Aim: The aim of the dissertation is to analyze the influence of selected social determinants on the mental health of children aged 11–15 from marginalised Roma communities, using data from the Health Behaviour in School-aged Children (HBSC) study. Additionally, the research will incorporate complementary analysis of data from the RomaREACH project, which focuses on children under the age of three, allowing for an exploration of potential age-related differences in risk and protective factors affecting mental health. 

Anotation: Children’s mental health is a fundamental component of healthy development and quality of life. It is shaped by a range of social determinants, including socioeconomic status, family dynamics, school environment, and access to social support. This dissertation will focus on identifying and analysing risk and protective factors associated with mental health among children from marginalised Roma communities. Primary data will be drawn from the HBSC study, targeting school-aged children (11–15 years), while supplementary insights will be obtained from the RomaREACH project, offering a unique opportunity to compare early childhood (under three years) and school-age developmental stages. The analysis aims to capture the complex interplay of social influences across age groups. The findings of this dissertation have the potential to deepen our understanding of the mental health challenges faced by children in marginalised communities and to inform the development of effective, evidence-based interventions and policies that promote wellbeing and equity.

I. Babinská: Kardiovaskulárny rizikový profil populácie žijúcej v segregovaných rómskych osadách a jeho porovnanie s majoritnou populáciou [The cardiovascular risk profile of the population living in segregated Roma settlements and its comparison with the majority population], 2014 

D. Bobáková: Youth subcultures and problem behaviours in Slovakia: Hip-hop, Techno-scene, Metal, Punk, Skinheads, and Roma, 2009-2013, http://irs.ub.rug.nl/ppn/357978870 

K. Rosičová: Regional mortality in the Slovak Republic in the context of socioeconomic indicators and ethnicity, 2006-2013, http://irs.ub.rug.nl/ppn/357966791 

P. Kolarčik: Self-reported health and health risky behaviour of Roma adolescents in Slovakia: a comparison with the non-Roma, 2007-2012, http://irs.ub.rug.nl/ppn/345878396

RIVER-EU (Reducing Inequalities in Vaccine uptake in the European Region – Engaging Underserved communities) brings together 14 renowned institutions from ten countries to investigate health system determinants of high and low vaccine uptake in eight specific contexts, including marginalized Roma communities in Slovakia. The evidence gathered is used to identify and develop interventions that reduce barriers to vaccination and build trust in the health system among underserved populations. The project aims to address health system barriers to vaccination against human papillomavirus (HPV) and measles, mumps, and rubella (MMR) in ethnic minority populations across Europe, where vaccine uptake remains low. The target populations and vaccines studied in each country include Migrant communities in Greece (HPV and MMR), Adolescent females with a Turkish or Moroccan migration background in the Netherlands (HPV), Ukrainian migrants living in Poland (HPV and MMR), Marginalised Roma communities in Slovakia (HPV). RIVER-EU uses a co-creative and collaborative approach to design, implement, and evaluate interventions to improve access to vaccination. The lessons learned will be compiled into a set of evidence-based guidelines and implementation recommendations, which will be disseminated to health policymakers and professionals across Europe to support more equitable vaccine delivery and reduce vaccination inequalities. 

Funding: H2020 RIVER-EU project “Reducing Inequalities in Vaccine uptake in the European Region – Engaging Underserved communities”  RIVER-EU is funded by the European Union Horizon 2020 Research Programme No 964353 called SC1-BHC-33-2020 Addressing low vaccine uptake. 

The RomaREACH project aimed to provide a more comprehensive understanding of the mechanisms influencing early childhood development — from conception to three years of age — in marginalized Roma communities. It considered the broader context of socio-cultural disadvantage and related exposure to environmental factors that pose risks to children’s health and development. One of the project’s key methodological strengths was its effort to approach early childhood development holistically, taking into account the complex interplay of influencing factors. By using a longitudinal design, the project yielded higher-quality insights compared to cross-sectional studies. RomaREACH was also innovative in its strong emphasis on translating research findings into practice. This was achieved through close collaboration with a range of stakeholders, including the Ministry of Education, Science, Research and Sport of the Slovak Republic, the Ministry of Health, the Research Institute of Child Psychology and Pathopsychology, the Office of the Plenipotentiary of the Government of the Slovak Republic for Roma Communities, non-governmental organizations, and others. 

Funding: The Research and Development Support Agency under Contract No. APVV-19-0493, the Scientific Grant Agency of the Ministry of Education, Science, Research and Sport of the Slovak Republic and the Slovak Academy of Sciences, Reg. No. 1/0593/21. 

Our HepaMETA project, conducted in 2011, resulted in a series of rigorous comparative studies that, for the first time in Slovakia, used clinical data to clearly document the stark disparities in health outcomes between residents of segregated Roma settlements and the local non-Roma population. The project also provided critical insights into the contributing exposures and social determinants of health within these communities. A major contribution of HepaMETA was its innovative integration of biomedical, behavioural, and socioeconomic data, which allowed for a more comprehensive understanding of health inequities in marginalized Roma populations. 

Funding: Institutional grant 

From 2011 to 2015, our team participated in the SOPHIE project (Evaluating the Impact of Structural Policies on Health Inequalities and Their Social Determinants and Fostering Change), funded by the European Union’s 7th Framework Programme (FP7). The project aimed to assess how structural policies influence health inequalities and their social determinants across Europe. As part of this international collaboration, we conducted a multi-perspective qualitative study focusing on employment among residents of segregated Roma communities in Slovakia. This study marked a key turning point, laying the groundwork for our subsequent collaboration with the World Health Organization (WHO). This cooperation resulted in a WHO publication that explored the context, mechanisms, and outcomes of Roma-targeted employment initiatives, and illustrated how improving employability can lead to better wellbeing and health outcomes in marginalized populations. 

Funding: 7FP SHOPHIE Evaluating the impact of structural policies on health inequalities and their social determinants and fostering change