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Orton L, Fuseini O, Kóczé A, Rövid M, Salway S. Researching the health and social inequalities experienced by European Roma populations: Complicity, oppression and resistance. SOCIOLOGY OF HEALTH & ILLNESS 2022; 44 Suppl 1:73-89. [PMID: 34919271 DOI: 10.1111/1467-9566.13411] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 10/20/2021] [Accepted: 10/28/2021] [Indexed: 06/14/2023]
Abstract
This paper draws on the experience of two Romani and three non-Romani scholars in knowledge production on the health and social inequalities experienced by European Roma populations. Together, we explore how we might better account for, and work against, the complex web of dynamic oppressions embedded within processes of academic knowledge production. Our aim is to encourage careful scrutiny through which sociologists of health and illness might better recognise our own complicity with oppression and identify concrete actions towards transforming our research practices. Drawing on a well-known domains of racism typology (Annual Review of Public Health, 40, 2019, 105), we use examples from our own work to illustrate three interconnected domains of oppression in which we have found ourselves entangled (structural, cultural and interpersonal). A new conceptual framework is proposed as an aid to understanding the spectrum of different "types" of complicity (voluntary-involuntary, conscious-unconscious) that one might reproduce across all three domains. We conclude by exploring how sociologists of health and illness might promote a more actively anti-racist research agenda, identifying and challenging subtle, hidden and embedded negative ideologies and practices as well as more obviously oppressive ones. We hope these reflections will help revitalise important conversations.
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Affiliation(s)
- Lois Orton
- Sociological Studies, University of Sheffield, Sheffield, UK
| | - Olga Fuseini
- Romani Studies Program, Central European University, Budapest, UK
| | - Angéla Kóczé
- Romani Studies Program, Central European University, Budapest, UK
| | - Márton Rövid
- Romani Studies Program, Central European University, Budapest, UK
| | - Sarah Salway
- Sociological Studies, University of Sheffield, Sheffield, UK
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The profile of HDL-C subfractions and their association with cardiovascular risk in the Hungarian general and Roma populations. Sci Rep 2022; 12:10915. [PMID: 35764677 PMCID: PMC9240088 DOI: 10.1038/s41598-022-15192-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 06/20/2022] [Indexed: 11/09/2022] Open
Abstract
High-density lipoprotein cholesterol (HDL-C) is not a homogenous lipid fraction, but it can be further divided into subfractions. It is well-known that the Roma population has a high prevalence of reduced HDL-C levels and cardiovascular diseases (CVDs). However, it is unknown how this reduction affects different HDL subfractions, and whether changes in their quantity/representation are associated with an increased cardiovascular risk among them. In the present study, the HDL subfraction profile of the Hungarian general (HG) and the Roma populations were compared, and the subfractions showing a significant difference between the two populations were identified. The association of HDL subfractions with CVD risk estimated by the Framingham risk score (FRS) and the Systematic COronary Risk Evaluation (SCORE) algorithms were also defined. The present study is the first to find a significant association between HDL subfractions and cardiovascular risk estimated by FRS and SCORE. Ten HDL subfractions were investigated on small but carefully selected samples comprising 100 control subjects (with normal lipid profile) and 277 case subjects (with reduced HDL-C levels) from HG and Roma populations of a complex health survey. The level of HDL-1 to 3 subfractions and HDL-L showed a significant inverse association with cardiovascular risk estimated by both SCORE and FRS algorithms, whereas HDL-4 to 6 and HDL-I only for FRS. A higher representation (in %) of HDL-1 to 3 has a significant risk-reducing effect, while HDL-8 to 10 has a risk-increasing effect estimated by FRS. Our results confirmed that reduced levels of HDL-6 and -7 expressed in mmol/L were significantly associated with Roma ethnicity.
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Piko P, Dioszegi J, Kosa Z, Sandor J, Moizs M, Adany R. Changes in the Prevalence of Metabolic Syndrome, Its Components, and Relevant Preventive Medication between 2011 and 2018 in the Northeast Hungarian Roma Population. J Pers Med 2021; 11:jpm11070595. [PMID: 34202560 PMCID: PMC8304367 DOI: 10.3390/jpm11070595] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Revised: 06/13/2021] [Accepted: 06/22/2021] [Indexed: 12/19/2022] Open
Abstract
Metabolic syndrome (MetS) is a cluster of clinical conditions that poses a major health burden worldwide. In the present study, we investigate the changes in the prevalence of MetS and its components among the Roma in two disadvantaged counties in Northeastern Hungary focusing on a seven-year-long period. The database of the present study is based on cross-sectional surveys of the Hungarian Roma population (aged 20-64 years) conducted in 2011 (n = 458) and 2018 (n = 374). The increase in the prevalence of MetS itself in the whole Roma population was not found to be significant in the period examined (although it increased from 40.0% up to 46.0%, p = 0.080); however, regarding its components, there was a significant increase in the prevalence of central obesity (from 62.7% to 73.3%, p = 0.001) and raised blood pressure (BP) or treated hypertension (from 45.2% to 54.5%, p = 0.007). These changes were mainly observed in the younger age groups, so the risk for MetS increased significantly in the 20-34 (OR = 1.10, p = 0.038) and 35-49 (OR = 1.07, p = 0.048) year age groups in the 2018 study population compared the 2011 one. The increasing prevalence of hidden hypertension and, consequently, untreated individuals with raised BP (from 29.6% to 43.5%, p = 0.014) among females is quite alarming; therefore, a targeted public health strategy and targeted interventions are desperately needed to prevent further worsening of the current situation.
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Affiliation(s)
- Peter Piko
- MTA-DE Public Health Research Group, University of Debrecen, 4032 Debrecen, Hungary; (P.P.); (J.D.)
| | - Judit Dioszegi
- MTA-DE Public Health Research Group, University of Debrecen, 4032 Debrecen, Hungary; (P.P.); (J.D.)
| | - Zsigmond Kosa
- Department of Health Methodology and Public Health, Faculty of Health, University of Debrecen, 4400 Nyíregyháza, Hungary;
| | - Janos Sandor
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary;
| | - Mariann Moizs
- Kaposi Mór Teaching Hospital, 7400 Kaposvár, Hungary;
| | - Roza Adany
- MTA-DE Public Health Research Group, University of Debrecen, 4032 Debrecen, Hungary; (P.P.); (J.D.)
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary;
- Correspondence: ; Tel.: +36-52-512-765 (ext. 77174)
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Mrzljak A, Bajkovec L, Vilibic-Cavlek T. Hepatotropic viruses: Is Roma population at risk? World J Gastroenterol 2021; 27:143-151. [PMID: 33510555 PMCID: PMC7807296 DOI: 10.3748/wjg.v27.i2.143] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Revised: 11/13/2020] [Accepted: 11/29/2020] [Indexed: 02/06/2023] Open
Abstract
Roma people make up a significant ethnic minority in many European countries, with the vast majority living in Central and Eastern Europe. Roma are a vulnerable population group in social, economic, and political terms. Frequent migrations, life in segregated communities, substandard housing, poverty, and limited access to quality health care, including low immunization coverage, affect their health status and predispose them to various diseases, including viral hepatitis. Hepatitis A, B, and E are highly prevalent among Roma and mainly associated with low socioeconomic status. In contrast, hepatitis C does not seem to be more frequent in the Roma population. Enhanced efforts should be directed towards the implementation of screening programs, preventive measures, and treatment of viral hepatitis in Roma communities throughout Europe.
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Affiliation(s)
- Anna Mrzljak
- Department of Gastroenterology, University Hospital Merkur, Zagreb 10000, Croatia
- School of Medicine, University of Zagreb, Zagreb 10000, Croatia
| | - Lucija Bajkovec
- Department of Medicine, County Hospital Cakovec, Cakovec 40000, Croatia
| | - Tatjana Vilibic-Cavlek
- Department of Virology, Croatian Institute of Public Health, Zagreb 10000, Croatia
- School of Medicine, University of Zagreb, Zagreb 10000, Croatia
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Macejova Z, Kristian P, Janicko M, Halanova M, Drazilova S, Antolova D, Marekova M, Pella D, Madarasova-Geckova A, Jarcuska P. The Roma Population Living in Segregated Settlements in Eastern Slovakia Has a Higher Prevalence of Metabolic Syndrome, Kidney Disease, Viral Hepatitis B and E, and Some Parasitic Diseases Compared to the Majority Population. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E3112. [PMID: 32365672 PMCID: PMC7246595 DOI: 10.3390/ijerph17093112] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 04/24/2020] [Accepted: 04/27/2020] [Indexed: 12/14/2022]
Abstract
Background: The Roma population is one of the largest marginalized population groups in Europe. The aim of our work was to summarize the morbidity of lifestyle-related diseases and infectious diseases in the Roma population living in segregated settlements. Methods: We used data from the cross-sectional study HepaMeta, in which we examined 452 Roma subjects with an average age of 34.7 ± 9.1 years, 35.2% of which were men, and 403 non-Roma subjects with an average age of 33.5 ± 7.4 years, 45.9% of which were men. We collected data by means of a questionnaire, anthropometric measures, and we analyzed blood and urine samples. Results: Roma subjects had a higher incidence of metabolic syndrome (RR: 1.478 (1.159-1.885), p < 0.0001), obesity or waist circumference >94 cm in men/80 cm in women (RR: 1.287 (1.127-1.470), p < 0.0001), and HDL-C < 1.03 mmol/L in men or <1.29 in women (RR: 2.004 (1.730-2.321), p < 0.0001) than their non-Roma counterparts. Subjects of the Roma population were more frequently diagnosed with kidney disease (RR: 1.216 (1.096-1.349), p < 0.0001), HBsAg positivity (RR: 4.468 (2.373-8.415), p < 0.0001), anti HBc IgG positivity (RR: 3.13 (2.598-4.224), p < 0.0001), and anti HEV positivity (RR: 2.972 (1.226-7.287), p < 0.0001). Serological markers of Toxoplasma gondii infection and Toxocara spp. were observed much more frequently among Roma than non-Roma subjects (RR: 1.868 (1.520-2.296), p < 0.0001, for Toxoplasma gondii; and RR: 21.812 (8.097-58.761), p < 0.0001, for Toxocara spp.). Conclusions: Poor socio-economic conditions, an unhealthy lifestyle, and barriers precluding access to healthcare are factors that affect the Roma population in settlements and lead to an increased prevalence of metabolic syndrome and its components, kidney disease, viral hepatitis B and E, and some parasitic diseases.
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Affiliation(s)
- Zelmira Macejova
- 1st Department of Internal Medicine, Faculty of Medicine, Pavol Jozef Safarik University and Louis Pasteur University Hospital, 040 11 Kosice, Slovakia;
| | - Pavol Kristian
- Department of Infectology and Travel Medicine, Faculty of Medicine, Pavol Jozef Safarik University and Louis Pasteur University Hospital, 040 01 Kosice, Slovakia
| | - Martin Janicko
- 2nd Department of Internal Medicine, Faculty of Medicine, Pavol Jozef Safarik University and Louis Pasteur University Hospital, 040 11 Kosice, Slovakia; (M.J.); (P.J.)
| | - Monika Halanova
- Department of Epidemiology, Faculty of Medicine, Pavol Jozef Safarik University, 040 01 Kosice, Slovakia;
| | - Sylvia Drazilova
- Department of Internal Medicine, Hospital Poprad and Faculty of Medicine, Pavol Jozef Safarik University, 058 01 Poprad, Slovakia;
| | - Daniela Antolova
- Department of Parasitic Diseases, Institute of Parasitology SAS, Hlinkova 3, 040 01 Kosice, Slovakia;
| | - Maria Marekova
- Department of Medical and Clinical Biochemistry, Faculty of Medicine, Pavol Jozef Safarik University, 040 11 Kosice, Slovakia;
| | - Daniel Pella
- 2nd Department of Cardiology, Faculty of Medicine, Pavol Jozef Safarik University and East Slovak, Institute of Cardiovascular Diseases, Faculty of Medicine, Pavol Jozef Safarik University, 040 11 Kosice, Slovakia;
| | - Andrea Madarasova-Geckova
- Department of Health Psychology, Faculty of Medicine, Pavol Jozef Safarik University, 040 11 Kosice, Slovakia;
| | - Peter Jarcuska
- 2nd Department of Internal Medicine, Faculty of Medicine, Pavol Jozef Safarik University and Louis Pasteur University Hospital, 040 11 Kosice, Slovakia; (M.J.); (P.J.)
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Pacáková D, Zábavníková M, Miklošová M, Kúkeľová D, Dankovčík R. Epidemiological Study of Orofacial Clefts among Population of Eastern Slovakia during the Period 1996-2013. Cent Eur J Public Health 2016; 24:128-32. [PMID: 27434244 DOI: 10.21101/cejph.a4131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Accepted: 12/31/2015] [Indexed: 11/15/2022]
Abstract
BACKGROUND Over the past 18 years, according to data from the Clinic of Plastic and Reconstructive Surgery, L. Pasteur University Hospital, there have been 493 cases of orofacial clefts (OC) reported in the area of Eastern Slovakia. The aim of this study was to map the occurrence of orofacial clefts reported in the area of Eastern Slovakia during the years 1996-2013. Also, we compared the occurrence of different types of clefts between the groups in relation to gender and ethnicity. METHODS AND RESULTS The statistical analysis shows relationship between variables of location and gender and gender differences in the occurrence of various types of clefts. Moreover, in comparison with another study which analyzed the years 1985-2000 (1.29/10(3) live births), there was an increase in the incidence (1.42/10(3) live births) of OC in Eastern Slovakia. CONCLUSION Our findings seem contradictive to similar studies which discuss ethnic differences in relation to OC. We recognize the relatively high occurrence of OC in Eastern Slovakia, and we link this phenomenon to several extrinsic factors, in particular socioeconomic status and embryotoxic factors.
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Affiliation(s)
- Diana Pacáková
- Institute of Biology and Ecology, P. J. Šafárik University in Košice, Košice, Slovak Republic
| | - Marianna Zábavníková
- Department of Plastic, Reconstructive and Aesthetic Surgery, L. Pasteur University Hospital, Košice, Slovak Republic
| | - Mária Miklošová
- Department of Anatomy, Faculty of Medicine and Dentistry, Palacký University, Olomouc, Czech Republic
| | - Diana Kúkeľová
- Institute of Biology and Ecology, P. J. Šafárik University in Košice, Košice, Slovak Republic
| | - Róbert Dankovčík
- 2nd Department of Obstetrics and Gynaecology, P. J. Šafárik University and L. Pasteur University Hospital, Košice, Slovak Republic.,Centre for Prenatal Diagnosis, Košice, Slovak Republic
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Kao LT, Chiu YL, Lin HC, Lee HC, Chung SD. Prevalence of chronic diseases among physicians in Taiwan: a population-based cross-sectional study. BMJ Open 2016; 6:e009954. [PMID: 26940106 PMCID: PMC4785281 DOI: 10.1136/bmjopen-2015-009954] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES The health of physicians is an important topic which needs to be addressed in order to provide the best quality of patient care. However, there are few studies on the prevalence of chronic diseases among physicians. In this study, we explored the prevalence of chronic diseases among physicians and compared the probability of chronic diseases between physicians and the general population using a population-based data set in Taiwan. STUDY DESIGN A cross-sectional study. SETTING Taiwan. PARTICIPANTS Our study consisted of 1426 practising physicians and 5704 general participants. PRIMARY OUTCOME MEASURES We chose 22 chronic diseases from the Elixhauser Comorbidity index and nine highly prevalent medical conditions in an Asian population for analysis. We used conditional logistic regression analyses to investigate the OR and its corresponding 95% CI of chronic diseases between these two groups. RESULTS The conditional logistic regression analyses showed that physicians had lower odds of peripheral vascular disorders (OR=0.41, 95% CI=0.19 to 0.90), uncomplicated diabetes (OR=0.76, 95% CI=0.60 to 0.97), complicated diabetes (OR=0.53, 95% CI=0.34 to 0.83), renal failure (OR=0.41, 95% CI=0.19 to 0.90), liver diseases (OR=0.78, 95% CI=0.66 to 0.94), and hepatitis B or C (OR=0.62, 95% CI=0.49 to 0.77) and higher odds of hypertension (OR=1.21, 95% CI=1.03 to 1.41), hyperlipidaemia (OR=1.43, 95% CI=1.23 to 1.67) and asthma (OR=1.59, 95% CI=1.16 to 2.18) than the general population. CONCLUSIONS We concluded that although physicians had decreased prevalence of some chronic diseases, they had a significantly increased prevalence of hypertension, hyperlipidaemia and asthma.
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Affiliation(s)
- Li-Ting Kao
- Graduate Institute of Life Science, National Defense Medical Center, Taipei, Taiwan
- School of Public Health, National Defense Medical Center, Taipei, Taiwan
- Sleep Research Center, Taipei Medical University Hospital, Taipei, Taiwan
| | - Yu-Lung Chiu
- Graduate Institute of Life Science, National Defense Medical Center, Taipei, Taiwan
- School of Public Health, National Defense Medical Center, Taipei, Taiwan
- Sleep Research Center, Taipei Medical University Hospital, Taipei, Taiwan
| | - Herng-Ching Lin
- Sleep Research Center, Taipei Medical University Hospital, Taipei, Taiwan
| | - Hsin-Chien Lee
- Department of Psychiatry and Medical Humanities, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Shiu-Dong Chung
- Sleep Research Center, Taipei Medical University Hospital, Taipei, Taiwan
- Graduate Program in Biomedical Informatics, College of Informatics, Yuan-Ze University, Chungli, Taiwan
- Department of Surgery, Far Eastern Memorial Hospital, Banciao, Taipei, Taiwan
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Lower Viral Response to Pegylated Interferon Alpha 2a Treatment of Chronic Hepatitis B in Roma People in Eastern Slovakia. Gastroenterol Res Pract 2015; 2016:8682494. [PMID: 26858755 PMCID: PMC4709670 DOI: 10.1155/2016/8682494] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2015] [Accepted: 08/18/2015] [Indexed: 01/05/2023] Open
Abstract
Aim. To evaluate the compliance and virological response to pegylated interferon alpha 2a treatment of chronic hepatitis B in Roma population compared to majority Caucasian population in Slovakia. Methods. Retrospective evaluation of a cohort of all Roma patients treated with pegylated interferon alpha 2a from 2007 to 2013 in 3 centers for treatment of chronic viral hepatitis B. The Study included 43 Roma patients with chronic viral hepatitis B and randomly selected control group. Treatment duration was 48 weeks. Viral response was evaluated after 24 weeks, at the end of treatment, and 24 weeks after the end of treatment. Results. Complete treatment course was finished by 79.1% of Roma patients compared to all patients from the control group (p = 0.0009). There was a tendency toward lower viral response rate in Roma at all time points; however significant difference was only at end of treatment viral response (51.2% Roma versus 81.4% majority, p = 0.003). We also did not find significant difference at the rate of HBsAg loss. Conclusion. Roma patients with chronic hepatitis B have significantly worse compliance to treatment with pegylated interferon and they have significantly lower rate of end of treatment viral response.
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Seroprevalence of human Toxocara infections in the Roma and non-Roma populations of Eastern Slovakia: a cross-sectional study. Epidemiol Infect 2015; 143:2249-58. [PMID: 25592864 DOI: 10.1017/s0950268814003665] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Socioeconomic conditions and health of the Roma population, the most numerous minority in Europe, are worse than that of the non-Roma population. Information about the occurrence of human toxocarosis and other parasitic diseases in the Roma population is scarce or completely missing. The aim of this study was to map the seroprevalence of toxocarosis in the population living in segregated Roma settlements and to compare the data with the occurrence of antibodies in the non-Roma population of Eastern Slovakia. The seropositivity to Toxocara in 429 examined Roma inhabitants of segregated settlements reached 22·1%, while only 4/394 samples of the non-Roma population were found to be positive (odds ratio 27·7, P < 0·0001). Headache, muscle pain, influenza-like symptoms and diarrhoea occurred significantly more often in seropositive persons than in seronegative individuals. In the Roma population positivity was not influenced by gender, level of education and poverty, but age, lack of sanitary facilities and heating with wood significantly increased the risk of infection. It can be assumed that besides the high prevalence of toxocarosis, other parasitic diseases and communicable diseases will also be more prevalent in the Roma population living in segregated settlements.
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