Original scientific paper
Traditional CVD Risk Factors and Socio-Economic Deprivation in Roma Minority Population of Croatia
Hrvojka Zeljko
Tatjana Škarić-Jurić
Nina Smolej Narančić
Marijana Peričić Salihović
Irena Martinović Klarić
Maja Barbalić
Lovorka Barać Lauc
Branka Janićijević
Abstract
Researches into health inequalities consistently show disadvantages in health status, morbidity and mortality for
various ethnic minority groups. Current knowledge about prevention of cardiovascular diseases (CVD) mainly derives
from studies carried out in populations of European origin while the evidences involving Roma population are scarce.
Roma, an ethnic minority of northern Indian origin, live in many countries throughout the world and are well known for
preserved traditions and resistance to assimilation. They are most often marginalized economically, spatially, politically
and in terms of culture. In order to assess the health status and health-related lifestyle attributes, a multidisciplinary anthropological
and epidemiological community-based study was carried out including a total of 423 members of the Bayash
Roma minority population living in two regions of Croatia (144 men and 279 women, aged 18–84 yrs). Hypertension
(HT) was found in 24.8% Bayash Roma (21.5% men and 26.5% women) using standard diagnostic criteria (i.e. BP
140/90 mm Hg or taking antihypertensive therapy). The prevalence increases from 5.9% in the age group 18–34 yrs;
35.0% in the age group 35–64 yrs and 51.4% in the age group 65+ yrs. The prevalence of hypertension in the Bayash
Roma is almost half of the magnitude of what is usually reported for the general population of Croatia. It is also lower
when compared with other European populations and this finding is not due to comparative younger average age of the
Bayash sample. The significant association of hypertension with age and BMI was confirmed in this study and the importance
of non-traditional SES-related CVD risk factors was highlighted. Smoking is a part of traditional Roma
life-style and with 70% of smokers almost the entire population is equally exposed to this risk factor in their family environment.
Since homogenously distributed, this risk factor did not show to be a significant predictor of hypertension. The
extent to which hypertension is influenced by traditional CVD risk factors as well as by some SES indicators was also assessed
using a forward stepwise method of the multivariate logistic analysis. Each risk factor was explored as quantitative
variable as well as qualitative one using various cut-offs. The best model showed to be the one having age and BMI
presented as quantitative variables and sex, region, smoking status, income and schooling years as categorical ones; with
cut-off 3 for number of income sources and 8 for the number of schooling years. In spite of the low prevalence of hypertension,
the presented results are showing that Bayash Roma are bearing a high CVD risk factors load. We expect that with
westernization of their life-style and along with increase of the economic power, the proportion of CVD in population of
Bayash Roma will also increase. Therefore, it is important to recognize the need for early cardiovascular disease risk factors
prevention in this minority population.
Keywords
hypertension; prevalence; CVD; risk factors; SES; poverty; Roma; Croatia
Hrčak ID:
23777
URI
Publication date:
8.5.2008.
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