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重新审视 2003-2012 年间罗姆人在健康和医疗保健方面的差异的证据:系统综述。

Revisiting the evidence on health and health care disparities among the Roma: a systematic review 2003-2012.

机构信息

Department of Psychiatry, Harvard Medical School, Boston, MA, USA,

出版信息

Int J Public Health. 2013 Dec;58(6):885-911. doi: 10.1007/s00038-013-0518-6. Epub 2013 Oct 5.

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.

摘要

目的

对 2003 年至 2012 年间与罗姆人相关的流行病学和卫生服务利用文献进行系统综述。

方法

通过电子数据库(PsycInfo、Medline、Google Scholar)检索 2003 年至 2012 年间发表的与罗姆人健康和卫生保健利用相关的实证研究,并对其进行系统评价。使用六点设计标准评估方法学严谨性。

结果

我们发现罗姆人自我报告的健康状况较差,死亡率明显高于非罗姆人,罗姆人儿童的健康风险因素更为普遍,包括环境风险、低出生体重和较低的疫苗接种率。对非传染性和传染病的研究仍然不足以对差异做出明确的结论。获得医疗服务的障碍包括缺乏文件记录和医疗费用负担,尽管需要更多关于卫生保健利用的研究。

结论

罗姆青年和成年人需要减少健康差距和增加死亡率风险的项目。减少接触诸如吸烟、肥胖和恶劣生活条件等风险因素可能是干预的目标。需要更多的干预研究和严格的评估。

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