The health of Roma children in the UK
Last week I emailed an interpreter friend in England to ask about the morale and wellbeing of local Roma families following the EU referendum. Her reply was that confusion reigns among the community but the Big Issue and other local organisations are doing a good job of providing support. For herself ‘apart from the xenophobia and racism’- she is fine. Until Article 50 has been triggered and negotiations with other countries are complete, the prospects for EU nationals, including Roma people, living in the UK are unknown.
Roma people are regarded as the most vulnerable and deprived ethnic group within Europe, and since 1984 the European Union has recommended that member states should develop programmes to improve the situation of Gypsies and Roma without damaging their cultural values. Roma people are known to experience severe health inequalities, poorer access to health services and worse health than other ethnic groups. This ill health is linked to living conditions; a recent large survey of the Roma population in Greece showed that 39% lacked either drinkable water, electricity or indoor drainage in their homes (Pappa et al, 2015). Roma people encounter extreme discrimination and racism in Europe at an individual and societal level. It will be recalled that in 2010 Roma people were offered 300 euros to leave France (BBC news 2010) and in 1992 and 1993 Roma people were repatriated from Germany (Liégeois 2007).
Post 2007, the vast majority of Roma people have migrated to the UK as EU citizens, rather than as asylum seekers. Only 13% of the UK population are migrants (defined as people born abroad who intend to stay for one year or longer) but children of migrants are a fast growing group. In 2011 25% of UK children were born to a mother born abroad (ONS 2014). The Millennium Cohort study has shown that lifestyle choices can worsen post migration. Migrant parents are likely to decrease practice of healthy behaviours such as exclusive breastfeeding and eating diets low in fat and to increase practice of less healthy behaviours, such as smoking and drinking alcohol (Hawkins et al, 2008).
The Roma are among the most vulnerable EU migrants. Roma people experience difficulty in finding work in the UK and encounter discrimination. A recent qualitative study (Condon & McClean, 2016) suggests that seeking better health and living conditions for their children are a primary motivation for migration. One Roma focus group participant said:
‘To be honest we are scared to say which things are better in this country, and do you know why, because we are afraid for someone to take these things from our children.’
Roma people cited the quality of healthcare and education, safer infrastructure (housing, roads and food safety standards) and access to leisure activities as contributing to better health and opportunities for children in the UK.
In the UK the health of refugees and asylum seekers has attracted more research interest than the health of legal migrants. However the health of all migrants and their families is of public health concern, particularly in view of the evidence about lifestyle change post-migration. Migrants to the UK have poorer health outcomes overall than the majority population (Jayaweera & Quigley 2010), and Roma children continue to be among the most disadvantaged. The uncertainty surrounding Brexit heightens anxiety for families, and the increase in racist incidents in the last two months fuels fear. Knowledge of the specific health issues for migrant children is of great importance to those offering healthcare to Roma children and their families, particularly in delivering acceptable health promotion tailored to need.
Condon L, McClean S (2016) Maintaining pre-school children's health and wellbeing in the UK: a qualitative study of the views of migrant parents Journal of Public Health 2016; doi: 10.1093/pubmed/fdw083
Hawkins S, Lamb K, Cole T, Law C (2008). Influence of moving to the UK on maternal health behaviours: prospective cohort study. BMJ: British Medical Journal 336, no. 7652: 1052.
Jayaweera H, Quigley M. Health status, health behaviour and healthcare use among migrants in the UK: evidence from mothers in the Millennium Cohort Study. Social Science &Medicine2010; 71: 1002-1010.
Liégeois J-P (2007) Roma in Europe Strasbourg: Council of Europe
Office for National Statistics. Fertility patterns in England and Wales in 2011. ONS, 2014.
Pappa, E et al. (2015) Health-Related Quality of Life of the Roma in Greece: The Role of Socio-Economic Characteristics and Housing Conditions. International journal of environmental research and public health 12.6: 6669-6681.