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Pus was seen in In many of the countries with large numbers of Roma, the public health services that, in the West, might be expected to act as agents to promote policies focusing on the health needs Prostitutes Natahoyo minorities, do not exist.

J Med Life5 425 Dec Ethn Health24 211 Apr Cited by: 5 articles PMID: Orv Hetil4301 Oct Cited by: 7 articles PMID: Contact us. Europe PMC requires Javascript Prostitutes Natahoyo function effectively. Recent Activity. Prostitutes Natahoyo life-sciences literature Over 39 million articles, preprints and more Search Advanced search. This website requires cookies, and the limited processing of your personal data in order to function.

By using the site you are agreeing to this as outlined in Prostitutes Natahoyo privacy notice and cookie policy. Hajioff S 1 .

The health of the Roma people: a review of the published literature. - Abstract - Europe PMC

McKee M. Affiliations 1 author 1. Share this article Share with email Share with twitter Share with linkedin Share with facebook. Abstract Background Prostitutes Natahoyo Roma people originated Prostitutes Natahoyo northern India and have been known in Europe for nearly a thousand years. Methods Published literature on the health of the Roma people was identified using Medline.

Discussion Published Prostitutes Natahoyo on the health needs of the Roma population is sparse. Free full text. J Epidemiol Community Health. PMID: Hajioff and M. Author information Copyright and License information Disclaimer.

The health of the Roma people: a review of the published literature.

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Outbreak of paralytic poliomyelitis in a highly immunized population in Jordan. J Infect Dis. What research exists seems to reflect views of the Roma as threats to the majority population, either through Prostitutes Natahoyo disease or their contribution to the gene pool.

Such research must Prostitutes Natahoyo handled with sensitivity, recognising the social and political context of the societies concerned.

An initial Prostitutes Natahoyo is the size of the Roma population. Estimates from different sources can vary 10 for several reasons. The history of oppression and forced assimilation in some countries may make people loath to declare Roma ethnicity. Some countries have only recently recognised the Roma as an ethnic group for the purposes of Prostitutes Natahoyo and others still do not.

Roma people are often Prostitutes Natahoyo deprived. This, added to itinerant lifestyle and a mistrust of authority figures may contribute to under-ascertainment. Taking these issues into account, the Minority Rights Group 11 compiled estimates of the populations in various European countries in the early s table 2. These do not include recent mass movements of population in the former Yugoslavia. Estimates of Roma population in Prostitutes Natahoyo European countries, early s.

Turning to the literature on health among the Roma, there is considerable variation in the number of citations from each country, which bears little relation to population size. Table 3 shows the distribution of papers by the country in which they are set. Some publications relate to more than one country so are counted for each country concerned. Seventy per cent of publications relate to just four countries: Spain 24 papersCzech Republic 19 papersSlovakia 16 papers and Hungary 14 papers.

Table 4 Prostitutes Natahoyo papers grouped by care group, disease or subject. These were counted in all relevant subject areas. Most papers relate to child health including congenital anomalies or communicable disease.

Only six were related to chronic and non-communicable disease. The subject areas will be examined in detail below. Health of Roma children has attracted particular attention. Many studies relate to communicable disease, but other issues have also been examined.

From birth, there seems to be a differential in health between Roma and majority populations. In Hungary, Roma infants were Prostitutes Natahoyo as likely to be born prematurely and there was a significant excess of births under g at most gestational ages.

A Spanish study of congenital malformations 13 found that recessive syndromes were Prostitutes Natahoyo times more common than in Prostitutes Natahoyo reference population, a finding Prostitutes Natahoyo to consanguinity 12 times as common as the majority population. High rates of consanguinity have been reported among Roma populations elsewhere. There was little research on common disorders of childhood. One study from Prostitutes Natahoyo 16 found excess morbidity from secretory otitis media in Roma children.

This was thought to Prostitutes Natahoyo explained by socioeconomic status, not ethnic factors. Other research is eclectic. A study of childhood brain tumours in Hungary 17 found a lower incidence than in the general population.

Both lead poisoning 18 and burns 19 have been shown to be more common in Prostitutes Natahoyo children, findings that are consistent with environmental exposure. Roma adolescents, even where drug use is prevalent, have a low rate of substance misuse 20 but a case-control study 21 seems to show an increase in neonatal abstinence syndrome in the offspring of young Roma mothers in Mexico between and Any discussion of the reproductive health of Roma people must take account of the practice of Prostitutes Natahoyo sterilisation of Roma women, prevalent in some countries, and its Prostitutes Natahoyo effect on present day help seeking behaviour.

A more detailed study of contraceptive practices among Roma women in Spain found significantly lower levels of knowledge about barrier methods of contraception, vasectomy and tubal occlusion and periodic abstinence.

The primary contraception was coitus interruptus. They were less likely to seek contraceptive advice than non-Roma women and had more pregnancies; leading both to more live births and terminations of pregnancy. Prostitutes Natahoyo Bulgarian study 24 found nearly half of pregnancies where the mother was aged 13—16 to be among women of Roma origin.

A study of Prostitutes Natahoyo sex workers attending a sexually transmitted disease clinic in Plovdiv, Bulgaria 25 found more than half to be of Roma origin. Sero-surveys among pregnant women in Spain have indicated high rates of hepatitis A 26 and hepatitis B 27 in the Roma population.

Non-communicable disease in Roma adults has received little attention. This review yielded Prostitutes Natahoyo three citations relating to adult disease the remainder related to paediatric conditions. Of these Prostitutes Natahoyo one was available. A study of cultural factors among Roma children found a high prevalence of diabetes mellitus and hypertension in family histories obtained.

A few studies have examined mental health, finding an excess of suicide and parasuicide over the general population. A large proportion of the literature on Roma health is devoted to communicable disease. Many papers are reports Prostitutes Natahoyo outbreaks or cases and Prostitutes Natahoyo the epidemiology of disease, although some draw Prostitutes Natahoyo to low immunisation coverage.

There Prostitutes Natahoyo to Prostitutes Natahoyo increased incidence and seroprevalence of many classic epidemic diseases as well as more newly identified infections. Mycobacterial infection is reported more common among Roma than in other populations, and increasing at a faster rate.

The six-year period was chosen to allow for errors in the recall of timing of abnormal smears.

Viral hepatitis Prostitutes Natahoyo attracted much attention. Seroprevalence surveys in pregnancy 26 27 show high levels of infection with hepatitis A and B which can be transmitted vertically. In Prostitutes Natahoyo Spanish study, 35 three groups were compared; non-Roma children, Roma children, and children in orphanages. From seven upwards Prostitutes Natahoyo was an excess in age specific seroprevalence of hepatitis A virus of Roma children over other groups.

Overcrowding seemed to be a factor, as did poverty and sanitary practices. The excess in seroprevalence Prostitutes Natahoyo hepatitis B in pregnant Roma women was also described in A seroprevalence survey of the prison population in north east Spain 38 found an excess over other prisoners.

There is evidence for an excess of hepatitis E morbidity among the Roma, with a study in Bohemia 39 showing a doubling in the seroprevalence of hepatitis E antibodies over non-Roma STD clinic attenders. With increased rates of other blood borne virus infections and low use of barrier contraception, one might expect a high rate of HIV infection. Two studies, however, one among a prison population in Spain 40 and another limited to intravenous drug users, 41 showed a significantly lower seroprevalence of HIV among Roma than non-Roma inmates.

In Prostitutes Natahoyo decades infection attributable to wild poliomyelitis, rather than vaccine associated viruses has been concentrated among Roma populations in some countries. Several studies have found differential access to health care by Roma people. Health care is, in some instances, seen as divided: with some diseases generally being dealt with within the community and others requiring the services of the Prostitutes Natahoyo health Prostitutes Natahoyo system.

For some Roma a stay in hospital other than for childbirth is associated with death.

Health care professionals may, without understanding the context, view this as irresponsible. Ironically, in pre-industrial times Roma played an Prostitutes Natahoyo part in the delivery of health care to much of Europe, acting as folk healers in the absence of trained physicians. Access to care is not simply a matter of culturally insensitive provision. She describes several Prostitutes Natahoyo of outright discrimination.

This review is subject to the limitations facing any literature review: incomplete ascertainment of papers and publication bias. It is limited to research published in journals indexed by major bibliographic databases.

These are known to provide partial coverage, which is likely to be Prostitutes Natahoyo especial problem here, where relevant studies are likely to have been published in journals that may be difficult to obtain. Elsewhere we will be reporting on the findings from a hand search Prostitutes Natahoyo Czech and Slovak literature on health of Roma populations, in which we found this to be so.

There Prostitutes Natahoyo a need to ensure that material that we were unable to review be accessible to a wider international audience. We Prostitutes Natahoyo recognised that some of the published research may have been carried out for reasons other than altruism. It was nevertheless decided to report findings fully, and not Prostitutes Natahoyo editorialise results.

The research examines health needs of a people that has been dispersed to countries as diverse as Jordan, Mexico, and the United Kingdom. Although the Roma populations in many places have adhered to traditional ways of life and Prostitutes Natahoyo many common beliefs, the literature encompasses tremendous heterogeneity, making it difficult to generalise.

Although the literature overall is fragmentary, the most striking finding is the almost complete absence of research on non-communicable diseases. Several possible explanations exist but each has different implications. Some may reflect the difficulties of undertaking research in marginalised populations with well developed sets of health beliefs. Classic risk factor epidemiology is difficult among Roma populations who, as well as being difficult Prostitutes Natahoyo access, may regard researchers with hostility: often appropriately in view Prostitutes Natahoyo their experiences with authorities.

There are, however, more problematic issues relating to values underlying the Prostitutes Natahoyo. The focus on communicable disease may reflect less a concern about the health needs of the Roma but more those of the majority population. This concentration on communicable disease also resonates, uncomfortably, with the Social Darwinist agenda, which viewed excess communicable disease in certain populations as a means of reducing those considered to be constitutionally weak and socially undesirable.

It is in the context of this climate that one must take a view on the appropriateness of different forms of intervention. Notwithstanding the evidence from the UK of the Prostitutes Natahoyo of targeted interventions, 44 52 any intervention that reinforces ideas of difference from the majority community may be divisive and cause net harm.

What limited evidence exists indicates that the health needs of the Roma Prostitutes Natahoyo are considerable. Recognising the need for sensitivity because of the dangers arising from nationalism in some countries, there is a need to move this issue higher up the public health agenda.

Such action faces a wide range of obstacles. The health needs Prostitutes Natahoyo the Roma population lack visibility, not only because of the absence of research but also the absence of advocacy on their behalf. In many of the countries with large numbers of Roma, the public health services that, in the West, might be expected to act as agents to promote policies focusing on the health needs of minorities, Prostitutes Natahoyo not exist.

Neither do the non-governmental organisations that have been effective in the West in raising the profile of otherwise ignored issues. Similarly there is little tradition of the inter-sectoral action that would be required to mount an effective policy response. One opportunity on the horizon is the growing Prostitutes Natahoyo in the Roma among international agencies and similar bodies; largely as a result of lobbying by Roma agencies. Agencies active in reform of health and social care, such as the World Bank and the Open Society Institute, have taken an increasing interest in this issue.

The rights of minorities are increasingly the focus of discussions with countries hoping to accede to the European Union and are also a major issue for the Council of Europe, of which many countries in central and eastern Europe are now members. The health of the Roma population presents a major challenge to public health professionals, especially in some countries where Prostitutes Natahoyo are a significant minority and where there may be discrimination, social exclusion and even Prostitutes Natahoyo racism.

There is a need to explore locally Prostitutes Natahoyo mechanisms that can begin to understand their health needs and ways of tackling them. To encourage involvement in public health research by those Roma people who have transcended discriminatory barriers to access to become health professionals may help to develop Prostitutes Natahoyo with community leaders, based on trust, and pursue agendas that reflect the needs of the Roma rather than the majority population.

Funding: this review was performed as part of a project funded by the World Bank. However the World Bank can accept no responsibility for the views expressed.

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