OBJECTIVES: This study aims to compare selected early childhood health risks and health outcomes of children from marginalized Roma communities (MRCs) in Slovakia with those of the majority. METHODS: We obtained cross-sectional data from mother-child dyads from the majority (N = 109) and MRCs (N = 143) via questionnaires and from medical records. Socioeconomic status, health risks and health outcomes were compared using chi-square and Mann-Whitney U tests in SPSS. RESULTS: Mothers from MRCs reported significantly worse socioeconomic status. Air quality in the households in MRCs was significantly worse, affected by heating with stoves, burning fresh wood and indoor smoking. The diet composition of children from MRCs was characterized by shorter breastfeeding and unhealthy diet composition less fresh fruits and vegetables, more processed meat products, and sweet and salty snacks. Children from MRCs more often suffered from respiratory and diarrheal diseases, used antibiotics and were hospitalized. CONCLUSION: The health and healthy development of children living in MRCs is endangered by various poverty-related factors. Persistent differences in exposures and health in early childhood should be a priority goal of the state's social and health policies.

• Keywords
• early childhood, health, health risks, marginalized Roma communities, poverty,
• MeSH
• Diet MeSH
• Outcome Assessment, Health Care MeSH
• Humans MeSH
• Child, Preschool MeSH
• Cross-Sectional Studies MeSH
• Roma * MeSH
• Social Class MeSH
• Check Tag
• Humans MeSH
• Child, Preschool MeSH
• Publication type
• Journal Article MeSH

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.

• Keywords
• Concept mapping, Czech Republic, Ethnicity, Health care access, Interventions, Policies, Roma, Vulnerable population,
• MeSH
• Healthcare Disparities MeSH
• Adult MeSH
• Health Services Accessibility * MeSH
• Culturally Competent Care * MeSH
• Cultural Competency MeSH
• Middle Aged MeSH
• Humans MeSH
• Adolescent MeSH
• Young Adult MeSH
• Delivery of Health Care * MeSH
• Spatial Analysis MeSH
• Roma * MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Social Inclusion MeSH
• Social Isolation MeSH
• Concept Formation MeSH
• Health Policy MeSH
• Health Facilities MeSH
• Vulnerable Populations MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Adolescent MeSH
• Young Adult MeSH
• Male MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH
• Geographicals
• China MeSH

Background: Ethnic information regarding juvenile idiopathic arthritis (JIA) exists for various populations across the world but is fully lacking for Roma. We assessed the occurrence and clinical characteristics of JIA in Roma vs. non-Roma children. Methods: We obtained data on all outpatients (n = 142) from a paediatric rheumatology centre (age 3 to 18 years) in the eastern part of Slovakia (Kosice region). We assessed patients' age, gender, disease type and related extra-articular conditions by ethnicity. We obtained population data from the 2011 census. Results: The share of Roma children was higher in the clinical JIA sample than in the overall population (24.6%, n = 35, Roma in the sample vs. 10.8%, n = 142, Roma in the population, p < 0.05). Moreover, Roma children had been diagnosed more frequently with extra-articular conditions but did not differ in other symptoms. Treatments also did not differ by ethnicity. Conclusion: Roma children had been diagnosed more with JIA than their non-Roma peers. This calls for further research on the causes of this increased disease burden in Roma children.

• Keywords
• Roma, Slovakia, ethnicity, juvenile idiopathic arthritis,
• MeSH
• Child MeSH
• Arthritis, Juvenile * epidemiology   ethnology   MeSH
• Humans MeSH
• Adolescent MeSH
• Child, Preschool MeSH
• Risk MeSH
• Roma * MeSH
• Check Tag
• Child MeSH
• Humans MeSH
• Adolescent MeSH
• Child, Preschool MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH
• Geographicals
• Slovakia epidemiology   MeSH

BACKGROUND: To confirm or refute the hypothesis that the morbidity of children (since birth to age 5) born and living in the heavily polluted (PM10, benzo[a]pyrene) eastern part of Ostrava, Czech Republic, was higher than the morbidity of children living in other parts of the city. METHODS: Ten pediatricians in 5 districts of Ostrava abstracted the medical records of 1878 children born in 2001-2004 to list all illnesses of each child in ICD-10 codes. The children were divided into four groups according to their residence at birth and thereafter. Most of the children in the eastern area were living in the city district Radvanice and Bartovice. RESULTS: We report on the incidence of acute illnesses in 1535 children of Czech ethnicity in the first 5 years of life. The most frequent acute illnesses (over 45% of all diagnoses) were upper respiratory infections (URI: J00-J02, J06). In the first year of life, the incidence of URI in 183 children in the eastern area - 372 illnesses/100 children/year - was more than twice as high as in the other 3 areas with a total number of 1352 children. From birth to the age of 5 years, the incidences of pneumonia, tonsillitis, viral infections (ICD-10 code B34) and intestinal infectious diseases were also several times higher in children living in the eastern part of Ostrava. The lowest morbidity was found in children living in the less polluted western part of the city. CONCLUSIONS: The children born and living in the eastern part of the city of Ostrava had from birth through 5 years significantly higher incidence rates of acute illnesses than children in other parts of Ostrava. They also had a higher prevalence of wheezing, atopic dermatitis and allergic rhinitis.

• MeSH
• Cohort Studies MeSH
• Infant MeSH
• Air Pollutants toxicity   MeSH
• Humans MeSH
• Morbidity * MeSH
• Respiratory Tract Diseases chemically induced   epidemiology   MeSH
• Intestinal Diseases chemically induced   epidemiology   MeSH
• Infant, Newborn MeSH
• Otitis Media chemically induced   epidemiology   MeSH
• Child, Preschool MeSH
• Prevalence MeSH
• Retrospective Studies MeSH
• Virus Diseases chemically induced   epidemiology   MeSH
• Air Pollution MeSH
• Check Tag
• Infant MeSH
• Humans MeSH
• Male MeSH
• Infant, Newborn MeSH
• Child, Preschool MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH
• Geographicals
• Czech Republic epidemiology   MeSH
• Names of Substances
• Air Pollutants MeSH

OBJECTIVES: The objective of this paper is to provide information on indoor air quality and on the quality of the broader indoor environment of the houses in Roma villages in Slovakia and Romania and to discuss possible implications for health. METHODS: Indoor air was sampled in 11 houses in a Romanian Roma village and in 19 houses in a Slovakian Roma village. Levels of carbon monoxide (CO), carbon dioxide (CO2), total particulate matter (PM), temperature and humidity were measured. A questionnaire and a checklist were used to obtain additional information on the indoor environment and behavioural factors. We have sampled the same houses in winter and in summer. RESULTS: Levels of CO and CO2 were higher in winter in both countries as compared to summer. The limit value of 10 mg/m3 CO was exceeded in a few cases in both countries. In general, levels of CO, CO2 and PM were higher in Romania. Further environmental and behavioural hazards such as indoor smoking, pets inside or lack of ventilation were found. The reported self-perceived quality of the indoor environment was poor in many aspects. CONCLUSIONS: Our findings of CO, CO2 and PM levels suggest that indoor air pollution in Roma settlements has the potential to be a health threat. The fact that the inhabitants spend a relatively long time inside the houses and that a number of additional environmental and behavioural hazards were identified by our study emphasizes the importance of the indoor air quality for health and thus priority attention should be paid to these issues by health authorities and researchers. Further research is essential and study designs must consider cultural background and specific characteristics of the community, especially in order to obtain valid data on health outcomes.

• MeSH
• Housing statistics & numerical data   MeSH
• Ethnicity * MeSH
• Risk Assessment MeSH
• Air Pollutants analysis   MeSH
• Humans MeSH
• Environmental Monitoring MeSH
• Carbon Monoxide analysis   MeSH
• Carbon Dioxide analysis   MeSH
• Particulate Matter analysis   MeSH
• Seasons MeSH
• Temperature MeSH
• Humidity MeSH
• Environmental Exposure statistics & numerical data   MeSH
• Health Status MeSH
• Air Pollution, Indoor analysis   statistics & numerical data   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH
• Research Support, N.I.H., Extramural MeSH
• Geographicals
• Romania MeSH
• Slovakia MeSH
• Names of Substances
• Air Pollutants MeSH
• Carbon Monoxide MeSH
• Carbon Dioxide MeSH
• Particulate Matter MeSH