LSE Health, London School of Economics and Political Science, Houghton Street, London, UK.
Eur J Public Health. 2010 Oct;20(5):549-54. doi: 10.1093/eurpub/ckq102. Epub 2010 Jul 22.
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.
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.
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.
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 policies are needed in the countries studied.
来自中东欧的罗姆人在工业化世界中遭受着一些最恶劣的健康状况。本文旨在确定保加利亚、罗马尼亚和匈牙利罗姆人与非罗姆人之间健康状况的决定因素。
针对三个不同的健康指标，我们估计了非线性模型：与前一年相比的自我报告健康状况、报告慢性疾病的概率以及因卫生和环境卫生条件而感到生病威胁的概率。种族出身通过罗姆人、国民人口和其他少数民族的自我报告进行区分。使用的数据来自联合国开发计划署 2004 年对罗姆人和生活在其附近人口的家庭调查提供的独特数据集。样本量分别为保加利亚 2536 个、匈牙利 2640 个和罗马尼亚 3292 个。
在控制人口统计学变量后，罗姆人在任何指标上报告健康状况较差的可能性都明显高于非罗姆人。然而，在包括社会经济变量后，罗姆人在罗马尼亚报告慢性疾病的可能性明显更高。对于因不卫生环境而感到生病威胁的概率，在匈牙利和罗马尼亚，罗姆人是主要决定因素，但在保加利亚则不是。自我报告健康的结果不确定。
尽管这些结果在一定程度上支持了针对罗姆人的健康政策的制定，但发现教育程度较低和较贫困的人群以及其他少数民族也存在健康不平等现象，这表明在研究的国家中需要更广泛的多部门政策。
