Roma living in marginalised communities are among the most disadvantaged groups in Slovakia. Socioeconomic disadvantage is associated with higher hair cortisol concentrations (HCC), including in parents. The aim of this study is therefore to assess differences in HCC, reflecting the levels of stress, between mothers living in MRCs and from the majority population, to assess the association of socioeconomic disadvantage with HCC, and whether disadvantage mediates the MRC/majority differences in HCC. Participants were mothers of children aged 15-18 months old living in MRCs (N=61) and from the Slovak majority population (N=90). During preventive paediatric visits, visits at community centres and home visits, hair samples and data by questionnaire were collected. HCC differed significantly between mothers living in MRCs and mothers from the majority population, with the mean HCC value being twice as high in mothers living in MRCs (22.98 (95% confidence interval, CI, 15.70-30.30) vs. 11.76 (8.34-15.20), p<0.05). HCC was significantly associated with education, household equipment and household overcrowding, but not with billing, socioeconomic stress and social support. The difference in HCC between mothers living in MRCs and mothers from the majority population was partially mediated by poor house equipment, such as no access to running water, no flushing toilet or no bathroom (the indirect effect of B=7.63 (95% CI: 2.12-13.92)). Practitioners and policymakers should be aware of high stress levels among mothers living in MRCs and aim at enhancing their living and housing conditions.

Department of Biochemistry Medical Faculty PJ Safarik University Trieda SNP 1 Kosice 040 11 Slovak Republic

Department of Community and Occupational Medicine University Medical Center Groningen University of Groningen Antonius Deusinglaan 1 Groningen 9713 AV the Netherlands

Department of Environment and Health Youth Health Care University of Leuven KU Leuven Kapucijnenvoer 35 Leuven 3000 Belgium

Department of Health Psychology and Research Methodology Medical Faculty PJ Safarik University Trieda SNP 1 Kosice 040 01 Slovak Republic

Graduate School Kosice Institute for Society and Health PJ Safarik University Trieda SNP 1 Kosice 040 11 Slovak Republic

Institute of Applied Psychology Faculty of Social and Economic Sciences Comenius University in Bratislava Mlynske Luhy 4 Bratislava 821 05 Slovak Republic

Olomouc University Social Health Institute Palacky University in Olomouc Univerzitni 22 Olomouc 771 11 Czech Republic

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