title: Health-endangering everyday settings and practices in a rural segregated Roma settlement in Slovakia: A descriptive summary from an exploratory longitudinal case study.
abstract: Research into social root-causes of poor health within segregated Roma communities in Central and Eastern Europe, i.e. research into how, why and by whom high health-endangering settings and exposures are maintained here, is lacking. The aim of this study was to assess the local setup of health-endangering everyday settings and practices over the long-term in one such community. It is the initial part of a larger longitudinal study qualitatively exploring the social root-causes of poor Roma health status through the case of a particular settlement in Slovakia.
  
  
  
  The study, spanning 10 years, comprised four methodologically distinct phases combining ethnography and applied medical-anthropological surveying. The acquired data consisted of field notes on participant observations and records of elicitations focusing on both the setup and the social root-causes of local everyday health-endangering settings and practices. To create the here-presented descriptive summary of the local setup, we performed a qualitative content analysis based on the latest World Health Organization classification of health exposures.
  
  
  
  Across all the examined dimensions - material circumstances, psychosocial factors, health-related behaviours, social cohesion and healthcare utilization - all the settlements' residents faced a wide range of health-endangering settings and practices. How the residents engaged in some of these exposures and how these exposures affected residents' health varied according to local social stratifications. Most of the patterns described prevailed over the 10-year period. Some local health-endangering settings and practices were praised by most inhabitants using racialized ethnic terms constructed in contrast or in direct opposition to alleged non-Roma norms and ways.
  
  
  
  Our summary provides a comprehensive and conveniently structured basis for grounded thinking about the intermediary social determinants of health within segregated Roma communities in Slovakia and beyond. It offers novel clues regarding how certain determinants might vary therein; how they might be contributing to health-deterioration; and how they might be causally inter-linked here. It also suggests racialized ethnically framed social counter-norms might be involved in the maintenance of analogous exposure setups.
authors.affiliation: Kosice Institute for Society and Health, Faculty of Medicine, P. J. Safarik University, Kosice, Slovakia. andrej.belak@upjs.sk.|Department of Health Psychology, Faculty of Medicine, P. J. Safarik University, Trieda SNP 1, 040 11, Kosice, Slovakia. andrej.belak@upjs.sk.|Department of Community and Occupational Medicine, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands. andrej.belak@upjs.sk.|Department of General Anthropology, Faculty of Humanities, Charles University, Prague, Czech Republic. andrej.belak@upjs.sk.
authors.forename: Andrej
authors.identifier: 0000-0001-6634-0137
authors.initials: A
authors.lastname: Belak
authors.affiliation: Kosice Institute for Society and Health, Faculty of Medicine, P. J. Safarik University, Kosice, Slovakia.|Department of Health Psychology, Faculty of Medicine, P. J. Safarik University, Trieda SNP 1, 040 11, Kosice, Slovakia.|Olomouc University Society and Health Institute, Palacky University Olomouc, Olomouc, Czech Republic.
authors.forename: Andrea
authors.initials: A
authors.lastname: Madarasova Geckova
authors.affiliation: Kosice Institute for Society and Health, Faculty of Medicine, P. J. Safarik University, Kosice, Slovakia.|Olomouc University Society and Health Institute, Palacky University Olomouc, Olomouc, Czech Republic.|Department of Community and Occupational Medicine, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: Jitse P
authors.initials: JP
authors.lastname: van Dijk
authors.affiliation: Department of Community and Occupational Medicine, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: Sijmen A
authors.initials: SA
authors.lastname: Reijneveld
mesh_terms: D003430:Cross-Sectional Studies; D005260:Female; D015438:Health Behavior / Q000208:ethnology*; D006304:Health Status; D006801:Humans; D008019:Life Style; D008137:Longitudinal Studies; D008297:Male; D012111:Residence Characteristics; D006178:Romani People / Q000706:statistics & numerical data*; D012424:Rural Population / Q000706:statistics & numerical data*; D018154:Slovakia; D012923:Social Class; D000072699:Social Segregation
keywords: Ethnography; Health inequality; Public health; Roma health; Slovakia; Social determinants of health