The universalisation of the access to health care services and the persistence of health inequalities among Spain´s Roma population
La Parra, Daniel
Instituto Universitario de Desarrollo Social y Paz University of Alicante Alicante, Spain
Spain´s National Health System has since 1986 become a universal health care system. This process has allowed the non-working population and those living in worse socioeconomic or legal circumstances (foreign population, people with scarce economic resources, ethnic minorities) to access health services. This paper explores the access to health care of Spain´s Roma population using data provided by the first national health survey of the Roma community (2006; 993 respondents) and comparing the results with data from the National Health Survey for Spain 2003 and 2006 (29,478 cases).
A comparative analysis between the levels of access to health care services (general medicine, hospitalisation, emergency care, preventive practices among women, dental and oral health, use of medicines) and the state of health of Spain?s Roma population, and the rest of the population using data from the national health survey by social class and sex.
The universalisation of health care has promoted patterns of access among the Roma community similar to the rest of the population regarding general medicine services, hospitalisation, emergency care services and access to medicines. However, the Roma population show a worse state of health, particularly in older age groups, which in some cases means that they use these services more frequently than the general population. As for services not provided by the national health system or those services addressed to disease prevention (rather than services dealing directly with diseases), the levels of access are insufficient or inadequate: dental and oral health, preventive practices among women, access to aids to improve the patients? sight or hearing.
A higher level of access to the health care system is a contributing factor to the reduction of health inequalities. Nevertheless, social factors (economic situation, discrimination, etc.) play a more important role. A better understanding of the cumulative effect on the lifecycle of the social determinants of health and a follow-up of the health situation of the Roma population would be necessary to improve the interpretative framework of the impact of inequality on the health of the Roma.