The health of segregated Roma: first-line views and practices: a case study in Slovakia using ethnographic methods

This thesis assesses the views and practices first of segregated Roma, i.e. Roma living in separated communities, and then of health system professionals in Slovakia regarding the poor health status of segregated Roma in the country. It aims to contribute to the understanding of the health inequalities between segregated Roma and the general populations in Central and Eastern Europe (CEE). Based on four ethnographic studies, the thesis offers novel insights regarding three kinds of pathways. First, it adds that some CEE segregated Roma develop themselves ethnically framed racialized ideologies against the culture of local “non-Roma” standards of life, including care. Such social norms then shape health-endangering exposures of these Roma within the segregated enclaves in various ways, which vary by the household’s social level. Second, the thesis adds that frequently provided substandard healthcare to segregated Roma can be sustained by a poor understanding of their conditions and practices, and not-aligned organizational features. This can in turn lead to the Roma using healthcare services less effectively and to further exacerbation of specific health problems in this group. Lastly, the thesis adds that both pathways can be driven by an omnipresence of a specific form of racism targeting Roma: antigypsyism. In sum, the thesis suggests that to better understand and tackle inequalities concerning Roma, more focus is needed on the specific exposure pathways that we identified and on the fundamental underlying role of racism. Simultaneously, it shows that use of ethnographic tools within such research can be productive.