To Achieve Roma Equality, Europe Must Address Health Disparities

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.

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I totally agree with Maja. The healthcare policies developed for Roma at EU level should be implemented at the national and local level and should be tailored on local needs. The policies should be focused not only on increasing the access of Roma to health care, but at the same time on increasing the quality of life in areas such as housing and income, which in turn will produce improvements in the area of health.

Is very important not only to continue the discussion after the last conference, but would be more important that the National Roma Integration Strategies (NRISs) to be effectively implemented monitored and evaluated with the active participation of Roma. Policies meant to lead to Roma inclusion cannot be effective without considering the real needs and participation of Roma people.

Many years of public policies for the Roma failed to bring major changes which can be measured locally, in the real life of people. The recent years, also due to the economic crisis, have brought about a backfire of the Roma development process, materialized by the deterioration of social and economic indicators. One of the causes might also be the fact that the political will diminished once the states with increased Roma population were accepted as members of the EU.

Considering its young age, capacity to develop and its important dimension, the Roma minority is one of the European resources of which potential have not yet been fully capitalized.

The primary key to successful integration would be a new European devotion to educating these young people and their children, as it would be anywhere else with respect to any other integration.

We still lack political weight to press for realization of
"policies" such as those on health. In former Yugoslavia we campaigned for many years to rise from "ethnic group" status to nationality (narod). We gained "narodnost". Yet
we see used "ethnic group" and "minority" as terms to describe the Romani nation. Nation status is need to improve
political standing and influence. Hence "Roma Nation Day - not "International Roma Day" This is going backwards!

When in doubt follow the lead of the G8+ in particular the U.S. and Obamacare for all. Why not create ONE EU preventative, compassionate healthcare system and utilize Roma as a pilot project. In mathematics, the least common denominator is the strongest value. All people will fall ill or have a preexisting condition at some point in their respective lives. Let us work as one across all socioeconomic possibilities and accept our humanity along with our ability for illness matched with healthcare for ONE EU. Roma show us the way to balance our equations.

I believe that progress begins by taking practical measures. Doctors and nurses need cultural awareness training in order for them to assess and treat their Roma patients in a culturally sensitive and appropriate way. I know that a lot of Roma women, for example, would avoid going to the doctor if they thought they'd have to discuss personal matters with a male doctor. I also believe that the nomadic lifestyle makes it difficult for Roma to effectively manage ongoing health issues because as soon as they've got a new doctor up to speed with their medical history, medications and treatments etc, they have often moved out of the area. It is for this reason that I believe nomadic people should be allowed to posses a copy of their own medical file, to take with them to the doctor.

Sadly, facing the ending of the Decade for Roma inclusion we are witnessing negligible progress on this field. Most of the social determinants of health, accompanied with discriminatory practices, still have very negative impact on Roma people's health and access to health care services. Policies that have been adopted in order to improve Roma people's health remained unimplemented, mainly due to lack of political commitment and lack of funds allocated for their implementation. EU must adopt policies for improvement of the status of Roma people (including health, education, housing, employment etc.) which will be mandatory for the member states but also for the candidate states. Having the obligations towards the EU could be a serious factor for the countries not only to adopt but also to implement these policies.

may be there is more need for community sensitization and awareness about the safety and need for mass immunization of the children at a tender age so as they can reach an average year.

lets accept that they are human beings like you and me

Yes! My grandmother never went to the hospital ( for specialist visits oustide her village) without taking one of her blonde grand daughters with her. We did this as a family so that she would pass for non-Roma. We had to play this game to ensure fair and equal treatment. Some people don't have that kind of luck to use this as an option. No one should be forced to think this way before visiting a hospital. There are many issues within the health sector that need to be addressed.

da svakako romi su najzagrozeni narod u svjetu i nitko ne pomaze romima
a svaka eu zemlja dobije pomos za romima ali ko dobije taj novac i dal stize u romskim zajednicama

As a researcher I carried out a mapping study for EMCDDA on s"Social Exclusion, 'Minorities' and drugs across 15 EU Member States" during 1999/2001. From the outset I included the Roma, Sinti and Gypsy populations amongst so-called minorities because of our race-equality approach. More than a decade on not much appears to have changed for the Roma or any other minorities. Indeed, it could be said that EU has gone backwards on multiculturalism and diversity, notably in UK and Germany, but also elsewhere: a case of 'plus ca change, plus c'est la meme chose'. The Open Society Foundation needs to be congratulated and supported in its initiative with EU and the European Commission to implement policies and issues of exclusion for the Roma

It is a tragedy human beings have not yet advanced their level of intelligence and changed their way of thinking to make the world a better place. Universal Healthcare is a humanitarian challenge that requires people, from the bottom to the top, to change the way they think. Wealth should not be the barrier of indifference between affordability, in medical treatment and care. WE MUST CHANGE THE WAY WE THINK, OR HUMAN BEINGS WILL PERISH; AND EVERYTHING WILL RETURN TO ONE!

The primary key to successful integration would be a new European devotion to educating these young people and their children, as it would be anywhere else with respect to any other integration.

As horrific as the plight of the Roma is, there is a subculture of abandoned children who are Romanian by birth and given up by their parents or Roma who have run away from abusive families. They run to the cities to survive and live in underground communities where they take care of each other and have children. We have young women giving birth underground or in abandoned buildings with no prenatal or postnatal care.
These babies are not exclusively Roma or Romanian but they are despised by all. They ALL need identity papers and access to medical care but with the focus on Roma they get very little attention. Can we include them in on this noble project?

Health inequalities experienced by Roma people living in Europe presents a persisting challenge for health research and practice. Roma people suffer from proper health and unhealthier living conditions compared to majority population and this poor health of Roma is closely linked to the social determinants of health. during recent years two notable developments research on Roma health we have been witnessing, first the focus has been on child health and genetic disorder and second is that determine the health inequalities faced by Roma . Roma women are also often overlooked in health-related research. So, to improve Roma health the EU should include (1) The advance health rights of Roma women (2) More research is needed to enable learning from cross country experience (3) Several programmes should initiated of national and international level to reduce the Roma health gap.(4) Furthermore , the effects of health system reforms on access to healthcare for Roma require systematic and comparative research.(5) As they are facing serious problems of healthcare, EU should give them better health service, break the communication barriers , give them human rights.

Roma people have to have presentation at the European Commission and Council of Europe- with programs. Roma are only asking for the same rights and priviledges as those other EU citizens are entitled to. Having access to schooling-housing-nourishment-healthcare instead of being deported from school (Leonarda Dibrani- Paris,France under Pres.Hollande)- deportations from Norway,Sweden to Romania,Bulgaria although they are EU citizens (the language used is from 1940s). 12 million minority people must have a voice in EU councils/parliament etc. ECHR (court- and other court venues to address any and all disparities in healthcare- living standards etc.

More has to be done by the individual EU member states on this issue. How can Open Society Foundations bring together key players in the most affected states in order to lay the foundations for serious change? - while not forgetting that the 'Roma issue' is heavily related to poverty, lack of education - which also affects huge numbers mainly in the recently joined EU states. If there is a new economic upturn and booming development in the next decade, how can we use that to ensure the most who need it - benefit from it? Who is in charge of the 'Decade for Roma' at the EU-level, and member-state level, and why is it that 'promises' have not been kept and policies delivered? It's all well us all commenting and blogging here but people are literally dying and being abused, so I hope next time something gets onto nicely printed paper and fresh signatures of politicians and NGO reps. - it is going to make some difference for those who desperately need it - I can assure you, you would not want to be in their shoes!


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