Roma Ethnicity Research Articles

Facilitating equal access to primary care for all: work experiences of health mediators in a primary health care model programme in Hungary

BackgroundA Primary Care Model Programme was implemented in Hungary between 2013 and 2017 in order to increase access of disadvantaged population groups to primary care and to offer new preventive services for all clients. In a country with single-handed practices, four group practices or GP clusters were created in the Programme. Six GPs comprised one cluster who together employed nonmedical health professionals and nonprofessional health mediators, the latter recruited from the serviced communities, many of them of Roma ethnicity. Health mediators were tasked by improving access of the local communities – including its vulnerable Roma members – to existing and new services. Health mediators were interviewed about their work experiences, motivation, and overall opinion as members of the clusters as part of the Programme evaluation.MethodsAs part of the Programme evaluation, structured interviews were conducted with all 40 health mediators employed at the time in the Programme. Interviews were transcribed and content analysis was carried out.ResultsThree themes emerged from the transcripts. The first focused on the health mediators’ personal characteristics such as motivation to join the Programme, the way their job increased their self-esteem, social status and health consciousness. Domains of the second theme of their work included importance of on-the-job training and of their insider knowledge of local communities, as well as their pride to have become members of the primary care team. The third theme covered overall functioning of the Programme of which they had mostly positive opinions, notwithstanding some criticism regarding procurement.ConclusionsHealth mediators had earlier worked in various European countries specifically to improve access of Roma ethnic groups to health services but the Hungarian Model Programme was globally the first in which health mediators as non-professional workers became equal members of the primary care team as employees. Their contribution and overwhelmingly positive experiences, along with their useful insights for improvement call for the establishment and funding of health mediator positions in primary care especially in areas with large numbers of disadvantaged Roma populations.

Roma Ethnicity and Sex-Specific Associations of Serum Uric Acid with Cardiometabolic and Hepatorenal Health Factors in Eastern Slovakian Population: The HepaMeta Study.

Background: Health characteristics associated with uric acid (UA) in the Roma minority remain less well known. The study sought to determine the ethnicity- and sex-specific associations of serum UA with health factors in Eastern Slovakian Roma and non-Roma populations. Methods: Data from the comparative cross-sectional HepaMeta study conducted in Slovakia in 2011 were used. The study enrolled 452 Roma subjects (35.2% men) and 403 non-Roma individuals (45.9% men) aged 18–55 years. Results: All study parameters differed between the sexes in both the Roma and non-Roma participants (p < 0.05). UA was related to sex with odds ratio for female sex 0.873, 95% CI 0.853–0.893 (p < 0.0001) per 10-unit increase of UA. Average level of UA ± standard deviation was lower in Roma than in non-Roma (226.54 ± 79.8 vs. 259.11 ± 84.53 umol/L; p < 0.0001). The Roma population presented with greater levels of high-sensitivity C-reactive protein (hsCRP) (3.07 ± 4 mg/L vs. 1.98 ± 2.83 mg/L; p < 0.0001) and ferritin in Roma males (403.78 ± 391.84 vs. 302.67 ± 236.26 mg/L; p < 0.0001). Conclusions: Serum UA is sex- and ethnicity specific. Elevated levels of hsCRP and ferritin particularly in Roma males can reflect low-grade systemic inflammation and thus serve as a marker of an increased cardiovascular risk.

Dietary Profile and Nutritional Status of the Roma Population Living in Segregated Colonies in Northeast Hungary.

Nutrition studies among Roma are scarce and to date no quantified dietary data are available. This report provides, for the first time, quantified dietary data and comprehensive anthropometric information for the Hungarian Roma (HR) population, with Hungarian general (HG) adults as reference. Data were obtained from a complex comparative health survey, involving 387 and 410 subjects of HR and HG populations, respectively. Using corporal measurements, body composition indicators were constructed, while daily nutrient intakes were evaluated in comparison with internationally accepted guidelines on nutrient requirements and recommended intakes. Associations between Roma ethnicity and nutrient intakes, as well as odds of achieving dietary recommendations were explored using regression models, adjusted for relevant covariates (i.e., age, gender, education, marital status and perceived financial status). Results showed occasional differences for selected nutrient intakes between the groups, with HR’s intake being less favorable. Total fat intake, predominantly animal-sourced, exceeded recommendations among HR (36.1 g, 95% confidence interval (CI): 35.2–37.0) and was not dissimilar to HG group (37.1 g, 95% CI: 36.3–38.0). Sodium intake among HR was significantly lower (5094.4 mg, 95% CI: 4866.0–5322.8) compared to HG (5644.0 mg, 95% CI: 5351.9–5936.0), but significantly greater than recommended intake in both groups. HR had greater estimated body fatness (25.6–35.1%) and higher average body mass index (BMI, 27.7 kg/m2, 95% CI: 26.9–28.4), compared to HG. In addition, HR had lower odds of achieving dietary recommendations (odds ratio (OR) = 0.81, 95% CI: 0.67–0.97, p < 0.05). Findings warrant further research, while highlighting the importance of establishing and integrating Roma nutrition into national surveillance and monitoring systems for key dietary risk factors.

External classification for ethnicity in health survey to monitor Roma vs non-Roma differences

Abstract Background The Roma population of European countries is characterized by a poor and poorly described health status. The lack of detailed data on health loss among Roma can be partly attributed to legal limitations based lack of reliable methodology to effectively identify them. On the other hand, it is among factors responsible for restricted effectiveness of policy to narrow gap between Roma and non-Roma health status. Objectives We aimed to compare directly results from population based health survey on Roma vs non-Roma differences based on self-declared and observer-reported Roma classification. Methods In a population based health interview survey of random sample of 1849 subjects aged 18-64 years representing 965680 adults, both self-reporting and observer-reporting on Roma was applied. Data collection covered 52 indicators of morbidity, functional loss, health behavior, social capital, and use of health services. Health status differences between the self-declared Roma (N = 124) and the non-Roma (N = 1725) as well as the observer-reported Roma (N = 179) and non-Roma populations (N = 1670) were described by logistic regression models controlled for age, sex, education and employment. Results There was no significant Roma vs non-Roma difference in the respect of 33 indicators, and 14 indicators showed significant difference by both Roma definitions. Differences between the observer- and self-reported Roma ethnicity in statistical inference were observed for 7 indicators. In ascertaining significant Roma vs non-Roma difference, self-reporting was more effective for 2, and observer-reporting was for 5 indicators. Conclusions The application of observer-reported ethnicity classification cannot increase the practical value of health survey on Roma to non-Roma differences, compared to the self-reporting based approach. Therefore, the use of observer-reported Roma ethnicity in health surveys to improve the reliability of Roma specific indicators seems to be not justified. Key messages Application of external classification for ethnicity cannot increase the effectiveness of population based health interview survey in monitoring Roma vs non-Roma differences. The use of observer-reported Roma ethnicity in health surveys to improve the reliability of Roma specific indicators seems to be not justified.

P292 Inflammatory bowel disease and their implications in Roma ethnicity: A preliminary study

Abstract Background The pathogenesis of inflammatory bowel disease (IBD) is multifactorial and many factors have been involved such as genetic or environmental elements. The characteristics of IBD in different ethnic groups have been investigated to clarify the North-South gradient. We considered that Roma patients seem to have a more aggressive disease than Caucasian patients but no data to support this feeling is published. For this reason, the aim of our study is to analyse clinical characteristics of our cohort of IBD patients comparing Roma and Caucasian ethnicity Methods A retrospective cohort study was realised in both IBD Units to compare Roma and Caucasian groups. IBD patients were identified in the outpatient clinic. Demographical, clinical characteristics, pharmaceutical requirements and surgeries were collected. This group was matched by age, gender, disease and location of IBD with Caucasian patients. Results 24 Roma patients were identified in our cohort. The prevalence of Gypsy ethnic group in our cohort was 1.66%. A percentage of 41.67% were men (n = 10) meanwhile 58.33% (n = 14) were women. The average age of the patients of our cohort was 43.77 years (SD 12.82). Crohn’s disease (CD) was observed in 62.5% (n = 15), ulcerative colitis (UC) in 29.19% (n = 7) and Unclassified IBD in 8.33% (n = 2). A statistic significant difference in family history was observed in the group of Roma patients (50%, n = 12 vs. 8.34%, n = 2) (p =0.001). Regarding to therapy, the Roma group required biological treatment in 58,32% (n = 14) compare to a percentage of 25% (n = 6) (p = 0.019) in the Caucasian group. We also found more hospital admissions (5.18 (SD 4,33) vs. 2,5 (SD 1,93) (p = 0,04)) and surgical procedures (41.66%, n = 10 vs. 12.5%, n = 3) (p = 0,023). Conclusion In our cohort, the Roma IBD patients showed more familial aggregation than the Caucasian group. An aggressive disease was also found in Roma patients and the subsequent increase in biological therapy, hospital admissions and surgical procedures to control the disease. Future studies should be performing to investigate genetic or environmental factors associated with this ethnic group.

'Differences between the earth and the sky': migrant parents' experiences of child health services for pre-school children in the UK.

To explore parents' experiences of using child health services for their pre-school children post-migration. Migrating between countries necessitates movement and adjustment between systems of healthcare. Children of migrants are known to have poorer health than local children on some measures and are less likely to access primary care. In the United Kingdom (UK), children are offered a preventive Healthy Child programme in addition to reactive services; this programme consists of health reviews and immunisations with some contacts delivered in the home by public health nurses. Five focus groups were held in a city in South West England. Participants were parents of pre-school children (n = 28) who had migrated to the UK from Romania, Poland, Pakistan or Somalia within the last 10 years. Groups selected included both 'new migrants' (from countries which acceded to the European Union in the 2000s) and those from communities long-established in the UK (Somali and Pakistani). One focus group consisted of parents of Roma ethnicity. Interpreters co-facilitated focus groups. Participants described profound differences between child health services in the UK and in their country of origin, with the extent of difference varying according to nationality and ethnic group. All appreciated services free at the point of delivery and an equitable service offered to all children. Primary care services such as treatment of minor illness and immunisation were familiar, but most parents expected doctors rather than nurses to deliver these. Proactive child health promotion was unfamiliar, and some perceived this service as intruding on parental autonomy. Migrants are not a homogenous group, but there are commonalities in migrant parents' experiences of UK child health services. When adjusting to a new healthcare system, migrants negotiate differences in service provision and also a changing relationship between family and state.

Mureş County Women’s Behaviour Associated with Pregnancy Risk Factors

Abstract The main objective was to identify pregnancy risk factors arising from the behaviour and lifestyle of Mureş county women during pregnancy. The postpartum women monitored in this study were from Mureş county and were interviewed by applying a questionnaire during the period they were in the hospital for postnatal care immediately after birth. The questions aimed at identifying prenatal risk factors and the unhealthy behaviour of women before and during pregnancy, referring to the socio-economic and cultural status (low family income or unemployment, less than high school studies, rural background and marital status), obesity during pregnancy, alcohol consumption, coffee consumption, no physical activity. We identified, among the three major ethnicities in Mureş county (Romanian, Hungarian, Roma), the behaviour and lifestyle components with risk in pregnancy and after comparing profiles of these groups we identified the Roma ethnicity as being at the highest perinatal risk.

Mobile clinic approach towards hard-to-reach populations’ health in Roman suburban settings

Abstract Among other vulnerable populations, Sinti and Roma ethnicity people are the ones more likely living in precarious housing conditions such as settlements, especially in Roman suburban and deprived neighbourhood. These hard-to-reach communities usually present poor health outcomes and reduced life expectancy. Since 2016, the project Nontiscordardimé (a partnership of Bambino Gesù Children’s Hospital, OSA Health Workers Cooperative and Vicariatus Urbis) provided 3 outreach per week in two different peripheral settings ensuring to children specialized visits, nutritional screening, growth monitoring and vaccinations by means of a mobile clinic. When necessary, second level examinations have been arranged in the hospital. Personal data, detected pathologies and services provided have been collected from January 2016 to December 2018. Main diseases detected during 2.226 examinations in Gipsy settlements were respiratory infection (26,3%), skin infection and parasitosis (13.3.%). Moreover 7,5% of visited children had malnutrition and 3,4 % presented oral hygiene related issues. Only 40% of planned second level examination and only 51% of planned hospital admission have been carried out. During outreach in parishes of suburban areas, 1.411 examinations have been performed, encountering mostly respiratory disease (30%), asthmatic bronchitis (8%), dermatitis (5,8%) and allergic rhinitis (3,8%). Adherence to hospital examination and admission reach respectively 72% and 85%. Poor housing, isolation and overcrowding are significant barriers to prevention and health care even if the national health system provides universal coverage, and free care. Indeed disease prevalence in gipsy settlements was mainly related to socio-economical and housing condition (poor hygiene, overcrowding) whereas others peripheral urban setting, even when deprived, showed an epidemiological framework close to the general population where asthmatic and allergic disorders are prevalent. Key messages Mobile clinics can close the gap between health services and disadvantaged children and hard-to-reach populations. Outreach can be a mean of promotion, prevention and health services inclusion.

Prevalence of Chronic Diseases and Activity-Limiting Disability among Roma and Non-Roma People: A Cross-Sectional, Census-Based Investigation.

The lack of recommended design for Roma health-monitoring hinders the interventions to improve the health status of this ethnic minority. We aim to describe the riskiness of Roma ethnicity using census-derived data and to demonstrate the value of census for monitoring the Roma to non-Roma gap. This study investigated the self-declared occurrence of at least one chronic disease and the existence of activity limitations among subjects with chronic disease by the database of the 2011 Hungarian Census. Risks were assessed by odds ratios (OR) and 95% confidence intervals (95% CI) from logistic regression analyses controlled for sociodemographic factors. Roma ethnicity is a risk factor for chronic diseases (OR = 1.17; 95% CI: 1.16–1.18) and for activity limitation in everyday life activities (OR = 1.20; 95% CI: 1.17–1.23), learning-working (OR = 1.24; 95% CI: 1.21–1.27), family life (OR = 1.22; 95% CI: 1.16–1.28), and transport (OR = 1.03; 95% CI: 1.01–1.06). The population-level impact of Roma ethnicity was 0.39% (95% CI: 0.37–0.41) for chronic diseases and varied between 0 and 1.19% for activity limitations. Our investigations demonstrated that (1) the Roma ethnicity is a distinct risk factor with significant population level impact for chronic disease occurrence accompanied with prognosis worsening influence, and that (2) the census can improve the Roma health-monitoring system, primarily by assessing the population level impact.

Behavioural challenges of minorities: Social identity and role models.

We present a lab-in-the-field experiment and surveys of marginalised Roma children in Slovakia to examine whether reminding Roma of their ethnicity reduces their performance in a cognitive task. Research on social identity and stereotypes has documented that when individuals feel that their social group is negatively stereotyped in a domain, their performance declines, which can reinforce discrimination. In an effort to break the cycle of negative stereotypes, we remind Roma subjects of either Roma or non-Roma role models. We find that the activation of a Roma’s ethnicity reduces cognitive performance. In contrast, Roma exposed to Roma role models outperform those reminded of their ethnicity and of non-Roma role models. We then attempt to understand the channels through which social identity and role models affect performance. We show that priming the identity of a Roma has a direct effect on confidence, decreasing performance.

Revealing the Genetic Impact of the Ottoman Occupation on Ethnic Groups of East-Central Europe and on the Roma Population of the Area.

History of East-Central Europe has been intertwined with the history of Turks in the past. A significant part of this region of Europe has been fallen under Ottoman control during the 150 years of Ottoman occupation in the 16–17th centuries. The presence of the Ottoman Empire affected this area not only culturally but also demographically. The Romani people, the largest ethnic minority of the East-Central European area, share an even more eventful past with Turkish people from the time of their migration throughout Eurasia and they were a notable ethnic group in East-Central Europe in the Ottoman era already. The relationship of Turks with East-Central European ethnic groups and with regional Roma ethnicity was investigated based on genome-wide autosomal single nucleotide polymorphism data. Population structure analysis, ancestry estimation, various formal tests of admixture and DNA segment analyses were carried out in order to shed light to the conclusion of these events on a genome-wide basis. Analyses show that the Ottoman occupation of Europe left detectable impact in the affected East-Central European area and shaped the ancestry of the Romani people as well. We estimate that the investigated European populations have an average identity-by-descent share of 0.61 with Turks, which is notable, compared to other European populations living in West and North Europe far from the affected area, and compared to the share of Sardinians, living isolated from these events. Admixture of Roma and Turks during the Ottoman rule show also high extent.

Why the “real” numbers on Roma are fictitious: Revisiting practices of ethnic quantification

This article scrutinizes the administrative and scientific practices by which the Gypsy/Roma category has been historically constructed in Europe, particularly in Central and South Eastern Europe. Censuses, police-led inquiries, social surveys and expert estimates made the ‘Roma’ category appear objective, making invisible the multiple technical and political decisions behind their interpretations. This paper examines the technologies behind the production of ethnic categories and that of Roma in particular: namely, guidelines and manuals for field workers, recruitment and census campaigns, consent forms, questionnaires, data processing, basic assumptions and interpretation of data. While expert networks give objectivity and flexibility to the collection and circulation of data, the labour involved in crafting ethnic statistics often remains obscure. This paper follows the historical departures and continuities of Roma categorization from the 18th century to present times. The category ‘Roma’ was produced and reproduced through quantification practices with the justification that ethnic data (or categorization) would help solve social problems and contribute to Roma integration. The technical literature reviewed in this paper and the auto-ethnographic analysis shed light on the machinery of ethnic categorization, and allows us to assess the impact of various kinds of labour upon this categorization: from the more visible work performed by ethnopolitical entrepreneurs and scholars – to the relatively invisible contributions of field workers, administrators and census takers. This article calls for a critical scrutiny of how Roma ethnicity is crafted through practices of ethnic quantification and encourages researchers to use methodological prudence and more self-reflection in their own academic practices.

Physical Activity as a Chance for Roma Children Living in Unfavorable Conditions // Fizička aktivnost kao šansa za romsku decu u nepovoljnim životnim uslovima

Until now no larger child sample of exclusively Roma ethnicity has been investigated concerning their basic somatic and motor performance attributes. The aim of the present comparison of Roma and non-Roma prepubertal and pubertal boys was to analyse if there were differences in some anthropometric measures and running performance to see if Roma children fall behind their non-Roma peers in growth and development, and if so, to what extent. Kinanthropometric data collection was carried out in 184 volunteer Roma boys aged 6.51 and 14.50 years. For a control group, exactly the same number of non-Roma subjects was selected randomly from each age group of the same region - Kanjiza and Novi Knezevac.

Generalizability and applicability of results obtained from populations of European descent regarding the effect direction and size of HDL-C level-associated genetic variants to the Hungarian general and Roma populations

ObjectivesLarge-scale association studies that mainly involve European populations identified many genetic loci related to high-density lipoprotein cholesterol (HDL-C) levels, one of the most important indicators of the risk for cardiovascular diseases. The question with intense speculation of whether the effect estimates obtained from European populations for different HDL-C level-related SNPs are applicable to the Roma ethnicity, the largest minority group in Europe with a South Asian origin, was addressed in the present study. DesignThe associations between 21 SNPs (in the genes LIPC(G), CETP, GALNT2, HMGCP, ABCA1, KCTD10 and WWOX) and HDL-C levels were examined separately in adults of the Hungarian general (N = 1542) and Roma (N = 646) populations by linear regression. Individual effects (direction and size) of single SNPs on HDL-C levels were computed and compared between the study groups and with data published in the literature. ResultsSignificant associations between SNPs and HDL-C levels were more frequently found in general subjects than in Roma subjects (11 SNPs in general vs. 4 SNPs in Roma). The CETP gene variants rs1532624, rs708272 and rs7499892 consistently showed significant associations with HDL-C levels across the study groups (p ˂ 0.05), indicating a possible causal variant(s) in this region.Although nominally significant differences in effect size were found for three SNPs (rs693 in gene APOB, rs9989419 in gene CETP, and rs2548861 in gene WWOX) by comparing the general and Roma populations, most of these SNPs did not have a significant effect on HDL-C levels.The β coefficients for SNPs in the Roma population were found to be identical both in direction and magnitude to the effect obtained previously in large-scale studies on European populations. ConclusionsThe effect of the vast majority of the SNPs on HDL-C levels could be replicated in the Hungarian general and Roma populations, which indicates that the effect size measurements obtained from the literature can be used for risk estimation for both populations.

Prevalence and Risk Factors for Hepatitis B Virus Infection in Roma and Non-Roma People in Slovakia.

Prevalence of Hepatitis B is relatively low in developed European countries. However specific subpopulations may exist within each country with markedly different Hepatitis B burden. Roma minority is very numerous in Slovakia and their lifestyle is completely different to non-Roma population. The aim of this study is to map Hepatitis B prevalence in Roma and compare it to non-Roma population and to explore potential socio-economic and health related risk factors. Cross-sectional epidemiology study was performed in Slovakia that included randomly sampled Roma population and geographically corresponding random sampled non-Roma population. Comprehensive questionnaire about risk factors was administered and blood samples were drawn for Hepatitis B serology and virology tests. Altogether 855 participants were included. Global Hepatitis B surface Antigen (HBsAg) positivity rate was 7.7% (i.e., active Hepatitis B) and anti Hepatitis B core IgG antibody (antiHBcIgG) positivity rate was 34.6%. Roma population had significantly higher prevalence of Hepatitis B, both active chronic infection (12.4%; 95% Confidence Interval (CI) 9.58%–15.97% versus 2.8%; 95% CI 1.56%–4.91%; p < 0.0001) and antiHBcIgG positivity (52.8%; 95% CI 48.17%–57.44% versus 25.9%; 95% CI 12.56%–20.02%; p < 0.0001) Main risk factors for HBsAg positivity were Roma ethnicity, male sex and tattoo. Conclusion: There is a very high prevalence of Hepatitis B in Roma communities in Slovakia, with potential for grave medical consequences.

Bullies and Victims in Primary Schools

This study examines the associations between four types of peer-reported bullying and peer-reported victimization (mocking, physical bullying, negative gossip, cyberbullying), and students’ ethnicity and academic achievement among sixth-grade Hungarian primary school students. For data analysis, multilevel regression models are used. Based on the analysis of 27 classes, it was found that students’ self-declared ethnicity is not significantly related to bullying and victimization among students with higher socio-economic status. In some models, however, a significant interaction term between ethnicity and low socio-economic status has been found, showing that among low status students, Roma ethnicity is more strongly associated with bullying and victimization than among high status students. Furthermore, there is no sign of the acting white phenomenon among the students in the study in general and among the Roma students in particular. In contrast, students having higher grades are less likely to be nominated as victims of any form of bullying except for mocking.

Risk factors for multiple suicide attempts among Roma in Hungary.

In recent years, suicide rates in Hungary have been among the highest in the European Union. Attempted suicide rates in the Roma population are 2-3 times higher than in the non-Roma population. Since individuals making multiple attempts have a higher pro-bability of eventual death by suicide, and there are limited data on suicidal behaviour of the Roma population, the aim of this study was to explore the sociodemographic and psychological background factors of multiple suicide attempts in the Hungarian Roma population. Semistructured interviews were conducted with 150 individuals admitted to hospital toxicology departments, who made suicide attempts by deliberate self-poisoning, 65 of whom were multiple attempters. Detailed information regarding the current attempt and previous suicidal acts was recorded. Patients also completed the Shortened Beck Depression, the Beck Hopelessness Questionnaire, and the Social Support Questionnaire. Independent samples t-tests were used to evaluate differences in psychological variables between the Roma ( N = 90) and non-Roma ( N = 60) groups. Stepwise linear regression and odds ratios analyses were performed to identify potential background factors of multiple suicide attempts. There was a significantly higher level of previous suicidal events among the Roma in the sample population (3.53 vs. 0.84, p < .001). Roma ethnicity was found to be a strong predictor of multiple suicide attempts. Current major depression, hopelessness, and diagnosed mood disorder were identified as significant risk factors of repeated attempts. Smoking (OR = 5.4), family history of suicide (OR = 4.9), and long-term unemployment (OR = 4.6) were additional risk factors among Roma patients. A thorough understanding of the ethnicity-specific risk factors for multiple suicide attempts could facilitate the development of effective intervention and postvention programmes.

Risk factors for multiple suicidality in Hungary

IntroductionSuicide rate in Hungary is among the highest in the European Union (2015: 18.9/100,000 inhabitant). Although there is no national registration system of suicide attempts in Hungary, according to previous studies Hungarian Romas have three times higher suicide attempt rate than non-Romas.ObjectivesThe aim of this study was to explore socio-demographic and mental health risk factors of multiple suicide attempts in Hungary.MethodsA total of 1547 suicide attempts were assessed via retrospective data analysis using patient records. Data on socio-demographic variables, psychiatric diagnoses, methods and reported reasons of suicide attempts were investigated. Binary logistic regression analyses were performed to identify potential risk factors for multiple suicide attempts.ResultsThe ratio of multiple attempters were 37.7% in the sample, with a Roma predominance (Roma: 51.8%, non-Roma: 34.8%, χ2(1) = 27.64; P &lt; 0.001). Of the potential factors examined, Roma ethnicity (OR: 2,03; CI: 1.53–2.70; P &lt; 0.001), economic inactivity (OR: 1.7; CI: 1.36–2.18; P &lt; 0.001), mood disorders (OR: 1.58; CI: 1.25–1.99; P &lt; 0.001), personality disorders (OR: 2.09; CI: 1.45–3.01; P = 0.00), organic mental disorders (OR: 1.76; CI: 1.01–3.07; P = 0.44) and mistreatment as reported reasons (OR: 3.95; CI: 1.17–13.32; P = 0.02) were found as significant risk factors of multiple suicide attempts.ConclusionNational registration of suicide attempts would be necessary for a more thorough analysis. Beside the more advanced treatment of mental health disorders, increased efforts in prevention are recommended with a special focus of low SES groups and Roma ethnicity. The specific background factors in Roma ethnic group should be further examined.Disclosure of interestThe authors have not supplied their declaration of competing interest.

“Yes, I am a racist! So what?” The incompetence of hegemonic discourse of the Czech media to reflect racism in sport

The paper presents results of discourse analysis focusing on the representation of racism in the news and online discussions dedicated to the case of the football team SU Junior Roma. This team was boycotted by other teams in the league. They did not want to play with them, referring to the alleged aggressiveness of players with Roma ethnicity. After analysing related articles and reader’s posts, the paper reveals a discrepancy between the representation of racism in sport by media and discussing readers. The findings support our hypothesis that discussions under articles allowed people to spread racist thoughts and build the resistance towards others. On the contrary, the journalists used hegemonic discourse, which the racism theme set aside or avoided it entirely.

Social Identity and Role Models

We present a lab-in-the-field experiment and surveys of marginalised Roma children in Slovakia to examine whether reminding Roma of their ethnicity reduces their performance in a cognitive task. Research on social identity and stereotypes has documented that when individuals feel their social group is negatively stereotyped in a domain their performance declines, which can reinforce discrimination. In an effort to break the cycle of negative stereotypes we remind Roma of either Roma or non-Roma role models. We find that the activation of a Roma's ethnicity reduces cognitive performance. In contrast Roma exposed to Roma role models outperform those reminded of their ethnicity and also non-Roma role models. We then attempt to understand the channels through which social identity and role models effect performance. We show that priming a Roma's identity has a direct effect on confidence, decreasing performance.