BACKGROUND: This study investigates the structural and socio-cultural drivers of medical indebtedness and hospital detention due to unpaid healthcare bills in the Fundong Health District, Cameroon. It explores how poverty, institutional shortcomings, and cultural beliefs converge to exacerbate patients' financial vulnerability and delay access to care. METHODS: A qualitative anthropological approach was employed between February and November 2022, combining 34 in-depth interviews with extended ethnographic observation in hospital wards, billing offices, and family waiting areas. Data were analyzed using iterative grounded theory methods, including open, axial, and selective coding of interview transcripts, focus group discussions, and field notes. This methodology allowed for a nuanced understanding of how debt and detention are experienced and perpetuated. All data were transcribed, manually coded, and analyzed using NVivo 14 software to identify recurring themes related to hospital detention. RESULTS: The findings show that medical indebtedness is driven by poverty, lack of health insurance, and limited social support. Institutional factors-including underfunded healthcare infrastructure and high user fees-compound these vulnerabilities. Cultural norms, such as beliefs discouraging financial preparation for illness, further heighten exposure to risk. The practice of hospital detention, though largely undocumented, imposes severe physical, emotional, and financial burdens, prompting some to delay care or adopt harmful coping mechanisms. CONCLUSION/POLICY IMPLICATIONS: Addressing medical debt and hospital detention requires a multifaceted policy response. Recommendations include eliminating maternal user fees, expanding health insurance coverage for vulnerable populations, protecting hospital-based social assistance, and replacing detention with legal safeguards and social mediation. Additionally, culturally sensitive financial literacy and mental health support programs are vital. Long-term investment in health infrastructure and governance is essential to reduce out-of-pocket spending and ensure equitable, rights-based healthcare access.

• Klíčová slova
• Cameroon, healthcare financing, hospital detention, medical indebtedness, universal health coverage, vulnerable populations,
• MeSH
• chudoba * statistika a číselné údaje   MeSH
• dospělí MeSH
• dostupnost zdravotnických služeb * ekonomika   MeSH
• kulturní antropologie MeSH
• kvalitativní výzkum MeSH
• lidé středního věku MeSH
• lidé MeSH
• rozhovory jako téma MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Kamerun MeSH

OBJECTIVES: Large socioeconomic inequalities in health are still present in the Central Europe. The aim was to explore socioeconomic inequalities in mortality in Visegrad countries-the Czech Republic, Hungary, Poland and Slovakia (V4), by three different socioeconomic indicators (unemployment, risk of poverty/social exclusion, education). The study was conducted within the H2020 Euro-Healthy project. METHODS: The associations between selected socioeconomic indicators and the standardised mortality rates by four main causes (mortality related to cancer, circulatory, respiratory and digestive system) in the economically active population aged 20-64 years in the 35 NUTS 2 level regions of the V4 in the period 2011-2013 were explored, using linear regression models. RESULTS: Lower education level was the most significant predictor of mortality in the V4. The lowest mortality rates by all causes of death were found in the regions of the Czech Republic, the highest in regions of Hungary. CONCLUSIONS: Despite the common origin, the pathways of the V4 countries in employment, poverty and education seem to be different, also having impact on health equity. Therefore, where you live in the V4 can significantly influence your health.

• Klíčová slova
• Ecological design, Health equity, Measurement, Mortality, Regional differences, Socioeconomic inequalities,
• MeSH
• chudoba statistika a číselné údaje   MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• lineární modely MeSH
• mladý dospělý MeSH
• mortalita trendy   MeSH
• nezaměstnanost statistika a číselné údaje   MeSH
• předpověď MeSH
• příčina smrti * MeSH
• sociální diskriminace * MeSH
• socioekonomické faktory * MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika epidemiologie   MeSH
• Maďarsko epidemiologie   MeSH
• Polsko epidemiologie   MeSH
• Slovenská republika epidemiologie   MeSH

BACKGROUND: Like most Central European countries Slovakia has experienced a period of socioeconomic changes and at the same time a decline in the mortality rate. Therefore, the aim is to study socioeconomic factors that changed over time and simultaneously contributed to regional differences in mortality. METHODS: The associations between selected socioeconomic indicators and the standardised mortality rate in the population aged 20-64 years in the districts of the Slovak Republic in the periods 1997-1998 and 2012-2013 were analysed using linear regression models. RESULTS: A higher proportion of inhabitants in material need, and among males also lower income, significantly contributed to higher standardised mortality in both periods. The unemployment rate did not contribute to this prediction. Between the two periods no significant changes in regional mortality differences by the selected socioeconomic factors were found. CONCLUSIONS: Despite the fact that economic growth combined with investments of European structural funds contributed to the improvement of the socioeconomic situation in many districts of Slovakia, there are still districts which remain "poor" and which maintain regional mortality differences.

• Klíčová slova
• Income, Material needs, Mortality, Regional differences, Unemployment,
• MeSH
• chudoba statistika a číselné údaje   MeSH
• dospělí MeSH
• etnicita MeSH
• lidé středního věku MeSH
• lidé MeSH
• lineární modely MeSH
• mladý dospělý MeSH
• mortalita trendy   MeSH
• nezaměstnanost statistika a číselné údaje   MeSH
• senioři MeSH
• socioekonomické faktory MeSH
• společenská třída MeSH
• zdravotní stav * MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Slovenská republika epidemiologie   MeSH

BACKGROUND: Roma represent one of the largest and oldest minorities in Europe. Health of many of them, particularly those living in settlements, is heavily compromised by poor dwelling, low educational level, unemployment, and poverty rooted in generational poverty, segregation and discrimination. The cross-sectional population-based study using community based approach aimed to map the prevalence of viral hepatitis B/C and metabolic syndrome in the population living in separated and segregated Roma settlements and to compare it with the occurrence of the same health indicators in the majority population, considering selected risk and protective factors of these health indicators. METHODS: The sample consisted of 452 Roma (mean age = 34.7; 35.2% men) and 403 non-Roma (mean age = 33.5; 45.9% men) respondents. Data were collected in 2011 via questionnaire, anthropometric measures and analysed blood and urine samples. A methodology used in the study as well as in the following scientific papers is described in the Methods section (i.e. study design, procedures, samples, methods including questionnaire, anthropometric measurements, physical measurements, blood and urine measurements). CONCLUSIONS: There are regions of declining prosperity due to high unemployment, long-term problems with poverty and depleted resources. Populations living in these areas, i.e. in Central and Eastern Europe in Roma settlements, are at risk of poverty, social exclusion and other factors affecting health. Therefore, we should look for successful long-term strategies and tools (e.g. Roma mediators, terrain work) in order to improve the future prospects of these minorities.

• MeSH
• charakteristiky bydlení statistika a číselné údaje   MeSH
• chudoba etnologie   statistika a číselné údaje   MeSH
• dospělí MeSH
• hepatitida B krev   etnologie   moč   MeSH
• hepatitida C krev   etnologie   moč   MeSH
• lidé středního věku MeSH
• lidé MeSH
• metabolický syndrom krev   etnologie   moč   MeSH
• mladiství MeSH
• mladý dospělý MeSH
• prevalence MeSH
• průřezové studie MeSH
• průzkumy a dotazníky MeSH
• Romové etnologie   statistika a číselné údaje   MeSH
• socioekonomické faktory MeSH
• venkovské obyvatelstvo statistika a číselné údaje   MeSH
• zdravotní stav MeSH
• zdravotnické přehledy metody   statistika a číselné údaje   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Slovenská republika epidemiologie   MeSH