Impact of Infrastructure on Mortality in Marginalised and Segregated Communities in the Slovak Republic

Abstract

Aim: Poverty and social exclusion is measured through different criteria and one of them is the health sector. The relationship between Roma population and the health sector is on the edge of researchers' interest in the Slovak Republic. The purpose of this paper is a quantification of the regional disparities in the development of mortality which is causally linked with selected infrastructural determinants - namely access to water and sewerage. These determinants differently participate in the structure of mortality in marginalised and segregated communities and they deepen regional disparities in health.

Methods: It is a spatial analysis of the districts of the Slovak Republic. The data from the Atlas of Roma communities in Slovakia 2013 is applied. Through the multiple linear regression model the relationship between mortality of the Roma population and water and sewerage availability in the Roma settlements is examined. Similarity between the districts is measured by the Euclidean metric system.

Results: The most appropriate district for representing the Slovak Republic average is the Dunajská Streda district in a field of arithmetic mean and the Veľký Krtíš district in a field of median value. The outermost district is represented by the Košice-okolie district, conversely, the Trnava district is the closest to the rest of the Slovak Republic. The highest statistically significant impacts on mortality are explored in public water supply extension plan and public sewerage supply extension plan. It seems that water play a greater role in determining health of Roma population. The highest number of inhabitants with supplied public water and public sewerage is kept by the Kežmarok district, the Košice district, and the Spišská Nová Ves district.

Conclusions: Our results can be beneficial for health decision making, since in the Strategic Framework for Health of the Slovak Republic metrics for measuring and evaluating health aspects in Roma communities absent and that prevents them to be correlated with the planned interventions.

Keywords: Roma nationality; Slovak Republic; mortality; public sewerage; public water supply; segregated concentrations.