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Are barriers in accessing health services in the Roma population associated with worse health status among Roma?



The health of Roma has been found to be poorer than that of the majority population. The aim of this study was to explore the differences between Roma and non-Roma regarding perceived barriers in accessing health services. Furthermore, we aimed to assess the association between self-rated health status and Roma ethnicity and explore to what degree barriers in accessing health services explain this association.


We used data from the cross-sectional HepaMeta study conducted in 2011 in Slovakia. The final sample comprised 452 Roma (mean age 34.7; 35.2 % men) and 403 (mean age 33.5; 45.9 % men) non-Roma respondents.


Roma ethnicity was found to be significantly associated with poorer self-rated health status. A considerable part of this association can be explained by barriers in accessing health services as perceived by Roma.


Worse health in Roma is partially mediated by worse access to health services, apart from a large educational gap between Roma living in settlements and the majority population. Interventions should focus not only on health literacy among Roma but also on the health care system and health care professionals.

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This project was partially supported by Roche Slovensko, s.r.o., and the Agency of the Slovak Ministry of Education for the Structural Funds of the EU, under project ITMS: 26220120058 (40 %).

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Corresponding author

Correspondence to Pavol Jarcuska.

Additional information

Members of HEPA-META team are given in Appendix



HEPA-META team: Jarčuška Peter, Pella Daniel, Mareková Mária, Siegfried Leonard, Pastvová Lýdia, Fedačko Ján, Kollárová Jana, Dražilová Sylvia, Rosenberger Jaroslava, Schréter Ivan, Kristián Pavol, Veseliny Eduard, Janičko Martin, Virág Ladislav, Birková Anna, Kmeťová Marta, Halánová Monika, Cáriková Katarína, Petrášová Darina, Lovayová Viera, Merkovská Lucia, Jedličková Lucia, Valková Ivana. * Safarik University, Trieda SNP 1, 040 01, Kosice, Slovak Republic.

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Jarcuska, P., Bobakova, D., Uhrin, J. et al. Are barriers in accessing health services in the Roma population associated with worse health status among Roma?. Int J Public Health 58, 427–434 (2013).

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  • Roma
  • Ethnicity
  • Self-rated health
  • Access to health services
  • Health inequalities
  • Slovakia