Bobakova Daniela, Dankulincova Veselska Zuzana, Babinska Ingrid, Klein Daniel, Madarasova Geckova Andrea, Cislakova Lydia
Graduate School Kosice Institute for Society and Health, Safarik University, Kosice, Slovak Republic.
Department of Health Psychology, Medical Faculty, Safarik University, Trieda SNP 1, 040 11, Kosice, Slovak Republic.
Int J Equity Health. 2015 Apr 14;14:37. doi: 10.1186/s12939-015-0165-z.
Roma are the most deprived ethnic minority in Slovakia, suffering from discrimination, poverty and social exclusion. Problematic access to good quality health care as result of institutional and interpersonal discrimination affects their health; therefore, factors which affect health care accessibility of Roma are of high importance for public health and policy makers. The aim of this study was to explore the association between health care accessibility problems and ethnicity and how different levels of social support from family and friends affect this association.
We used data from the cross-sectional HepaMeta study conducted in 2011 in Slovakia. The final sample comprised 452 Roma (mean age = 34.7; 35.2% men) and 403 (mean age = 33.5; 45.9% men) non-Roma respondents.
Roma in comparison with non-Roma have a more than 3-times higher chance of reporting health care accessibility problems. Social support from family and friends significantly decreases the likelihood of reporting health care accessibility problems in both Roma and non-Roma, while the family seems to be the more important factor.
The worse access to health care of Roma living in so-called settlements seems to be partially mediated by social support. Interventions should focus on Roma health mediators and community workers who can identify influential individuals who are able to change a community's fear and distrust and persuade and teach Roma to seek and appropriately use health care services.
罗姆人是斯洛伐克最贫困的少数民族,遭受着歧视、贫困和社会排斥。由于制度性和人际歧视导致难以获得高质量医疗保健,这影响了他们的健康;因此,影响罗姆人医疗保健可及性的因素对公共卫生和政策制定者至关重要。本研究的目的是探讨医疗保健可及性问题与种族之间的关联,以及来自家人和朋友的不同程度的社会支持如何影响这种关联。
我们使用了2011年在斯洛伐克进行的横断面HepaMeta研究的数据。最终样本包括452名罗姆人(平均年龄=34.7岁;35.2%为男性)和403名(平均年龄=33.5岁;45.9%为男性)非罗姆人受访者。
与非罗姆人相比,罗姆人报告医疗保健可及性问题的可能性高出3倍多。来自家人和朋友的社会支持显著降低了罗姆人和非罗姆人报告医疗保健可及性问题的可能性,而家庭似乎是更重要的因素。
生活在所谓定居点的罗姆人获得医疗保健的情况较差,这似乎部分是由社会支持介导的。干预措施应侧重于罗姆人的健康调解人和社区工作者,他们能够识别有影响力的个人,这些人能够改变社区的恐惧和不信任,并说服和教导罗姆人寻求并适当使用医疗保健服务。