title: Delivery of cardio-metabolic preventive services to Hungarian Roma of different socio-economic strata.
abstract: Because the cardiovascular mortality in Hungary is high, particularly among the socio-economically deprived and the Roma, it is implied that primary health care (PHC) has a limited ability to exploit the opportunities of evidence-based preventions, and it may contribute to social health inequalities.
  
  
  
  Our study investigated the underuse of PHC preventive services.
  
  
  
  Random samples of adults aged 21-64 years free of hypertension and diabetes mellitus were surveyed with participation rate of 97.7% in a cross-sectional study. Data from 2199 adults were collected on socio-demographic status, ethnicity, lifestyle and history of cardio-metabolic preventive service use. Delivery rates were calculated for those aged 21-44 years and those aged 45-64 years, and the influence of socio-demographic variables was determined using multivariate logistic regression.
  
  
  
  Delivery rates varied between 12.79% and 99.06%, and the majority was far from 100%. Although most preventive service use was independent of education, younger participants with vocational educations underutilized problematic drinking (P = 0.011) and smoking (P = 0.027) assessments, and primary or less educated underutilized blood glucose (P = 0.001) and serum cholesterol (P = 0.005) checks. Health care measures of each lifestyle assessment (Pnutrition= 0.032; Psmoking= 0.021; Palcohol= 0.029) and waist circumference measurement (P = 0.047) were much less frequently used among older Roma. The blood glucose check (P = 0.001) and family history assessment (P = 0.043) were less utilized among Roma.
  
  
  
  The Hungarian PHC underutilizes the cardio-metabolic prevention contributing to the avoidable mortality, not generating considerably health inequalities by level of education, but contributing to the bad health status among the Roma.
authors.affiliation: Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Debrecen, Hungary, sandor.janos@sph.unideb.hu.|WHO Collaborating Centre on Vulnerability and Health, Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Debrecen, Hungary.
authors.forename: János
authors.initials: J
authors.lastname: Sándor
authors.affiliation: Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Debrecen, Hungary.|WHO Collaborating Centre on Vulnerability and Health, Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Debrecen, Hungary.
authors.forename: Attila
authors.initials: A
authors.lastname: Nagy
authors.affiliation: Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Debrecen, Hungary.
authors.forename: Anett
authors.initials: A
authors.lastname: Földvári
authors.affiliation: Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Debrecen, Hungary.
authors.forename: Edit
authors.initials: E
authors.lastname: Szabó
authors.affiliation: Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Debrecen, Hungary.
authors.forename: Orsolya
authors.initials: O
authors.lastname: Csenteri
authors.affiliation: Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Debrecen, Hungary.
authors.forename: Ferenc
authors.initials: F
authors.lastname: Vincze
authors.affiliation: Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Debrecen, Hungary.
authors.forename: Valéria
authors.initials: V
authors.lastname: Sipos
authors.affiliation: Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Debrecen, Hungary.
authors.forename: Nóra
authors.initials: N
authors.lastname: Kovács
authors.affiliation: Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Debrecen, Hungary.
authors.forename: Anita
authors.initials: A
authors.lastname: Pálinkás
authors.affiliation: National Institute of Primary Care, Budapest, Hungary and.
authors.forename: Magor
authors.initials: M
authors.lastname: Papp
authors.affiliation: Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Debrecen, Hungary.
authors.forename: Gergely
authors.initials: G
authors.lastname: Fürjes
authors.affiliation: Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Debrecen, Hungary.|WHO Collaborating Centre on Vulnerability and Health, Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Debrecen, Hungary.|MTA-DE-Public Health Research Group, University of Debrecen, Debrecen, Hungary.
authors.forename: Róza
authors.initials: R
authors.lastname: Ádány
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000208:ethnology / Q000517:prevention & control; D001786:Blood Glucose / Q000378:metabolism; D002784:Cholesterol / Q000097:blood; D003430:Cross-Sectional Studies; D003695:Delivery of Health Care / Q000706:statistics & numerical data; D004522:Educational Status; D005260:Female; D006300:Health Services Misuse / Q000706:statistics & numerical data*; D054624:Health Status Disparities; D006331:Heart Diseases / Q000208:ethnology / Q000517:prevention & control*; D006801:Humans; D006814:Hungary / Q000208:ethnology; D008019:Life Style; D008297:Male; D008487:Medical History Taking; D008659:Metabolic Diseases / Q000208:ethnology / Q000517:prevention & control*; D008875:Middle Aged; D011314:Preventive Health Services / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000706:statistics & numerical data*; D006178:Romani People; D000074606:Smoking Prevention / Q000706:statistics & numerical data; D055105:Waist Circumference; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D002784:Cholesterol
keywords: Cardiovascular disorders; cross-sectional research; health disparities; metabolic syndrome; prevention; primary care; survey.