Mortality, Health Status and Self-Perception of Health in Slovak Roma Communities

The impact of specific living conditions on the population of geographically and socially segregated Roma settlements in Eastern Slovakia is considerable. They are characterized by high unemployment, lower education, poor housing and sanitary conditions, a poor quality of life, which all affects significantly their higher mortality rates and worse health status. In this paper we try to approach the problem of adverse mortality conditions and health with a deeper demographic insight. The fundamental goal of the paper is to analyse mortality in the population from Roma settlements over the past two decades using complex demographic methods such as life tables, direct standardization with the objective of eliminating differences in the age structure, single and multi-dimensional decomposition of age, sex and causes of death. We also analyse mortality using the concept of avoidable mortality. The results obtained from Roma settlements confirmed significantly worse mortality rates for both sexes. In addition, it appears that the disparities between them and the majority population are growing over time. The primary reason is the higher mortality of the youngest children and persons at post-reproductive age. Basically, all main chapters of the causes of death shorten the life expectancy of persons from Roma settlements, but cardiovascular diseases have the greatest negative impact. Conclusions obtained from the avoidable mortality analysis point to problems related to the accessibility and quality of health care, as well as the lack of interest of population from Roma settlements in their own health, along with the need for more targeted prevention and screening campaigns in this environment. Although the answers of respondents from Roma settlements to their own health confirm the deteriorating quality of health, increasing morbidity and the degree of restriction of normal daily activities with increasing age, they also point to some problems associated with the use of this approach.