Objectives. We compared the health of people living in Roma settlements with that of the general population in Hungary. Methods. We performed comparative health interview surveys in 2003 to 2004 in representative samples of the Hungarian population and inhabitants of Roma settlements. Results. In persons older than 44 years, 10% more of those living in Roma settlements reported their health as bad or very bad than did those in the lowest income quartile of the general population. Of those who used any health services, 35% of the Roma inhabitants and 4.4% of the general population experienced some discrimination. In Roma settlements, the proportion of persons who thought that they could do much for their own health was 13% to 15% lower, and heavy smoking and unhealthy diet were 1.5 to 3 times more prevalent, than in the lowest income quartile of the general population. Conclusions. People living in Roma settlements experience severe social exclusion, which profoundly affects their health. Besides tackling the socioeconomic roots of the poor health of Roma people, specific public health interventions, including health education and health promotion programs, are needed.

Background: Several models have been proposed to explain the association between ethnicity and health. It was investigated whether the association between Roma ethnicity and health is fully mediated by socioeconomic status in Hungary. Methods: Comparative health interview surveys were performed in 2003–04 on representative samples of the Hungarian population and inhabitants of Roma settlements. Logistic regression models were applied to study whether the relationship between Roma ethnicity and health is fully mediated by socioeconomic status, and whether Roma ethnicity modifies the association between socioeconomic status and health. Results: The health status of people living in Roma settlements was poorer than that of the general population (odds ratio of severe functional limitation after adjustment for age and gender 1.8 (95% confidence interval 1.4 to 2.3)). The difference in self-reported health and in functionality was fully explained by the socioeconomic status. The less healthy behaviours of people living in Roma settlements was also related very strongly to their socioeconomic status, but remained significantly different from the general population when differences in the socioeconomic status were taken into account, (eg odds ratio of daily smoking 1.6 (95% confidence interval 1.3 to 2.0) after adjustment for age, gender, education, income and employment). Conclusion: Socioeconomic status is a strong determinant of health of people living in Roma settlements in Hungary. It fully explains their worse health status but only partially determines their less healthy behaviours. Efforts to improve the health of Roma people should include a focus on socioeconomic status, but it is important to note that cultural differences must be taken into account in developing public health interventions.

Background: COVID-19 has changed the world and strongly affected the health of the people and the quality of their life. These changes might impact employees’ physical activity (PA) and sedentary behavior (SB). This study aimed to summarize the literature focusing on the COVID-19-caused changes in physical activity and sedentary behavior among the adult working population. Methods: Literature searches were conducted in June 2021 using multiple electronic databases. The following keywords and synonyms were used during the searching process: physical activity, sedentary behavior, COVID-19, employee. After the data cleaning process (duplicates, inclusion criteria), the title and the abstract of all manuscripts from the searches were screened independently by two reviewers. Results: Thirty-nine manuscripts were selected as a result of the searching process. Of these, 5 were SB related, 15 were PA related and 19 addressed both PA and SB. There were longitudinal (10), cross-sectional (28) and a case study (1) in the selected manuscripts. The majority of studies were conducted in the USA (6) and Europe (18), and four studies examined the PA and/or SB in multiple countries. The majority (34 studies) of the studies used subjective, self-reported, but mostly before-validated questionnaires. Objective measures were less common and used only 12.8% of the examined studies. Moreover, 76.4% of the studies described an overall decrease in the amount of PA during the COVID-19 pandemic. In three cases, researchers observed an increase in PA among the workers. Five studies reported no significant changes in the amount of PA during the pandemic. As far as SB is concerned, 18 out of 24 of the studies reported an overall increase in the amount of SB between the two periods. Four manuscripts reported no significant change in the amount of SB, and there was only one manuscript in the examined studies that reported an overall decrease in the SB time before and during the COVID-19 pandemic. Discussion: There is no doubt that the COVID-19 pandemic, including lockdown and work from home (WFH) policies, impaired the PA and SB level of the populations. This period has delivered an important message for the adult working population as well. They should be as active as possible and avoid high levels of SB and uninterrupted sitting time. Therefore, organizations, policies and public health bodies should motivate workers, especially office workers, to be more active and interventions must be developed to mitigate the negative effects of the COVID-19 on PA and SB.

There are important disparities in health outcomes between racial/ethnic minorities and majorities in all countries where minority health has been investigated. This holds true for the largest minority population of Europe, the Roma, although research data related to Roma are scarcer and more contested than for other minorities. We discuss major obstacles that hinder or prevent the collection of reliable data in Roma and other minorities. The definitions and classification systems on race/ethnicity vary widely, pointing to the social construction of both race and ethnicity. Imprecision in taxonomy and definition of target groups is compounded by challenges in data collection, analysis, and interpretation, along with ethnocentricity that shapes the perspectives and approaches of the researchers. However, administrative data collection on race/ethnicity serves legitimate purposes although such data must comply with less-stringent quality requirements as opposed to data meant for scientific analysis. Research on minorities should consider race/ethnicity as proxy indicators of complex health determinants, and should aim at dissecting these determinants into separate items. Careful documentation of methodology and active involvement of the minorities themselves can increase trust between the investigators and the research subjects, which can in turn improve research on minority health.

Background: Roma people, the largest minority in Europe live in segregated communites in several countries. The size of the Roma population is based on estimations deriving from various sources, whereas only narrative accounts of their living conditions have been available. Methods: A comprehensive environmental survey of all settlements in Hungary (n = 3145) was carried out employing Roma field workers in order to locate and characterize segregated parts (colonies) of human habitats. Based on the collected data on environmental conditions and aggregate population numbers of the colonies, ranking of colonies and maps on their characteristics were prepared for all counties of Hungary. Results: Seven hundred fifty-eight colonies were identified with approximately 134 000 inhabitants. Ninety-four percent of all colonies are populated dominantly by Roma. Most frequent environmental problems in the colonies were found to be lack of sewage and gas mains, garbage deposits, waterlogged soil and lack of water mains. Conclusion: Census data cannot be used for policy design aiming at those Roma who are in greatest need of help; that is, living in segregated settlements (colonies). Colonies constitute disadvantaged living conditions of varying severity which can be quantified by a composite score based on indicators of access to services and presence of environmental dangers. The proportion of colony-dwelling Roma is approximately one-fifth to one-quarter of the estimated number of Roma people in Hungary.