title: The decade of Roma Inclusion: did it make a difference to health and use of health care services?
abstract: OBJECTIVE
  We investigated whether the severely disadvantaged health of Hungarian Roma adults living in segregated settlements changed by the Decade of Roma Inclusion program.
  
  
  METHODS
  We compared the results of two paired health interview surveys that we carried out using the same methodology before and after the Decade, on the general Hungarian and Roma populations.
  
  
  RESULTS
  Self-perceived health status of younger Roma worsened, while it improved among older Roma. Reported experience of discrimination reduced considerably and health care utilization improved in general. Positive changes in smoking and nutrition, and negative changes in alcohol consumption and overweight were observed. Many of observed changes can plausibly be linked to various government policies, including a quadrupling of public works expenditure, banning smoking in public places, restricting marketing of tobacco products, increasing cigarette prices, and a new tax on unhealthy foods. Liberalization of rules on alcohol distillation coincided with worsening alcohol consumption.
  
  
  CONCLUSIONS
  We have shown that Roma remain severely disadvantaged and present an innovative sampling method which can be used to monitor changes in groups where identification is a challenge.
authors.affiliation: Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Kassai str 26/B, 4028, Debrecen, Hungary. sandor.janos@sph.unideb.hu.|Department of Preventive Medicine, Faculty of Public Health, WHO Collaborating Centre on Vulnerability and Health, University of Debrecen, Debrecen, Hungary. sandor.janos@sph.unideb.hu.
authors.forename: János
authors.initials: J
authors.lastname: Sándor
authors.affiliation: Department of Methodology for Health Visitors and Public Health, Faculty of Health, University of Debrecen, Nyíregyháza, Hungary.
authors.forename: Zsigmond
authors.initials: Z
authors.lastname: Kósa
authors.affiliation: Department of Health Systems Management and Quality Management in Health Care, Faculty of Public Health, University of Debrecen, Debrecen, Hungary.
authors.forename: Klára
authors.initials: K
authors.lastname: Boruzs
authors.affiliation: Central Statistical Office, Budapest, Hungary.
authors.forename: Julianna
authors.initials: J
authors.lastname: Boros
authors.affiliation: Central Statistical Office, Budapest, Hungary.
authors.forename: Ildikó
authors.initials: I
authors.lastname: Tokaji
authors.affiliation: ECOHOST, London School of Hygiene and Tropical Medicine, London, UK.
authors.forename: Martin
authors.initials: M
authors.lastname: McKee
authors.affiliation: Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Kassai str 26/B, 4028, Debrecen, Hungary.|Department of Preventive Medicine, Faculty of Public Health, WHO Collaborating Centre on Vulnerability and 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: D000293:Adolescent; D000328:Adult; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data*; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D006814:Hungary; D008297:Male; D008875:Middle Aged; D015397:Program Evaluation; D006178:Romani People / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: Decade of Roma Inclusion; Health behaviour survey; Public policy; Roma