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To Achieve Roma Equality, Europe Must Address Health Disparities

two women and a boy
Romina Kajtazova, a Roma paralegal with the Humanitarian and Charitable Association of Roma, talks with Ljutvia Demyrova, a mother of eight children at her home in Vinica, Macedonia during the European Immunization Week.  © Bjorn Steinz/Panos Pictures for the Open Society Foundations

Like all Europeans, we represent the patients, caregivers, and families—as well as the doctors, nurses, and paramedics—who make up Europe’s health systems. 

Yet on average, we will die ten years earlier than most Europeans. 

We are less vaccinated, have fewer opportunities for good nutrition, and experience higher rates of illness. In some countries, six times as many of our infants do not make it to childhood. If they do, they will have had more infections and diseases than other groups living in similar economic conditions.

We are Europe’s 12 million Roma—the youngest, largest, and most disadvantaged ethnic group in Europe today.

Roma are socially marginalized, with prejudice and discrimination marking our everyday lives. Many of us live in poverty. Both circumstances contribute to worse health outcomes. 

When we need to seek health services, many of us cannot because we do not have identity documents or transportation. For those who can, the discrimination and exclusion that we face in our daily lives does not disappear at the door of the doctor’s office. 

Although Roma doctors, nurses, scholars, and public health experts are undertaking transformative work within Roma communities to minimize health disparities, nearly one out of every five Roma reports experiencing discrimination in health care during the last year.

When Roma are segregated from other patients, coerced into sterilization during childbirth, given substandard treatment, or told to go elsewhere for follow-up, all Europeans are degraded. It is a shocking irony that many of us should experience such harm at the very hospitals and clinics that ought to provide us with support and care.

The result is costly for Europe’s economy and for health systems. Europe’s Roma population is young—the average age of Roma is only 25—but too many of us lack the education and training needed to enter the labor market, resulting in the loss of 175 million euros each year, according to the World Bank. This widespread unemployment leads to poverty, which contributes to worse health outcomes and places an even greater strain on health systems that are already under-serving Roma. 

For years the European Commission has rightly recognized that inequality in health is a pressing issue requiring political solutions. But it has made little progress on behalf of vulnerable populations like the Roma. The EU has the legislative and policy instruments to promote Roma integration, but they are not being effectively used to reduce the gap in health outcomes. 

We have a chance to change this.  

This week, the European Commission hosts a high-level conference, Health in Europe, Making It Fairer, that will explore how to increase access to services and combat discrimination in health. There are several steps the Commission and Member States should take to improve Roma health. 

Commissioners should commit to concrete targets and set a timetable for raising Roma life expectancy, as well as child vaccination rates. This would create a standard against which EU Member States can establish goals in their required National Roma Integration Strategies 

In addition, every country with a significant Roma population should create a Roma health action plan alongside the adoption of legislation prohibiting discrimination. To support these plans, EU officials and ministers of health should share best practices, encourage cooperation between ministries, and should allocate resources to address discrimination in health care. After all, the issue of Roma health does not exist in a vacuum. A truly holistic approach is needed in which inter-ministerial collaboration leads to collective progress around education, labor, and health care.

Importantly, states should include Roma in the development and implementation of health programs that affect their communities. Policymakers cannot expect to end discrimination in health care without involving these experts in policy discussions, bringing into them the representation of Roma experience.

While this week’s conference is a commendable and important step, participants must ensure that the conversation continues. Improving Roma health requires a real and long-term political commitment to the European values of solidarity, equity, and participation. The European Union’s Europe 2020 strategy calls for smart, sustainable, an inclusive growth. We cannot hope to achieve this while leaving millions of Roma at the margins of society. 

Because in the end, this is an issue not just about Roma, but about our common vision of a truly integrated Europe.

This piece originally appeared in New Europe.

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