Investigation of Health Inequalities in Childhood Vaccinations of the Roma Minority in Greece of the Crisis

Introduction: The existence of inequalities in childhood vaccinations is one of the major problems faced by citizens of all countries, according to the findings of international literature. Roma internationally, but also in Greece, face acute social inequalities, resulting in lower rates of vaccination of their children compared to those of Greeks. Aim: The purpose of this study is to investigate the sanitary and social inequalities experienced by Roma in terms of childhood immunization, as well as to estimate the vaccination rates (based on the National Vaccination Program) between Greeks and Greeks Roma children, in the southwestern Greek region. Material and Method: A cross-sectional study was conducted on simple stratified random sampling in public health units and private pediatric clinics. 204 Greek and Greek Roma, aged 2-14 years, participated with an 85% response rate. A specially designed questionnaire in Greek was completed, with additional data from the "Child Health Booklet". The questionnaires were coded and then entered into the software for data analysis and inference. Bilateral significance levels were set and statistical significance was set at 0.05. The statistic program SPSS 22.0 was used for data analysis. Results: 47.5% were Greek-speaking Roma, while boys were 54.2% of Greek and 63.9% of Roma. Roma were found to have more adverse conditions in living, education and information on vaccinations (p<0.001). Greeks reported significantly higher rates of insurance (99.1%) and possession of a personal health book (98.1%), as well as more frequent visits to the pediatrician compared to Roma (p <0.001). A higher percentage of Greek Roma (18.6%) expressed the view that the general economic situation in Greece has a negative impact on vaccination and that access to vaccination clinics is not easy (p<0.001). The overall immunization levels of the minority population were found to be much lower than those of Greeks, with differences between 20 and 70% for each vaccine. Conclusions: Compared to the general population, Roma are experiencing disparities in their living conditions and general information on vaccination issues and in addition they are more frequently targeted by health professionals. Despite measures such as the free provision of health care to vulnerable social groups by public health structures, Roma seem to be experiencing the effects of the economic crisis in Greece more strongly. The immediate consequence of all these conditions is the lower immunization rates of their children compared to Greeks.