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International Journal for Equity in Health
Published in: International Journal for Equity in Health 1/2015

Open Access 01-12-2015 | Research

The mediating effect of discrimination, social support and hopelessness on self-rated health of Roma adolescents in Slovakia

Authors: Peter Kolarcik, Andrea Madarasova Geckova, Sijmen A. Reijneveld, Jitse P. Van Dijk

Published in: International Journal for Equity in Health | Issue 1/2015

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Abstract

Background

According to the EU-MIDIS report on discrimination, Roma are the most discriminated against group in Europe. Research suggests that experiencing discrimination may itself be detrimental to health. The aim of this paper is to investigate whether discrimination, hopelessness and social support mediate differences in self-rated health (SRH) between Roma and non-Roma adolescents.

Methods

We conducted a cross-sectional study among Roma from separated and segregated settlements in the eastern part of Slovakia (N = 330; mean age = 14.50; interview) and non-Roma adolescents (N = 722; mean age = 14.86; questionnaire); only non-missing data were used for analyses (n = 759). The effect of perceived discrimination, mother and father social support, and hopelessness on SRH was analysed as crude and adjusted for ethnicity, age, gender, parental education and social desirability. Mediating effects were separately assessed using the Sobel test and structural equation modelling.

Results

Roma adolescents reported poorer SRH and more discrimination, mother and father social support, hopelessness and social desirability. Roma ethnicity (Odds ratio/95 %-Confidence interval 3.27/2.40–4.47), discrimination (2.66/1.82–3.88), hopelessness (1.35/1.20–1.51) and mother (0.92/0.88–0.97) and father social support (0.96/0.93 – 0.997) were statistically significant predictors of poor SRH. Perceived discrimination, social support and hopelessness mediated the ethnicity-health association, with adjustment for social support increasing its strength and the other two variables decreasing it.

Conclusions

Perceived discrimination, social support and hopelessness mediate a part of the association between Roma ethnicity and poor SRH, with discrimination and hopelessness being risk factors and social support a protective factor.
Literature
1.
European Union Agency for Fundamental Rights. Housing conditions of Roma and Travellers in the European Unioin. Comparative report. Wien: European Union Agency for Fundamental Rights; 2009.
2.
Fundación Secretariado Gitano. Health and the Roma community, analysis of the situation in Europe. Bulgaria, Czech Republic, Greece, Portugal, Romania, Slovakia, Spain. Madrid: Fundación Secretariado Gitano; 2009.
3.
Mudde C. Racist Extremism in Central and Eastern Europe. London: Routledge; 2005.
4.
Council of Europe. Human Rights of Roma and Travellers in Europe. Strasbourg: Council of Europe Publishing; 2012.
5.
European Roma Rights Centre. Attacks against Roma in Slovakia: January 2008-July 2012. Budapest: European Roma Rights Centre; 2012.
6.
Schaaf M. Roma health. In: Koller T, editor. Poverty and social exclusion in the WHO European Region: health systems respond. Copenhagen: WHO Regional Office for Europe; 2010. p. 226–56.
7.
Filadelfiová J, Gerbery D, Škobla D. Report on the living conditions of Roma in Slovakia. Bratislava: United Nations Development Programme Regional Bureau for Europe; 2007.
8.
Kolarcik P, Geckova AM, Orosova O, van Dijk J, Reijneveld SA. To what extent does socioeconomic status explain differences in health between Roma and non-Roma adolescents in Slovakia? Soc Sci Med. 2009;68(7):1279–84.CrossRefPubMed
9.
10.
Richardson LD, Norris M. Access to Health and Health Care: How Race and Ethnicity Matter. Mount Sinai J Med. 2010;77(2):166–77.CrossRef
11.
12.
D'Anna LH, Ponce NA, Siegel JM. Racial and ethnic health disparities: evidence of discrimination's effects across the SEP spectrum. Ethn Health. 2010;15(2):121–43.CrossRefPubMed
13.
14.
15.
Schulz AJ, Israel BA, Gravlee CC, Mentz G, Williams DR, Rowe Z. Discrimination, Symptoms of Depression, and Self-Rated Health Among African American Women in Detroit: Results From a Longitudinal Analysis. Am J Public Health. 2006;96(7):1265–70.PubMedCentralCrossRefPubMed
16.
Huurre T, Aro H, Rahkonen O. Well-being and health behaviour by parental socioeconomic status: A follow-up study of adolescents aged 16 until age 32 years. Social Psych Psych Epid. 2003;38(5):249–55.CrossRef
17.
Panzarella C, Alloy LB, Whitehouse WG. Expanded Hopelessness Theory of Depression: On the Mechanisms by which Social Support Protects Against Depression. Cognit Ther Res. 2006;30(3):307–33.CrossRef
18.
Proctor C, Linley P, Maltby J. Youth Life Satisfaction: A Review of the Literature. J Happiness Stud. 2009;10(5):583–630.CrossRef
19.
Roxburgh S. Untangling Inequalities: Gender, Race, and Socioeconomic Differences in Depression. Sociol Forum. 2009;24(2):357–81.CrossRef
20.
Stansfeld SA, Head J, Marmot MG. Explaining social class differences in depression and well-being. Soc Psych Psych Epid. 1998;33(1):1–9.CrossRef
21.
Idler EL, Benyamini Y. Self-Rated Health and Mortality: A Review of Twenty-Seven Community Studies. J Health Soc Behav. 1997;38(1):21–37.CrossRefPubMed
22.
Smith PM, Glazier RH, Sibley LM. The predictors of self-rated health and the relationship between self-rated health and health service needs are similar across socioeconomic groups in Canada. J Clin Epidemiol. 2010;63(4):412–21.CrossRefPubMed
23.
Bak CK, Andersen PT, Dokkedal U. The association between social position and self-rated health in 10 deprived neighbourhoods. BMC Public Health. 2015;15(1):512–27.CrossRef
24.
Klineberg E, Clark C, Bhui KS, Haines MM, Viner RM, Head J, et al. Social support, ethnicity and mental health in adolescents. Soc Psych Psych Epid. 2006;41(9):755–60.CrossRef
25.
Whitfield KE, Weidner G, Clark R, Anderson NB. Cultural aspects of health psychology. In: Nezu AM, Nezu CM, Geller PA, editors. Handbook of psychology: Volume 9, Health psychology. New Jersey: John Wiley & Sons, Inc; 2003. p. 545–68.
26.
Goward P, Repper J, Appleton L, Hagan T. Crossing boundaries. Identifying and meeting the mental health needs of Gypsies and Travellers. J Ment Health. 2006;15(3):315–27.CrossRef
27.
Farquharson AB. The effect of hopelessness on students engaged in pattern misbehavior: a replication. In: MSc. Menomonie: The Graduate College University of Wisconsin-Stout; 2002.
28.
Kashani JH, Reid JC, Rosenberg TK. Levels of hopelessness in children and adolescents: A developmental perspective. J Consult Clin Psychol. 1989;57(4):496–9.CrossRefPubMed
29.
Banks KH, Singleton JL, Kohn-Wood L. The Influence of Hope on the Relationship Between Racial Discrimination and Depressive Symptoms. J Multicult Couns D. 2008;36(4):231–44.CrossRef
30.
van deMortel TF. Faking it: social desirability response bias in self-report research. Aust J Adv Nurs. 2008;25(4):40–8.
31.
Nederhof AJ. Methods of coping with social desirability bias: a review. Eur J Soc Psychol. 1985;15(3):263–80.CrossRef
32.
Bardwell WA, Dimsdale JE. The impact of ethnicity and response bias on the self-report of negative affect. J Appl Biobehav Res. 2001;6(1):27–38.CrossRef
33.
Zhang S, Benson T, Deng X. A test-retest reliability assessment of the international self-report delinquency instrument. J Crim Just. 2000;28(4):283–95.CrossRef
34.
Ware JEJ, Sherbourne CD. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care. 1992;30(6):473–83.CrossRefPubMed
35.
Geckova AM, van Dijk JP, Zezula I, Tuinstra J, Groothoff JW, Post D. Socio-economic differences in health among Slovak adolescents. Soz Praventivmed. 2004;49(1):26–35.CrossRefPubMed
36.
Matthews S, Manor O, Power C. Social inequalities in health: are there gender differences? Soc Sci Med. 1999;48(1):49–60.CrossRefPubMed
37.
Sadava SW, O'Connor R, McCreary DR. Employment status and health in young adults: Economic and behavioural mediators? J Health Psychol. 2000;5(4):549–60.CrossRefPubMed
38.
Turner RJ, Marino F. Social Support and Social Structure: A Descriptive Epidemiology. J Health Soc Behav. 1994;35(3):193–212.CrossRefPubMed
39.
Bolland JM. Hopelessness and risk behaviour among adolescents living in high-poverty inner-city neighbourhoods. J Adolesc. 2003;26(2):145–58.CrossRefPubMed
40.
Kazdin AE, French NH, Unis AS, Esveldt-Dawson K, Sherick RB. Hopelessness, depression, and suicidal intent among psychiatrically disturbed inpatient children. J Consult Clin Psychol. 1983;51(4):504–10.CrossRefPubMed
41.
Hays RD, Hayashi T, Stewart AL. A five-item measure of socially desirable response set. Educ Psychol Meas. 1989;49(3):629–36.CrossRef
42.
Clark LA, Watson D. Constructing validity: Basic issues in objective scale development. Psychol Assess. 1995;7(3):309–19.CrossRef
43.
Parker JDA, Taylor GJ, Bagby RM. The 20-Item Toronto Alexithymia Scale: III. Reliability and factorial validity in a community population. J Psychosom Res. 2003;55(3):269–75.CrossRefPubMed
44.
45.
Salonna F, Geckova AM, Zezula I, Sleskova M, Groothoff JW, Reijneveld SA, et al. Does social support mediate or moderate socioeconomic differences in self-rated health among adolescents? Int J Public Health. 2012;57:609–17.PubMedCentralCrossRefPubMed
46.
Cederblad M, Dahlin L, Hagnell O, Hansson K. Salutogenic childhood factors reported by middle-aged individuals: Follow-up of the children from the Lundby Study grown up in families experiencing three or more childhood psychiatric risk factors. Eur Arch Psychiatry Clin Neurosci. 1994;244(1):1–11.CrossRefPubMed
47.
Ajrouch KJ, Reisine S, Lim S, Sohn W, Ismail A. Perceived everyday discrimination and psychological distress: does social support matter? Ethn Health. 2010;15(4):417–34.CrossRefPubMed
48.
Crone MR, Bekkema N, Wiefferink CH, Reijneveld SA. Professional identification of psychosocial problems among children from ethnic minority groups: Room for improvement. J Pediatr. 2010;156(2):277–84.CrossRefPubMed
49.
Brittingham A, Tourangeau R, Kay W. Reports of smoking in a National survey: data from screening and detailed interviews, and from self- and interviewer-administered questions. Ann Epidemiol. 1998;8(6):393–401.CrossRefPubMed
50.
Bowling A. Mode of questionnaire administration can have serious effects on data quality. J Public Health. 2005;27(3):281–91.CrossRef
51.
Brener ND, Billy J, Grady WR. Assessment of factors affecting the validity of self-reported health-risk behavior among adolescents: evidence from the scientific literature. J Adolesc Health. 2003;33(6):436–57.CrossRefPubMed
52.
53.
Paradies Y. A systematic review of empirical research on self-reported racism and health. Int J Epidemiol. 2006;35(4):888–901.CrossRefPubMed
54.
Belák A. Health-system limitations of Roma health in Slovakia: A qualitative study. Bratislava: WHO Country Office in Slovakia; 2013.
55.
Belák A. Responding to health literacy needs of the Roma in Slovakia. In: Dodson S, Good S, Osborne RH, editors. Health literacy toolkit for lowand middle-income countries: a series of information sheets to empower communities and strengthen health systems. New Delhi: World Health Organization, Regional Office for South-East Asia; 2015. p. 141–4.
56.
Open Society Institute. Roma Health Mediators: Successes and Challenges. New York: Open Society Foundations; 2011.
Metadata
Title
The mediating effect of discrimination, social support and hopelessness on self-rated health of Roma adolescents in Slovakia
Authors
Peter Kolarcik
Andrea Madarasova Geckova
Sijmen A. Reijneveld
Jitse P. Van Dijk
Publication date
01-12-2015
Publisher
BioMed Central
Published in
International Journal for Equity in Health / Issue 1/2015
Electronic ISSN: 1475-9276
DOI
https://doi.org/10.1186/s12939-015-0270-z

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