BACKGROUND: Infant mortality rates are reliable indices of the child and general population health status and health care delivery. The most critical factors affecting infant mortality are socioeconomic status and ethnicity. The aim of this study was to assess the association between socioeconomic disadvantage, ethnicity, and perinatal, neonatal, and infant mortality in Slovakia before and during the COVID-19 pandemic. METHODS: The associations between socioeconomic disadvantage (educational level, long-term unemployment rate), ethnicity (the proportion of the Roma population) and mortality (perinatal, neonatal, and infant) in the period 2017-2022 were explored, using linear regression models. RESULTS: The higher proportion of people with only elementary education and long-term unemployed, as well as the higher proportion of the Roma population, increases mortality rates. The proportion of the Roma population had the most significant impact on mortality in the selected period between 2017 and 2022, especially during the COVID-19 pandemic (2020-2022). CONCLUSIONS: Life in segregated Roma settlements is connected with the accumulation of socioeconomic disadvantage. Persistent inequities between Roma and the majority population in Slovakia exposed by mortality rates in children point to the vulnerabilities and exposures which should be adequately addressed by health and social policies.
- MeSH
- COVID-19 MeSH
- etnicita statistika a číselné údaje MeSH
- kojenec MeSH
- kojenecká mortalita * etnologie trendy MeSH
- lidé MeSH
- novorozenec MeSH
- perinatální mortalita * etnologie trendy MeSH
- Romové * statistika a číselné údaje MeSH
- socioekonomické faktory * MeSH
- socioekonomické nerovnosti ve zdraví MeSH
- těhotenství MeSH
- Check Tag
- kojenec MeSH
- lidé MeSH
- mužské pohlaví MeSH
- novorozenec MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Slovenská republika MeSH
BACKGROUND: Emotional and behavioural problems (EBP) are the most common mental health issues during adolescence, and their incidence has increased in recent years. The system of care for adolescents with EBP is known to have several problems, making the provision of care less than optimal, and attention needs to be given to potential improvements. We, therefore, aimed to examine what needs to be done to improve the system of care for adolescents with EBP and to assess the urgency and feasibility of the proposed measures from the perspective of care providers. METHODS: We used Concept mapping, a participatory mixed-method research, based on qualitative data collection and quantitative data analysis. A total of 33 stakeholders from 17 institutions participated in our study, including psychologists, pedagogues for children with special needs, teachers, educational counsellors, social workers and child psychiatrists. RESULTS: Respondents identified 43 ideas for improving of the system of care for adolescents with EBP grouped into 5 clusters related to increasing the competencies of care providers, changes at schools and school systems, support for existing services, transparency of the care system in institutions and public administration, and the adjustment of legislative conditions. The most urgent and feasible proposals were related to the support of awareness-raising activities on the topic of EBP, the creation of effective screening tools for the identification of EBP in adolescents, strengthening the role of parents in the process of care, comprehensive work with the family, creation of multidisciplinary support teams and intersectoral cooperation. CONCLUSIONS: Measures which are more accessible and responsive to the pitfalls of the care system, together with those strengthening the role of families and schools, have greater potential for improvements which are in favour of adolescents with EBP. Care providers should be invited more often and much more involved in the discussion and the co-creation of measures to improve the system of care for adolescents with EBP.
In the absence of suitable indicators of adolescent socioeconomic status, the Family Affluence Scale (FAS) was first developed in Scotland 25 years ago. Since then, it has been adapted for use in the Health Behaviour in School-Aged Children (HBSC) Study to research inequalities in adolescent health in Europe and North America. FAS has also been used as an indicator of adolescent socioeconomic status in research studies outside of HBSC, worldwide. There has been a need for FAS to evolve and change its component items over time in order to take into account social and technological changes influencing the families of adolescents. This paper uniquely charts the development of FAS describing the methodological work carried out to validate the measure internationally and over time. It also presents an overview of the body of evidence on adolescent health inequalities produced over years from the HBSC Study and other research studies. Interviews conducted with policy stakeholders reveal that the evidence from FAS-related HBSC work has influenced their strategic work to raise awareness of inequalities and make the case for action to address these. Finally, the future of FAS is discussed with respect to its continual evolution in the context of technological, environmental and social change.
- Publikační typ
- časopisecké články MeSH
Roma are the largest and most disadvantaged ethnic minority in Europe often facing generational poverty, and limited access to education, employment, housing, and various types of services. Despite many international and national initiatives, children from marginalized Roma communities face multiple risks and are being disadvantaged as early as from conception onward. We, therefore, aimed to identify measures and/or interventions targeting equity in early childhood health and development in marginalized Roma communities which implementation is considered to be urgent but not feasible. We used a group concept mapping approach-a participatory mixed research method-and involved 40 experts and professionals from research, policy and practice. From 90 measures and interventions proposed to achieve early childhood equity for children from marginalized Roma communities, 23 measures were identified as urgent but not feasible. These concerned particularly measures and interventions targeting living conditions (including access to income, access to housing, and basic infrastructure for families) and public resources for instrumental support (covering mainly topics related to financial and institutional frameworks). Our results reflect the most pressing issues in the area of equality, inclusion and participation of Roma and expose barriers to implementation which are likely to arise from public and political discourses perpetrating a negative image of Roma, constructing them as less deserving. Measures to overcome persistent prejudices against Roma need to be implemented along with the measures targeting equity in early childhood health and development.
- MeSH
- dítě MeSH
- dostupnost zdravotnických služeb MeSH
- etnicita MeSH
- lidé MeSH
- menšiny MeSH
- předškolní dítě MeSH
- Romové * MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- předškolní dítě MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Slovenská republika MeSH
BACKGROUND: This study aims to assess which measures could improve the healthy early childhood development of children from marginalized Roma communities and to identify priority measures. METHODS: Concept mapping approach was used, using mixed methods. In total 54 professionals, including social workers, educators, health care providers, municipality representatives, and project managers participated in our study. RESULTS: Four distinct clusters of measures targeting living conditions, public resources, healthcare and community interventions, and 27 individual priority measures of highest urgency and feasibility were identified. The cluster 'Targeting living conditions', was rated as the most urgent but least feasible, whereas the cluster 'Targeting health care', was considered least urgent but most feasible. Among the 27 priority measures, 'Planning parenthood' and 'Scaling up existing projects' had the highest priority. CONCLUSION: Our results reflect the public and political discourse and indicate significant barriers to implementation. Reducing inequalities in early childhood needs to be addressed through coordinated efforts.
BACKGROUND: Half of the people living in social exclusion in the Czech Republic are of Roma origin. The worse health of Roma could be partly explained by numerous barriers to accessing health care. Therefore, our study aimed to explore the perceptions of various stakeholders and experts who may have an impact on the inclusion of Roma and/or their access to health care on how to improve health care access for Roma living in social exclusion in the Czech Republic. METHODS: We conducted a concept mapping study and obtained data from 32 participants from health and social services, policymakers and others who were involved in different study phases (brainstorming, sorting, rating, interpretation). RESULTS: Out of 64 proposed measures sorted into six distinct clusters, 20 were rated as the most urgent and the most feasible and should be implemented with a priority to improve access to health care for Roma living in social exclusion. The proposed measures covered various topics, such as education and awareness of the target group as well as education and supervision of helping professionals, strengthening capacities and streamlining the health care system, health promotion and associated services and increasing the local and financial accessibility of health care. Overall, measures concerning the education and supervision of helping professionals were rated as both the most urgent and the most feasible. Individual priority measures targeted, for example, the health needs assessment of Roma living in social exclusion to set up interventions or to include topics such as participation, empowerment, cultural competence and communication training in the curricula of health care and helping professionals in postgraduate and continuing studies. CONCLUSIONS: Stakeholders proposed a set of relevant and acceptable measures that may help improve access to health care for Roma living in social exclusion. The way they rated the proposed measures reflects both the current unfavourable mainstream and public discourse concerning Roma living in social exclusion and the most acute policy issues identified by several European and national bodies.
- MeSH
- disparity zdravotní péče MeSH
- dospělí MeSH
- dostupnost zdravotnických služeb * MeSH
- kulturně kompetentní péče * MeSH
- kulturní kompetence MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- poskytování zdravotní péče * MeSH
- prostorová analýza MeSH
- Romové * MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- sociální inkluze MeSH
- sociální izolace MeSH
- vytváření pojmu MeSH
- zdravotní politika MeSH
- zdravotnická zařízení MeSH
- zranitelné populace MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Čína MeSH
BACKGROUND: The effect of inequalities aggravated by economic recessions in the mortality rates of certain diseases has been previously described. In this study, we analyzed the relationship between socio-economic deprivation and cancer mortality. We focused on lung, colon, prostate, and breast cancers in nine European urban areas over three periods: two before (2000-2003 and 2004-2008) and one after (2009-2014) the onset of the 2008 financial crisis. METHODS: This is an ecological study of trends. The units of analysis were small areas within nine European urban areas. We used a composite deprivation index as a socio-economic indicator. As a mortality indicator, we used the smoothed standardized mortality ratio, calculated using the hierarchical Bayesian model proposed by Besag, York and Mollié. To analyze the evolution of socio-economic inequalities, we fitted an ecological regression model that included the socio-economic indicator, the period of time, and the interaction between these terms. RESULTS: In men, socio-economic inequalities in all-cancer and lung cancer mortality were observed in most of the cities studied, but did not increase after the onset of the economic crisis. In women, only two cities (Stockholm and London) showed socio-economic inequalities in all-cancer and lung cancer mortality; there was also no increase in inequalities. CONCLUSIONS: Our results did not validate our hypothesis that inequalities increase in times of crisis. However, they emphasize the importance of socio-economic measurements for understanding mortality inequalities, and can be used to inform prevention strategies and help plan local health programs aimed at reducing health inequalities.
- MeSH
- dospělí MeSH
- ekonomická recese MeSH
- lidé středního věku MeSH
- lidé MeSH
- mortalita trendy MeSH
- nádory ekonomika mortalita MeSH
- socioekonomické faktory * MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Evropa MeSH
OBJECTIVES: Education is an important tool to reduce health inequalities. Several factors influence the educational trajectory of children, with school satisfaction being one of them. The aim was to explore how learning difficulties, a disrupted social context and family affluence relate to school satisfaction. METHODS: We used data from the 2018 Slovak cross-sectional Health Behaviour in School-aged Children-study (age 15 years; N = 913; 50.3% boys). School satisfaction was categorized as liking school and caring about education (satisfied), disliking school but caring about education or vice versa (inconsistent), and disliking school and not caring about education (indifferent). We explored the association of learning difficulties, disrupted social context and family affluence with school satisfaction using multinomial logistic regression. RESULTS: Boys, and children having learning difficulties, or disruption in the social context and living in low affluence family were significantly less likely to be satisfied at school. CONCLUSIONS: The key is to create a stimulating and encouraging environment at school, where children successfully learn functional literacy and feel well. The more satisfaction pupils get from school, the more likely is a favourable educational trajectory for them.
- MeSH
- chování mladistvých psychologie MeSH
- dítě MeSH
- lidé MeSH
- mladiství MeSH
- osobní uspokojení * MeSH
- poruchy učení psychologie MeSH
- průřezové studie MeSH
- rodinné vztahy psychologie MeSH
- sexuální faktory MeSH
- školy statistika a číselné údaje MeSH
- sociální prostředí * MeSH
- socioekonomické faktory MeSH
- studenti psychologie MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- srovnávací studie MeSH
- Geografické názvy
- Slovenská republika MeSH
Our earlier article showed that increased employability of segregated Roma may improve their well-being and health. To achieve that, appropriate employment based on a public-private partnership could be the key. For optimal design of such a partnership, we need insight into its potential mechanisms. Evidence on this is lacking, however. This paper builds on the previously published article by focusing on mechanisms for achieving better health. Therefore, our aim was to identify the potential mechanisms by which a public-private Roma employment project could increase employability. We investigated a Roma employment project called Equality of Opportunity established by a private company, U.S. Steel Kosice in eastern Slovakia. We conducted a multi-perspective qualitative study to obtain key stakeholders' perspectives on the potential mechanisms of a public-private Roma employment project in terms of increased employability. We found three types of mechanisms. The first type regarded formal job mechanisms, such as an appropriate employment and salary offer and a bottom-up approach in capacity building. The second type involved sustainability mechanisms, such as the personal profile of project and work-shift coordinators, the continuous offer of training and cooperation with relevant stakeholders (municipalities, community centers, etc.). The third type was cultural mechanisms, such as personal contact with project participants, attention to less-voiced groups like children, the motivation of project participants, a counter-value reciprocity approach and respect for the specifics of Roma history. Our findings imply that policymakers could consider public-private partnerships for increasing the employability of segregated Roma, as they have the potential to address a wider range of social needs simultaneously.
- MeSH
- dítě MeSH
- dospělí MeSH
- lidé MeSH
- partnerství veřejného a soukromého sektoru * MeSH
- Romové * MeSH
- velkoměsta MeSH
- zaměstnanost * MeSH
- Check Tag
- dítě MeSH
- dospělí MeSH
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Slovenská republika MeSH
- velkoměsta MeSH
BACKGROUND: Few studies have assessed the impact of the financial crisis on inequalities in suicide mortality in European urban areas. The objective of the study was to analyse the trend in area socioeconomic inequalities in suicide mortality in nine European urban areas before and after the beginning of the financial crisis. METHODS: This ecological study of trends was based on three periods, two before the economic crisis (2000-2003, 2004-2008) and one during the crisis (2009-2014). The units of analysis were the small areas of nine European cities or metropolitan areas, with a median population ranging from 271 (Turin) to 193 630 (Berlin). For each small area and sex, we analysed smoothed standardized mortality ratios of suicide mortality and their relationship with a socioeconomic deprivation index using a hierarchical Bayesian model. RESULTS: Among men, the relative risk (RR) comparing suicide mortality of the 95th percentile value of socioeconomic deprivation (severe deprivation) to its 5th percentile value (low deprivation) were higher than 1 in Stockholm and Lisbon in the three periods. In Barcelona, the RR was 2.06 (95% credible interval: 1.24-3.21) in the first period, decreasing in the other periods. No significant changes were observed across the periods. Among women, a positive significant association was identified only in Stockholm (RR around 2 in the three periods). There were no significant changes across the periods except in London with a RR of 0.49 (95% CI: 0.35-0.68) in the third period. CONCLUSIONS: Area socioeconomic inequalities in suicide mortality did not change significantly after the onset of the crisis in the areas studied.
- MeSH
- Bayesova věta MeSH
- ekonomická recese * MeSH
- lidé MeSH
- mortalita MeSH
- sebevražda * MeSH
- socioekonomické faktory MeSH
- velkoměsta MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Španělsko MeSH
- velkoměsta MeSH
