[The health status of the Gypsy community in Spain. A review of the literature].
BACKGROUND
Gypsies form an ethnic minority settled in Spain in the 15th century. At present, this collective presents certain social, economic, and health inequalities in comparison with the remaining population. The need for health interventions among the gypsy population is well known.


OBJECTIVE
To determine which health-related matters among the Spanish gypsy community had received attention in the literature, and whether their ethnic differences and social inequalities in health had been studied.


METHODS
We reviewed the literature published in the last 20 years. An international Medline search was performed. We also searched national and local papers through the IME-CSIC (Spanish Medical Index) database and the Internet.


RESULTS
There were 96 valid articles on health among Spanish gypsies, of which 62 were published in Spanish journals and 47 had been published within the previous 6 years. Fifty-seven studies were performed in hospitals, 20 in public health centers and 13 in primary care centers. Eighty-eight percent were observational studies. The most frequent topics were genetics or congenital anomalies (30%), transmissible diseases (21%), child health (11%) and health sociology (11%). Fifty-seven percent of the studies reported some social inequalities in health.


CONCLUSIONS
The Spanish gypsy community constitutes a health risk group due to ethnic and genetic factors. Moreover, they also have strong social inequalities in health related to mortality and morbidity in transmissible, chronic and environmental diseases due to socioeconomic and cultural factors, as well as to insufficient access to and use of health services.
Departamento de Salud Pública, Universidad de Alicante, Spain. pacaferrer@ono.com
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D006304:Health Status; D006801:Humans; D006178:Romani People; D013030:Spain