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Andrej Belák from the Institute of Ethnology and Social Anthropology SAS published a scientific study in one of the most prestigious social science journals in the world. It is not a co-authorship in a large collective or a partial report: the publication summarizes the most significant results from two decades of Andrej's pioneering research program, focused on the causes of the extremely inferior health status of excluded Roma in Slovakia.

The published study is mainly based on a series of in-depth field research that Andrej conducted from 2004 to 2015. The study maps in detail the daily practice of the excluded Roma themselves and the various health system professionals who worked with the excluded Roma on a daily basis. They gradually focused on questions such as: "What and how threatens the health of Roma in excluded communities?" "Why don't they do more for their health?" "Why don't health professionals do more for their health?" "Why can't field workers do more for their health?" and "Who, how, and why maintains all related restrictions, both directly in municipalities and regions and centrally?" The results helped design a comprehensive model of the causes of the poor health status of excluded Roma, which was supported by representative research for practice (Figure 1).

The currently published study from the detailed model brings to the fore and graphically summarizes the deeper connections, which have been little known so far in the international context - especially in relation to the Roma and their health, but also in general. It explains, for example, that (see also Figure 2):

• One of the cultural adaptations to the long-lasting pressure in the excluded Roma communities is also the formation of groups and the following of new (ethnic) ideals that contrast with the norms of the rest of society - including ideals promoting greater negligence of one's own body.
• The degree of acceptance or rejection of such a path is an important determinant of internal differences in health practices and health within excluded Roma communities.
• One of the cultural adaptations to the insufficient amenities of one´s services in relation to the excluded Roma on the part of health system professionals is also the informal introduction or tolerance of a double standard of care quality - including practices of direct discrimination.
• Ideals contrasting with the norms of the rest of the society on the Roma side and services discriminating against the Roma are phenomena that in the long term fundamentally support each other - the former is often justified by the latter and vice versa.
• All the mentioned phenomena are fundamentally supported by the ubiquity of (racist or racialized) ideas about natural differences in abilities between Roma and non-Roma, whether negative or positive.

Source: TS Ústavu etnológie a sociálnej antropológie SAV, v. v. i.

Foto: TASR/Roman Hanc