Health Status and Self-Perception of Health in Czech Roma Community

Abstract Background The Roma population is reported to have a lower life expectancy in several European countries. The reasons for this are not well described, which limits the development of effective health promotion programs. This report investigates some possible reasons: self-perception of health risks and discrimination in a sample of Czech Roma. The study is a part of a complex health awareness program. Methods This is a pilot descriptive, cross-sectional survey conducted in Brno, Czech Republic in March 2022. Respondents were identified by community gatekeepers using quotas of gender and education. Data on disease incidence, lifestyle, attitudes to health care and risk perception were collected. Results In the sample of 30 participants, 60% were female, average age 42±5, 60% primary education. 57% daily smokers, with an average 17 cigarettes daily during 18 years. 35% had 1 chronic disease, another 38% had 2 and more. The most prevalent diseases were hypertension (43%) and obesity (41%). 60% of respondents with hypertension as compared to 23% without hypertension considered their stroke risk as medium. 43% smokers as compared to 21% non-smokers consider their risk of COPD as medium (for lung cancer 41% vs. 0%). Roma report not visiting a doctor due to a lack of time (33%), expecting the problem to resolve itself (33%), long waiting time (33%), but not discrimination (0%). Conclusions The Roma with risk factors correctly identify their risk of stroke, COPD, lung cancer as higher. None of them feel discriminated from physicians, but they limit contact with them due to other reasons. It appears that the prevalence of risk factors is higher in the Roma when compared to Caucasians based on the European Health Interview Survey (16% female, 31% male hypertension; 14% female, 29% male obesity). Self-perception of health and feeling of discrimination in Roma communities should be taken into account when designing health interventions. Key messages Roma people evaluate their risk of diseases adequately to their health status. The reasons for not using healthcare are not connected to discrimination.


Background:
Studies have shown an elevated risk of Covid-19 among foreign-born healthcare workers (HCWs), but data on the distribution of the risk in different occupational roles are lacking. Such data are needed for the effective control of Covid-19 risk among HCWs. Here, we examined the risk of Covid-19 infection and hospitalization in foreign-born HCWs in different occupational roles in Sweden.

Methods:
We prospectively linked occupational data (2018-2019) of 783950 employed foreign-born (20-65 years) workers to Covid-19 data registered between 1 January 2020 and 30 September 2021. We used Cox proportional hazards regression to estimate the risk of Covid-19 infection and hospitalization in foreign-born HCWs in eight different occupational groups compared to non-HCWs, and to assess whether the associations varied by region of birth. The analyses were adjusted for sociodemographic and socioeconomic factors, comorbidities, and Covid-19 vaccination. Results: All HCWs had a higher risk of Covid-19 outcomes than non-HCWs, but the risk differed by occupational role.

Background:
The Roma population is reported to have a lower life expectancy in several European countries. The reasons for this are not well described, which limits the development of effective health promotion programs. This report investigates some possible reasons: self-perception of health risks and discrimination in a sample of Czech Roma. The study is a part of a complex health awareness program.

Methods:
This is a pilot descriptive, cross-sectional survey conducted in Brno, Czech Republic in March 2022. Respondents were identified by community gatekeepers using quotas of gender and education. Data on disease incidence, lifestyle, attitudes to health care and risk perception were collected.

Results:
In the sample of 30 participants, 60% were female, average age 42AE5, 60% primary education. 57% daily smokers, with an average 17 cigarettes daily during 18 years. 35% had 1 chronic disease, another 38% had 2 and more. The most prevalent diseases were hypertension (43%) and obesity (41%). 60% of 15th European Public Health Conference 2022 respondents with hypertension as compared to 23% without hypertension considered their stroke risk as medium. 43% smokers as compared to 21% non-smokers consider their risk of COPD as medium (for lung cancer 41% vs. 0%). Roma report not visiting a doctor due to a lack of time (33%), expecting the problem to resolve itself (33%), long waiting time (33%), but not discrimination (0%).

Conclusions:
The Roma with risk factors correctly identify their risk of stroke, COPD, lung cancer as higher. None of them feel discriminated from physicians, but they limit contact with them due to other reasons. It appears that the prevalence of risk factors is higher in the Roma when compared to Caucasians based on the European Health Interview Survey (16% female, 31% male hypertension; 14% female, 29% male obesity). Self-perception of health and feeling of discrimination in Roma communities should be taken into account when designing health interventions.

Background:
The rapid expansion of internet and social media use has meant that both useful and potentially harmful health information can spread rapidly. Groups experiencing barriers to health systems may be more reliant on social media as a source of health information. We did a systematic review to determine the extent and nature of social media use in migrant and ethnic minority communities for COVID-19 information, and implications for preventative health measures including vaccination intent and uptake.

Methods:
We reviewed published and grey literature following PRISMA guidelines (PROSPERO registered CRD42021259190). Global research was included that reported on the use of social media by migrants and/or ethnic minority groups in relation to COVID-19.

Results:
1849 unique records were screened, and 21 data sources included in our analysis involving studies from the UK, US, China, Jordan, Qatar, and Turkey. We found evidence of consistent use of a range of social media platforms for COVID-19 information in some migrant and ethnic minority populations (including WeChat, Facebook, WhatsApp, Instagram, Twitter, YouTube), which may stem from difficulty in accessing COVID-19 information in their native languages or from trusted sources. There were positive and negative associations with social media use reported, with some evidence suggesting circulating misinformation and social media use may be associated with lower participation in preventative health measures, including vaccine intent and uptake, findings of which are likely relevant to multiple population groups.

Conclusions:
Urgent actions and further research are now needed to better understand the use of social media platforms for accessing health information by groups who may be marginalised from health systems, effective approaches to tackling circulating misinformation, and to seize on opportunities to make better use of social media platforms to support public health communication.

Key messages:
We found evidence of consistent use of a range of social media platforms for COVID-19 information in some migrant and ethnic minority populations. Further research is needed to better understand the use of social media platforms for accessing health information by groups who may be marginalised from health systems.

Background:
Sexual and gender-based violence (SGBV) is a severe human rights violation as well as a widespread global health problem with several negative consequences for emotional-psychological, sexual-reproductive and physical health. People who have experienced forced migration have a heightened exposure to SGBV, yet face several challenges to access support. Increased understanding of the help seeking processes of forced migrants who have experienced SGBV can help improve access to adequate support.

Methods:
Interviews with thirty forced migrants in Sweden who have experienced SGBV have been analyzed using thematic analysis to generate an understanding of their help-seeking processes. The participants were recruited through a broad range of service providers, nongovernmental organizations and community sites.

Results:
The disempowerment experienced after arrival to Sweden exacerbated health needs, increased the risk of violence, and prevented help seeking. Increased independency and more stable circumstances ameliorated the anticipated risks of seeking help and improved well-being. Activities and places providing a platform for social interactions as well as opportunities to acquire needed knowledge, such as language, were highlighted as valuable and could become a pathway to specialized services through a process of increased trust.

Conclusions:
Help-seeking processes for SGBV can be promoted by early access to support services and social networks, as well as language classes and information about the society. Access to support can be facilitated by increased collaboration between non-violence-related service providers working close to forced migrants, such as language schools, and specialized services. The societal factors influencing help seeking processes are being further explored in an ongoing analysis of interviews with 29 service providers. The findings will inform the codevelopment of a new service model.

Key messages:
Forced migrants describe that current services are not meeting their need of support for SGBV. There is a need to co-develop an enhanced service model involving both service users and providers.