The socio-economic determinants of the health status of Roma in comparison with non-Roma in Bulgaria, Hungary and Romania
The socio-economic determinants of the health status of Roma in comparison with non-Roma in Bulgaria, Hungary and Romania
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DOI：
10.1093/eurpub/ckq102
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发表时间：
2010-10-01
影响因子：
4.4
通讯作者：
Hernandez-Quevedo, Cristina
中科院分区：
文献类型：
--
作者：
Masseria, Cristina;Mladovsky, Philipa;Hernandez-Quevedo, Cristina
背景：来自中欧和东欧的罗姆人的健康状况是工业化世界中最糟糕的。这篇文章的目的是确定决定保加利亚、罗马尼亚和匈牙利罗姆人与非罗姆人健康状况的因素。方法：对三个不同的健康指标进行非线性模型估计：自我报告的健康状况与前一年的比较，报告慢性病的概率和由于卫生和卫生环境而感到疾病的威胁。根据罗姆人、民族人口和其他少数民族区分的民族血统是自我报告的。所使用的数据来自联合国开发计划署2004年关于罗姆人和居住在罗姆人附近的人口的家庭调查提供的独特数据集。保加利亚的样本量为2536，匈牙利为2640，罗马尼亚为3292。结果：在控制人口变量之后，罗姆人在任何指标中报告的健康状况都明显比各地的非罗姆人差。然而，在纳入社会经济变量后，罗姆人仅在罗马尼亚报告慢性病的可能性要高得多。就因不卫生的环境而感到受到疾病威胁的可能性而言，在匈牙利和罗马尼亚，罗姆人身份是一个主要决定因素，但在保加利亚并非如此。自我报告健康状况的结果尚无定论。结论：虽然这些结果在一定程度上支持制定针对罗姆人的卫生政策，但关于受教育程度较低和较不富裕的人以及其他少数民族也经历卫生不平等的发现表明，所研究的国家需要更广泛的多部门政策。
Backgrounds: Roma people from Central and Eastern Europe suffer some of the worst health conditions in the industrialized world. This article aims at identifying the determinants of health status among Roma in comparison with non-Roma in Bulgaria, Romania and Hungary. Methods: Non-linear models were estimated for three different health indicators: self-reported health compared with the previous year, probability of reporting chronic conditions and feeling threatened by illness because of sanitary and hygienic circumstances. Ethnic origin differentiated by Roma, national population and other ethnic minorities is self-reported. The data used are from a unique data set provided by the United Nations Development Programme household survey on Roma and populations living in their close proximity for 2004. Sample sizes are 2536 for Bulgaria, 2640 for Hungary and 3292 for Romania. Results: After controlling for demographic variables the Roma were significantly more likely to report worse health in any indicator than the non-Roma everywhere. However, after including socio-economic variables, Roma had a significantly higher probability of reporting chronic conditions only in Romania. For the probability of feeling threatened by illness because of unhygienic circumstances, being Roma was a main determinant in Hungary and Romania, but not in Bulgaria. The results for self-reported health were inconclusive. Conclusions: While these results in part support the development of health policies targeting Roma, the finding that poorly educated and less wealthy people, as well as other ethnic minorities also experience health inequalities suggests that broader multisectoral polices are needed in the countries studied.