International Journal of Public Health

, Volume 59, Issue 2, pp 271–277 | Cite as

Differences in health-related quality of life between Roma and non-Roma coronary heart disease patients: the role of hostility

  • Barbora SilarovaEmail author
  • Jitse P. van Dijk
  • Iveta Nagyova
  • Jaroslav Rosenberger
  • Sijmen A. Reijneveld
Original Article



The aim of this study was to assess differences in health-related quality of life (HRQoL) between Roma and non-Roma coronary heart disease (CHD) patients, and whether differences in hostility contribute to this association.


We examined 570 CHD patients (mean age 57.8, 28.1 % female) scheduled for coronary angiography, 88 (15.4 %) of whom were Roma. Hostility was measured using the 27-item Cook-Medley Scale and HRQoL using the Short-Form Health Survey 36, from which the mental and physical component summary (MCS, PCS) were calculated. The relationship between ethnicity, hostility and HRQoL was examined using regression analyses.


Roma ethnicity was associated with poorer MCS (B = −3.44; [95 % CI = −6.76; −0.13] and poorer PCS (B = −4.16; [95 % CI = −7.55; −0.78]) when controlled for age, gender and socioeconomic status. Adding hostility to the model weakened the strength of the association between Roma ethnicity and MCS (B = −1.87; [95 % CI = −5.08; 1.35]) but not between Roma ethnicity and PCS (B = −4.07; [95 % CI = −7.50; −0.64]).


Roma ethnicity is associated with poorer MCS and PCS. Hostility may mediate the association between Roma ethnicity and MCS. The poorer HRQoL of Roma CHD patients requires attention in both care and research, with special attention on the role of hostility.


Ethnic groups Roma Health-related quality of life Hostility Coronary heart disease 



The authors would like to thank the patients with cardiological problems who participated in this study and also Adriana Sudzinova MD, Helena Vargova MD, Antonia Halecka MD, Diana Matlakova, Eva Hackenberg and Zuzana Skodova PhD, for their substantial help in the data collection. This work was supported by the Slovak Research and Development Agency under contract No. APVV-20-038305 (20 %) and No. APVV-0220-10 (60 %). Furthermore, this work was partially supported by the Agency of the Slovak Ministry of the Education, Science, Research and Sport of the Slovak Republic for the Structural Funds of the EU under project No. ITMS: 26220120058 (20 %).

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Swiss School of Public Health 2013

Authors and Affiliations

  • Barbora Silarova
    • 1
    • 2
    Email author
  • Jitse P. van Dijk
    • 1
    • 3
  • Iveta Nagyova
    • 1
    • 2
  • Jaroslav Rosenberger
    • 1
    • 2
  • Sijmen A. Reijneveld
    • 3
  1. 1.Faculty of Medicine, Graduate School Kosice Institute for Society and HealthSafarik UniversityKosiceSlovak Republic
  2. 2.Department of Social Medicine, Faculty of Medicine, Institute of Public HealthSafarik UniversityKosiceSlovak Republic
  3. 3.Department of Community and Occupational HealthUniversity Medical Center Groningen, University of GroningenGroningenThe Netherlands

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