Journal of Immigrant and Minority Health

, Volume 19, Issue 6, pp 1304–1314 | Cite as

Vision and Hearing Health Inequities in the Roma population: A National Cross-Sectional Study in Spain

  • Sergio Latorre-ArteagaEmail author
  • Diana Gil-González
  • Carmen Vives-Cases
  • Daniel La Parra Casado
Original Paper


We analyzed vision and hearing health status in the Spanish Roma population compared with the general population and its influence on mental health and social participation. We conducted a Cross-sectional study on Roma population (n = 1.167) compared to general population in Spain (n = 21.007). We analyzed the use of optical and hearing aids, vision and hearing limitations and associations with mental health, diagnosed depression and social participation; through prevalence, odds ratio adjusted by age (AOR), Chi square independence test and contrast of proportions (p < 0.05). The Roma population are more likely to present vision limitations—far sight AOR = 3.76 (3.13–4.55), near sight AOR = 3.18 (2.33–4.35)-, hearing difficulties—AOR = 1.41 (1.15–1.72)-, and lower use of corrective aids than the general population. These findings were associated with poor mental health and lower social participation (p < 0.01). Vision and hearing limitations affect unequally in Spain. Addressing avoidable vision and hearing impairment among Roma population is needed to reduce health inequities.


Vision and hearing impairment Roma population Ethnicity Health inequities 



The authors give thanks for the financial support of the following institutions: Ministry of Economy and Competitiveness of Spain, FEDER Funds, (“National Health Survey to Roma Population 2013–2014”, Project Ref. PI12/00842), and Ministry of Health, Social Services and Equality of Spain, Carlos III Health Institute. We also wish to thank the interviewers and associations of the Roma community in Spain for participating in this study and José Fernandez Sáez for his technical support for the data analysis.

Compliance with Ethical Standards

Conflict of Interest

None declared.


  1. 1.
    Kósa Z, Széles G, Kardos L, Kósa K, Németh R, Országh S. A comparative health survey of the inhabitants of Roma settlements in Hungary. Am J Public Health. 2007;97:853–9.CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    La Parra D, Gil-González D, Jiménez A. Social exclusión processes and the health status of the Roma people in Spain. Gac Sanit. 2013;27:385–6.CrossRefPubMedGoogle Scholar
  3. 3.
    Cook B, Wayne GF, Valentine A, Lessios A, Yeh E. Revisiting the evidence on health and health care disparities among the Roma: a systematic review 2003–2012. Int J Public Health. 2013;58:885–911.CrossRefPubMedGoogle Scholar
  4. 4.
    Hassler S, Eklund L. Sense of coherence and self-reported health among Roma people in Sweden: a pilot study. Int J Circumpolar Health. 2012. doi: 10.3402/ijch.v71i0.18438.PubMedPubMedCentralGoogle Scholar
  5. 5.
    Janevic T, Jankovic J, Bradley E. Socioeconomic position, gender, and inequalities in self-rated health between Roma and non-Roma in Serbia. Int J Public Health. 2012;57(1):49–55.CrossRefPubMedGoogle Scholar
  6. 6.
    Parry G, Van Cleemput P, Peters J, Walters S, Thomas K, Cooper C. Health status of Gypsies and Travellers in England. J Epidemiol Community Health. 2007;61:198–204.CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Vozarova de Courten B, de Courten M, Hanson RL, Zahorakova A, Egyenes HP, Tataranni PA, et al. Higher prevalence of type 2 diabetes, metabolic syndrome and cardiovascular diseases in gypsies than in non-gypsies in Slovakia. Diabetes Res Clin Pract. 2003;62:95–103.CrossRefPubMedGoogle Scholar
  8. 8.
    World Health Organization (WHO). Universal Eye Health. A Global Action Plan. 2013. Accessed 24 Jan 2016.
  9. 9.
    Chou K-L. Combined effect of vision and hearing impairment on depression in older adults: evidence from the English Longitudinal Study of Ageing. J Affect Disord. 2008;106:191–6.CrossRefPubMedGoogle Scholar
  10. 10.
    Lopez D, McCaul KA, Hankey GJ, Norman PE, Almeida OP, Dobson AJ, et al. Falls, injuries from falls, health related quality of life and mortality in older adults with vision and hearing impairment—is there a gender difference? Maturitas. 2008;69:359–64.CrossRefGoogle Scholar
  11. 11.
    World Health Organization (WHO). World report on disability. 2011. Accessed 24 Jan 2015.
  12. 12.
    Scase MO, Johnson MRD. Visual impairment in ethnic minorities in the UK. Int Congr Ser. 2005;1282:438–42.CrossRefGoogle Scholar
  13. 13.
    Nelson D I, Nelson R Y, Concha-Barrientos M, Fingerhut M. The global burden of occupational noise-induced hearing loss. Am J Ind Med. 2005;48(6):446–458.CrossRefPubMedGoogle Scholar
  14. 14.
    Laparra M, Arza J, Fernández A, García A, Iturbide R, López de la Nieta M, Sánchez B. Diagnóstico Social de la Comunidad Gitana en España. Un análisis contrastado de la Encuesta del CIS a Hogares de Población Gitana 2007. Ministerio de Sanidad, Política Social e Igualdad 2011. Accessed 5 May 2015.
  15. 15.
    La Parra Casado D, Gil-González D, de la Torre Esteve M. The social class gradient in health in Spain and the health status of the Spanish Roma. Ethn Health. 2015;12:1–12.Google Scholar
  16. 16.
    Ministerio de Sanidad, Servicios Sociales e Igualdad. Estrategia Nacional para la Inclusión Social de la Población Gitana en España 2012–2020. 2012. Accessed 24 Jan 2016.
  17. 17.
    European Commission. An EU Framework for National Roma Integration Strategies up to 2020. Brussels 2011. Accessed 24 Jan 2016.
  18. 18.
    Fundación Secretariado Gitano. Mapa sobre vivienda y comunidad gitana en España. Madrid: Ministerio de Vivienda, Fundación Secretariado Gitano y D’Aleph; 2007. Accessed 24 Jan 2016.
  19. 19.
    La Parra Casado D. Hacia la equidad en salud: Estudio comparativo de las encuestas nacionales de salud a población gitana y población general de España, 2006. Madrid: Ministerio de Sanidad y Política Social, y Fundación Secretariado Gitano; 2009.Google Scholar
  20. 20.
    ENSE 2012. Instituto Nacional de Estadistica. Madrid: INE; 2013. Accessed 30 Jul 2016.
  21. 21.
    Lam BL, Lee DJ, Zheng DD, Davila EP, Christ SL, Arheart KL. Disparity in prevalence of self-reported visual impairment in older adults among U.S. race-ethnic subgroups. Ophthalmic Epidemiol. 2009;16:144–50.CrossRefPubMedPubMedCentralGoogle Scholar
  22. 22.
    Mansberger SL, Romero FC, Smith NH, Johnson CA, Cioffi GA, Edmunds B, Becker TM. Causes of visual impairment and common eye problems in Northwest American Indians and Alaska Natives. Am J Public Health. 2005;95(5):881–6.CrossRefPubMedPubMedCentralGoogle Scholar
  23. 23.
    Ying G, Maguire MG, Cyert LA, Ciner E, Quinn GE, Kulp MT, et al. Prevalence of vision disorders by racial and ethnic group among children participating in head start. Ophthalmology. 2014;121:630–6.CrossRefPubMedGoogle Scholar
  24. 24.
    Baker RS, Bazargan M, Bazargan-Hejazi S, Calderón JL. Access to vision care in an urban low-income multiethnic population. Ophthalmic Epidemiol. 2005;12:1–12.CrossRefPubMedGoogle Scholar
  25. 25.
    Cruickshanks KJ, Dhar S, Dinces E, Fifer RC, Gonzalez F, Heiss G, et al. Hearing impairment prevalence and associated risk factors in the hispanic community health study/study of Latinos. JAMA Otolaryngol Head Neck Surg. 2015;141(7):641–8.CrossRefPubMedPubMedCentralGoogle Scholar
  26. 26.
    Nieman CL, Marrone N, Szanton SL, Thorpe RJ Jr, Lin FR. Racial/ethnic and socioeconomic disparities in hearing health care among older Americans. J Aging Health. 2016;28(1):68–94.CrossRefPubMedGoogle Scholar
  27. 27.
    Pratt SR, Kuller L, Talbott EO, McHugh-Pemu K, Buhari AM, Xu X. Prevalence of hearing loss in Black and White elders: results of the Cardiovascular Health Study. J Speech Lang Hear Res. 2009;52(4):973–89.CrossRefPubMedPubMedCentralGoogle Scholar
  28. 28.
    Lin FR, Maas P, Chien W, Carey JP, Ferrucci L, Thorpe R. Association of skin color, race/ethnicity, and hearing loss among adults in the USA. J Assoc Res Otolaryngol. 2012;13:109–17.CrossRefPubMedGoogle Scholar
  29. 29.
    Genĉík A. Epidemiology and genetics of primary congenital glaucoma in Slovakia. Description of a form of primary congenital glaucoma in gypsies with autosomal-recessive inheritance and complete penetrance. Dev Ophthalmol. 1989;16:76–115.PubMedGoogle Scholar
  30. 30.
    Bobakova D, Dankulincova Veselska Z, Babinska I, Klein D, Madarasova Geckova A, Cislakova L, et al. Differences between Roma and non-Roma in how social support from family and friends helps to overcome health care accessibility problems. Int J Equity Health. 2015;14:37.CrossRefPubMedPubMedCentralGoogle Scholar
  31. 31.
    Van Ryn Michelle. Research on the provider contribution to race/ethnicity disparities in medical care. Med Care. 2002;40(1):I–140.CrossRefGoogle Scholar
  32. 32.
    Bourne RRA, Jonas JB, Flaxman SR, Keeffe J, Leasher J, Naidoo K, et al. Prevalence and causes of vision loss in high-income countries and in Eastern and Central Europe: 1990–2010. Br J Ophthalmol. 2014;98:629–38.CrossRefPubMedGoogle Scholar
  33. 33.
    Verbeek JH, Kateman E, Morata TC, Dreschler WA, Mischke C. Interventions to prevent occupational noise-induced hearing loss: a Cochrane systematic review. Int J Audiol. 2014;53:S84–S96.CrossRefPubMedPubMedCentralGoogle Scholar
  34. 34.
    López-Torres Hidalgo J, Gras CB, Lapeira JT, Verdejo MÁL, Del Campo JM, Rabadán FE. Functional status of elderly people with hearing loss. Arch Gerontol Geriatr. 2009;49:88–92.CrossRefPubMedGoogle Scholar
  35. 35.
    Mithen J, Aitken Z, Ziersch A, Kavanagh AM. Inequalities in social capital and health between people with and without disabilities. Soc Sci Med. 2015;126:26–35.CrossRefPubMedGoogle Scholar
  36. 36.
    Harada S, Nishiwaki Y, Michikawa T, Kikuchi Y, Iwasawa S, Nakano M, et al. Gender difference in the relationships between vision and hearing impairments and negative well-being. Prev Med. 2008;47:433–7.CrossRefPubMedGoogle Scholar
  37. 37.
    Vokó Z, Csépe P, Németh R, Kósa K, Kósa Z, Széles G, et al. Does socioeconomic status fully mediate the effect of ethnicity on the health of Roma people in Hungary? J Epidemiol Community Health. 2009;63:455–60.CrossRefPubMedGoogle Scholar
  38. 38.
    Krieger N. Discrimination and health inequities. Int J Health Serv. 2014;44:643–710.CrossRefPubMedGoogle Scholar
  39. 39.
    Krahn GL, Walker DK, Correa-De-Araujo. Persons with disabilities as an unrecognized health disparity population. Am J Public Health. 2015;105:198–206.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  1. 1.Public Health Research GroupUniversity of AlicanteAlicanteSpain
  2. 2.Universidade LurioNampulaMozambique
  3. 3.Department of Community Nursing, Preventive Medicine and Public Health and History of Science, Faculty of Health SciencesUniversity of AlicanteAlicanteSpain
  4. 4.CIBER Epidemiología y Salud Pública (CIBERESP)AlicanteSpain
  5. 5.Department of SociologyUniversity of AlicanteAlicanteSpain

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