Roma Health:An Overview of Communicable Diseases in Eastern and Central Europe

The Roma are Europe's largest minority. They are also one of its most disadvantaged, with low levels of education and health and high levels of poverty. Research on Roma health often reveals higher burdens of disease in the communities studied. This paper aims to review the literature on communicable diseases among Roma across Eastern and Central Europe. A PubMed search was carried out for communicable diseases among Roma in these parts of Europe, specifically in Romania, Bulgaria, Hungary, Serbia, Slovakia, the Czech Republic and North Macedonia. The papers were then screened for relevance and utility. Nineteen papers were selected for review; most of them from Slovakia. Roma continue to have a higher prevalence of communicable diseases and are at higher risk of infection than the majority populations of the countries they live in. Roma children in particular have a particularly high prevalence of parasitic disease. However, these differences in disease prevalence are not present across all diseases and all populations. For example, when Roma are compared to non-Roma living in close proximity to them, these differences are often no longer significant

Jehovah's Witnesses and Their Compliance with Regulations on Smoking and Blood Treatment

Jehovah’s Witnesses (JWs) are known as a religious group compliant with the national laws in the case of smoking, but not-compliant when it comes to blood treatment. Their beliefs prevent them from taking part in a blood transfusion, which is widely included in standard methods of a life-saving treatment. The aim of this study was to compare the behavior of JWs regarding their approach to blood treatment and to smoking in relation to legal regulations in the field of health. We measured JWs’ compliance with health laws regarding blood treatment and smoking (the Framework Convention on Tobacco Control—FCTC). We used the concept of a semi-autonomous social field by Moore and the theory of planned behavior developed by Ajzen. Our findings show that in the case of JWs, the group rules often prevail over state rules contained in generally-binding legislation. In the case of smoking, this means that they seem compliant to the FCTC and to their group rules. In the case of blood treatment, it seems that they are breaking the national rules, because of their group rules. Breaking the latter can result in exclusion from the JWs community. JWs are compliant with national laws as long as these are congruent with their own group rules. If this is not the case, the group influence is very strong and the fear of exclusion from the JW group is often greater than the potential negative health consequences in real life

The Framework Convention on Tobacco Control in Slovakia and in Finland:one law, two different practices?

Background The Framework Convention on Tobacco Control (FCTC) was ratified in 2004 in Slovakia and in 2005 in Finland. The aim of this study was to compare the implementation of the FCTC in the national laws and policies regarding smoking in Finland and Slovakia. Methods In this case study the following areas are compared: the legal framework; the monitoring system and health promotion; treatment; and policies aimed at reducing tobacco consumption. We report on these in this order after a short historical introduction. Results The legal frameworks are similar in Slovakia and in Finland. Finland far exceeds the minimum legal requirements. Slovakian regulations reflect the FCTC requirements; however, social tolerance is very high. In Finland the monitoring system and health promotion are aimed more at tobacco consumption. Slovakia does not follow the surveillance plans recommended by WHO so strictly; often there are no current data available. No additional documents regarding the FCTC have been adopted in Slovakia. The financial contribution to treatment is very low. Slovakian tobacco control policy is more focused on repression than on prevention, in contrast to Finland. Smoking bans meet European standards. Excise duties rise regularly in both countries. Conclusion Implementation of the FCTC is at different levels in the compared countries. Finland has a clear plan for achieving the goal of a smoking-free country. Slovakia meets only the minimum standard required for fulfillment of its international obligations. Its policy should become more transparent by making more up-to-date data available

Compliance with the Framework Convention on Tobacco Control in Slovakia and in Finland:Two Different Worlds

The Framework Convention on Tobacco Control (FCTC) developed by the State Parties to the World Health Organization was ratified in Slovakia in 2004 and in Finland in 2005. The aim of this study was to explore and compare compliance with the FCTC in Finland and Slovakia. This is a two-country comparative study of tobacco control policy based on implementation of the FCTC in Slovakia and Finland. Compliance with the FCTC was measured similarly in Slovakia and Finland in terms of their institutional structure supporting a smoking free environment and implementation of selected articles of the FCTC. In Finland the responsibilities for anti-tobacco policy are clearly assigned. Slovakia does not have specifically responsible institutions. Finland has a clear plan for achieving the goal of a smoking-free country based on empirical evidence. Slovakia meets only the minimum standard resulting from its commitment as ratified in the FCTC and data are out of date or missing completely

To Comply or Not to Comply:Roma Approach to Health Laws

According to the general public in Slovakia, compliance with the law is problematic when it comes to Roma and health. Roma compliance with laws has not yet been studied. The aim of this is study was to explore the determinants of Roma behavior in the field of health laws. We used the concept of a semi-autonomous field proposed by Moore (1973) and the theory of planned behavior by Ajzen (1985). We found that Roma (non-)compliance with health laws was influenced by many different factors, such as beliefs, traditions, living conditions and culture. Group beliefs overrule national laws and also individual preferences, which tend to be subordinate to the group view. The less contact Roma from settlements have with non-Roma, the stronger their own rules are in the field of health. Roma health status is influenced by many factors: group beliefs and community traditions are stronger and overrule individual and state behavioral influence. A community-based participatory approach together with improvement of living conditions in cooperation with Roma is desirable

Aspects of Illness and Death among Roma-Have They Changed after More than Two Hundred Years?

Augustini studied Roma and published reports in 1775-1776 on their illnesses and death. Our intention was to compare the features of these two topics described by him in the late 18th century with those in the present time. We studied Augustini's work on illnesses and death in the past. The present qualitative study was conducted in 2012-2013 in the same geographical area in which Augustini lived and worked more than two hundred years ago, i.e., the Tatra Region in Slovakia; our findings were evaluated in 2017-2018. We carried out semi-structured interviews with more than 70 informants and organised two sessions of focus groups. Data were analysed using content analysis (Augustini) and an open coding process. Our findings suggest that illnesses in Roma are treated differently nowadays compared with 1775-1776. For example, the traditional forms of healing have completely disappeared in the area of investigation. We did not observe any differences in dying and death perceptions between the past and nowadays. Although data and knowledge on health disparities and related mechanisms exist, and much more about perceptions of Roma regarding illnesses is now known compared with 1775-1776, so far, this knowledge has not helped to design effective interventions to overcome them. Substandard living conditions in marginalised Roma communities have not significantly improved since 1775-1776, which may contribute to their higher morbidity and mortality also nowadays. Political and social consensus should lead to a comprehensive vision for enhancing the social situation and living conditions in segregated settlements, especially providing housing for the poorest classes and overcoming health disparities

Vaccine refusal in the czech republic is associated with being spiritual but not religiously affiliated

A strong reduction in the deleterious effects of the COVID-19 pandemic can be achieved by vaccination. Religiosity and spirituality (R/S) may play an important role in vaccine acceptance. However, evidence is lacking for the associations with religious conspiracy theories (RCT) in a non-religious environment. This study investigated the associations between R/S and RCT about COVID-19 vaccination and the links of R/S with vaccine refusal and hesitancy. A sample of Czech adults (n = 459) participated in the survey. We measured R/S, RCT, religious fundamentalism, and COVID-19 vaccination intentions. We found spirituality to be significantly associated with RCT belief, with odds ratios (OR) of 2.12 (95% confidence interval [CI] 1.42–3.19). A combination of R/S groups revealed that spirituality with non-religious affiliation was associated with higher beliefs in RCT, with ORs from 3.51 to 7.17. Moreover, associations were found between spirituality with non-religious affiliation [OR 2.22(1.33–7.76)] with vaccine refusal. Our findings showed associations of spirituality and religious fundamentalism with RCT about COVID-19 vaccination. Furthermore, spirituality was linked to a higher possibility of vaccine refusal. Understanding these associations may help prevent the development of RCT and negative impact of spirituality on vaccine intentions and contribute to the effectiveness of the vaccination process

The Coronavirus Pandemic and the Occurrence of Psychosomatic Symptoms:Are They Related?

Most studies on the coronavirus pandemic focus on clinical aspects of the COVID-19 disease. However, less attention is paid to other health aspects of the pandemic. The aim of this study was to assess the relationship between the coronavirus pandemic (risk of infection by virus together with associated measures taken to combat it), and the occurrence of a wide range of psychosomatic symptoms and to explore if there is any factor that plays a role in this association. We collected data from a sample of Czech adults (n = 1431) and measured the occurrence of nine health complaints, respondents' experience during the pandemic and sociodemographic characteristics. The results showed associations between the coronavirus pandemic and increased psychosomatic symptoms and negative emotions. We further found higher risks of increased health complaints in younger people and women. It is also possible that there is higher risk of increased health complaints for respondents with secondary school education, students, and highly spiritual people, but this relationship has to be further investigated. In contrast, respondents with their highest achieved education level being secondary school graduation had a lower risk of increased frequency of stomach-ache. We also found that more negative emotions could increase the frequency of health complaints. Our findings suggest that the coronavirus pandemic and associated government measures could have a significant influence on the prevalence of health complaints and emotional state

Childhood Trauma and Experience in Close Relationships Are Associated with the God Image:Does Religiosity Make a Difference?

Religiosity and spirituality (R/S) and some of their specific aspects are associated with health. A negatively perceived relationship with God, which has adverse health outcomes, can be formed by human attachment both in childhood and adulthood. The aim of this study was to assess the associations of childhood trauma (CT) and experience in close relationships (ECR) with the God image in a secular environment by religiosity. A national representative sample of Czech adults (n = 1800, 51.1 +/- 17.2 years; 43.5% men) participated in a survey. We measured CT (Childhood Trauma Questionnaire), ECR (Experiences in Close Relationships-Revised Questionnaire), image of God (questions from the 2005 Baylor Survey) and religiosity. Our results showed associations of CT and ECR with God images. Respondents who experienced CT were less likely to describe God as loving, always present and forgiving. Religious respondents were less likely to report positive God images with odds ratios (ORs) from 0.78 (0.66-0.94) to 0.95 (0.91-0.99), nonreligious respondents reported negative God images with ORs from 1.03 (1.00-1.06) to 1.22 (1.08-1.37). We found CT and problems in close relationships in adulthood are associated with a less positive God image, especially in nonreligious people. Understanding these associations may help prevent detrimental health outcomes