Why don't health care frontline professionals do more for segregated Roma? Exploring mechanisms supporting unequal care practices
The result's identifiers
Result code in IS VaVaI
<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F61989592%3A15260%2F20%3A73603186" target="_blank" >RIV/61989592:15260/20:73603186 - isvavai.cz</a>
Result on the web
<a href="https://obd.upol.cz/id_publ/333183072" target="_blank" >https://obd.upol.cz/id_publ/333183072</a>
DOI - Digital Object Identifier
<a href="http://dx.doi.org/10.1016/j.socscimed.2019.112739" target="_blank" >10.1016/j.socscimed.2019.112739</a>
Alternative languages
Result language
angličtina
Original language name
Why don't health care frontline professionals do more for segregated Roma? Exploring mechanisms supporting unequal care practices
Original language description
Rationale: Unequal provision of health care contributes to the poor health status of segregated Roma in Central and Eastern Europe. Studies on the drivers and mechanisms behind this are lacking. Objective: We explored what kinds of substandard practices health care frontline professionals engage in regarding segregated Roma and what mechanisms support such practices during the professionals' careers in care services. Methods: Over a three-month period at five different locations in Slovakia we interviewed and observed 43 frontline professionals serving segregated Roma. Next, through qualitative content analysis we identified in the data three themes regarding kinds of substandard practices and 22 themes regarding supporting mechanisms. We organized these themes into an explanatory framework, drawing on psychological models of discrimination and intergroup contact. Results: The frontline staffs substandard practices mostly involved substandard communication and commitment to care, but also some overt ethnic discrimination. These practices were supported by five mechanisms: the staffs negative experiences with people labelled "problematic Roma patients"; the staffs negative attitudes regarding segregated Roma; adverse organizational aspects; adverse residential-segregation aspects; and poor state governance regarding racism. In the course of their careers, many professionals first felt obliged and diligent regarding segregated Roma patients, then failing, unequipped and abandoned, and ultimately frustrated and resigned regarding the equal standard of care towards the group. Conclusions: Health care frontline staffs practices towards segregated Roma are frequently substandard. The psychological processes underlying this substandard care are supported by specific personal, organizational and governance features. These mechanisms cause many frontline professionals gradually to become cynical regarding segregated Roma over the course of their careers. Health care staff should be supported with skills and tools for effectively handling their own and others' racism, the culturebound and structural vulnerabilities of patients as well as related professional expectations regarding equity.
Czech name
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Czech description
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Classification
Type
J<sub>imp</sub> - Article in a specialist periodical, which is included in the Web of Science database
CEP classification
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OECD FORD branch
30304 - Public and environmental health
Result continuities
Project
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Continuities
I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace
Others
Publication year
2020
Confidentiality
S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů
Data specific for result type
Name of the periodical
SOCIAL SCIENCE & MEDICINE
ISSN
0277-9536
e-ISSN
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Volume of the periodical
246
Issue of the periodical within the volume
February
Country of publishing house
GB - UNITED KINGDOM
Number of pages
10
Pages from-to
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UT code for WoS article
000515194800015
EID of the result in the Scopus database
2-s2.0-85076690990