequalities in self-rated health between Roma and non-Roma in Serbia," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 57(1), pages 49-55, February.
    8. Andreassen, Trude & Weiderpass, Elisabete & Nicula, Florian & Suteu, Ofelia & Itu, Andreea & Bumbu, Minodora & Tincu, Aida & Ursin, Giske & Moen, Kåre, 2017. "Controversies about cervical cancer screening: A qualitative study of Roma women's (non)participation in cervical cancer screening in Romania," Social Science & Medicine, Elsevier, vol. 183(C), pages 48-55.
    9. Smith, G.D., 2000. "Learning to live with complexity: Ethnicity, socioeconomic position, and health in Britain and the United States," American Journal of Public Health, American Public Health Association, vol. 90(11), pages 1694-1698.
    10. Kagawa Singer, M. & Dressler, W. & George, S., 2016. "Culture: The missing link in health research," Social Science & Medicine, Elsevier, vol. 170(C), pages 237-246.
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    1. Belak, Andrej & Filakovska Bobakova, Daniela & Madarasova Geckova, Andrea & van Dijk, Jitse P. & Reijneveld, Sijmen A., 2020. "Why don't health care frontline professionals do more for segregated Roma? Exploring mechanisms supporting unequal care practices," Social Science & Medicine, Elsevier, vol. 246(C).
    2. Barbara Pavlikova & Lenka Freel & Jitse P. van Dijk, 2020. "To Comply or Not to Comply: Roma Approach to Health Laws," IJERPH, MDPI, vol. 17(9), pages 1-13, April.
    3. Michal Kozubik & Jitse P. van Dijk & Daniela Filakovska Bobakova, 2019. "Aspects of Illness and Death among Roma—Have They Changed after More than Two Hundred Years?," IJERPH, MDPI, vol. 16(23), pages 1-11, November.
    4. Andrej Belak & Andrea Madarasova Geckova & Jitse P. van Dijk & Sijmen A. Reijneveld, 2019. "What Roma nonadherence is likely and what drives it? Reply to Broz and Nunes," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 64(5), pages 805-807, June.
    5. Richard Filčák & Daniel Škobla, 2021. "Sanitation Infrastructure at the Systemic Edge: Segregated Roma Settlements and Multiple Health Risks in Slovakia," IJERPH, MDPI, vol. 18(11), pages 1-11, June.
    6. Lucia Bosakova & Andrea Madarasova Geckova & Jitse P. van Dijk & Sijmen A. Reijneveld, 2020. "Appropriate Employment for Segregated Roma: Mechanisms in a Public–Private Partnership Project," IJERPH, MDPI, vol. 17(10), pages 1-18, May.
    7. Teresa Janevic, 2019. "Romani maternal and child health: moving from documenting disparities to testing progress and interventions to achieve equity," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 64(7), pages 981-982, September.
    8. Jan Brož & Marisa Nunes, 2019. "Why don’t segregated Roma do more for their health? A complex question," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 64(5), pages 803-804, June.
    9. Daniela Filakovska Bobakova, 2019. "Challenges for research, policy and practice in the field of Roma health," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 64(5), pages 645-646, June.

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