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

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International Journal for Equity in Health

, 14:137

First Online: 19 November 2015Received: 06 May 2015Accepted: 10 November 2015DOI: 10.1186-s12939-015-0270-z

Cite this article as: Kolarcik, P., Geckova, A.M., Reijneveld, S.A. et al. Int J Equity Health 2015 14: 137. doi:10.1186-s12939-015-0270-z


BackgroundAccording 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.

MethodsWe 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.

ResultsRoma 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.

ConclusionsPerceived 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.

KeywordsRoma ethnicity Adolescents Discrimination Social support Hopelessness Self-rated health AbbreviationsEU-MIDISEuropean Union minorities and discrimination survey

SESSocioeconomic status

SRHSelf-rated health

ISRDInternational Self-Report Delinquency Study

SDRS-5Social Desirability Response Set

OROdds ratio

CIConfidence interval

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Author: Peter Kolarcik - Andrea Madarasova Geckova - Sijmen A. Reijneveld - Jitse P. Van Dijk


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