25 Roma and Pro-Roma European and National level organisations join forces to ask for urgent policy actions to tackle Roma public health crisis
Europe is facing a Roma public health emergency: We, the undersigned organisations are extremely concerned about the alarming health situation of the Roma[1] in Europe and the lack of awareness and actions concerning their situation. It is unacceptable and unfair that, in too many cases, belonging to this ethnic minority results in poor physical and mental health. We are especially worried about the Roma in specific vulnerable situations such as Roma living with disabilities, young Roma, Roma children[2], women and their families, Roma elderly and Roma who are homeless or affected by chronic or infectious diseases. In the case of children, a lack of early years health services has a detrimental impact on their overall development in the long run, thus contributing to a widening of the health gap and a need for more expensive interventions later on.[3][4] As well as consideration of the social and environmental factors such as housing, employment and education which determine Roma health, urgent assessment and action is needed to assess discrimination, anti-gypsyism and the additional existing barriers preventing proper access by Roma to Healthcare.
Urgent policy actions are needed to tackle the Roma public health crisis! On the occasion of the 10th European Platform for Roma Inclusion taking place on 29-30 November in Brussels, and prior to the 2017 mid-term evaluation of the European Framework of National Roma Integration Strategies, we urgently call on all stakeholders, in the spirit of ‘Mutual Accountability,’ to consider the following Recommendations in the area of Roma Health:
- Primary and community health care services, including mental health services (access to national and European health insurance cards), must be distributed more equally and cost-efficiently in disadvantaged communities.
- The experience underpinning Roma health mediation to improve Roma population health is impressive and convincing. However, a careful assessment of the lessons learnt from its implementation is needed to identify the potential and limits of Roma health mediation, including lack of recognition by health providers and absence of systemic financing. It is essential to set standards of professional competence which are included in the national education structure qualifying these persons so that a mediator can be hired to work on an equal basis with other health actors and, lessons learnt should be searched from various countries.
- As well as improving accessibility of public health facilities, complementary and alternative solutions should be further explored (eg. Mobile health units, Community healthcare monitoring including for maternal health care, Medical Caravans for cancer screening, vaccination etc.).
- Health determinants of disadvantaged Roma affected by such constraints as access to services, or information and influence (e.g. social norms, discrimination) must be addressed.
- Proper monitoring and evaluation mechanisms concerning the health status of the Roma population should be in place. The conclusions which can be drawn from the existing data on Roma health should be identified, as well as which methodologies can be scaled up or sustained in the long term.
- The disconnection between European processes and the policies implemented at regional and local level should be addressed. The synergies between, and concrete results of, the European 2020 targets and the Pillar of Social Rights should be carefully assessed with regard to Roma integration.
- The lack of accurate information on Roma communities must be addressed to develop and implement effective and appropriate policies and services. Ethnicity should be included as a category in the collection of official data.
AMALIPE Center for Interethnic Dialogue and Tolerance – Bulgaria ● Association for Culture, Education and Communication (ACEC) – Slovakia ● AwenAmenca – Czech Republic ● European Roma Information Office (ERIO) ● Eurochild ● Eurodiaconia ● European Anti Poverty Network (EAPN) ● European Coalition for Vision (ECV) ● European Federation of National Organisations Working with the Homeless (FEANTSA) ● European Institute for Women’s Health (EIWH) ● European Patients Forum (EPF) ● European Public Health Alliance (EPHA) ● European Roma and Travellers Forum (ERTF) ● European Roma Grassroots Organisations Network (ERGO) ● International Step by Step Association (ISSA) and Romani Early Years Network (REYN) ● Mental Health Europe (MHE) ● National Roma Center (NRC) – Macedonia ● Organisation pour la Prévention de la Cécité (OPC) – France ● Partners Hungary Foundation ● Platform for Supporting Health of Disadvantaged Groups and Healthy Communities – Slovakia ● Roma Association Unga – Spain ● Roma Cultural Centre “O Del Amenca” (ODA) – Romania ● SASTIPEN – Romania ● Vision 2020 UK ● World Without Borders Association – Bulgaria
[1] The term “Roma” is used – similarly to other political documents of the European Parliament and the European Council – as an umbrella which includes groups of people who have more or less similar cultural characteristics, such as Sinti, Travellers, Kalé, Gens du voyage, etc. whether sedentary or not; around 80% of Roma are estimated to be sedentary (SEC(2010)400).
[2] Mental health disparities between Roma and non-Roma children in Romania and Bulgaria http://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-014-0297-5
[3] Mc Daid, D. (2011). Making the long-term economic case for investing in mental health to contribute to sustainability. European Union. http://ec.europa.eu/health/mental_health/docs/long_term_sustainability_en.pdf
[4] The case for investing in public health” (2014) World Health Organization, Regional office for Europe. http://www.euro.who.int/__data/assets/pdf_file/0009/278073/Case-Investing-Public-Health.pdf