title: Are barriers in accessing health services in the Roma population associated with worse health status among Roma?
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Infectology and Travel Medicine, Medical Faculty, PJ Safarik University, Trieda SNP 1, 040 01, Kosice, Slovak Republic. pavol.jarcuska@gmail.com
authors.forename: Pavol
authors.initials: P
authors.lastname: Jarcuska
authors.forename: Daniela
authors.initials: D
authors.lastname: Bobakova
authors.forename: Jan
authors.initials: J
authors.lastname: Uhrin
authors.forename: Ladislav
authors.initials: L
authors.lastname: Bobak
authors.forename: Ingrid
authors.initials: I
authors.lastname: Babinska
authors.forename: Peter
authors.initials: P
authors.lastname: Kolarcik
authors.forename: Zuzana
authors.initials: Z
authors.lastname: Veselska
authors.forename: Andrea
authors.initials: A
authors.lastname: Madarasova Geckova
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006297:Health Services Accessibility; D054624:Health Status Disparities; D006509:Hepatitis B / Q000453:epidemiology / Q000208:ethnology; D006526:Hepatitis C / Q000453:epidemiology / Q000208:ethnology; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology / Q000208:ethnology; D008875:Middle Aged; D054525:Minority Health / Q000208:ethnology*; D006178:Romani People; D057566:Self Report; D018154:Slovakia / Q000453:epidemiology; D055815:Young Adult
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