Health-Related Effects at the Outbreak of COVID-19 Pandemic in Vulnerable Communities of Romania
Keywords:COVID-19, health equity, health services access, health behavior, social distancing, Roma, vulnerable, Romania
This paper reports on health-related effects of the COVID-19 pandemic impact on vulnerable populations from Romania’s vulnerable communities, Roma and non-Roma. Transmission in the most marginalized communities has been expected to be particularly high as self-isolation and social distancing are difficult to pursue as a result of crammed living conditions, limited access to basic services and infrastructure. The study reports research results from a qualitative survey based on expert interviews in communities. The sample includes a total number of 34 communities, out of which 10 Roma vulnerable rural communities, 10 vulnerable rural localities and a counterfactual of 10 resilient communes. In addition, four small urban areas with large Roma neighborhoods complete the sample. Data collection has been organized in four rounds, during the period May−July, 2020. Since the lockdown, a large number of interviewees declared non-compliance with the hygiene measures for preventing COVID-19 transmission to be a problem. While in the resilient communes this problem was not reported, it appeared to be widespread in the selected vulnerable communes. The non-compliant behavior of poor and Roma people is considered an aggregated effect of a lack of access to relevant infrastructure, particularly water, and lack of finances for the necessary sanitary products. According to opinions expressed by local institutional representatives, between Round 1 and Round 3 of research (May−June 2020), a large part of the population either has never observed the hygiene rules or has relaxed after the lockdown was lifted. Constant positive evolution was reported in the resilient communes and the vulnerable non-Roma ones. This study adds knowledge on social and economic health-related effects of the COVID-19 at the level of the most vulnerable segments of Romanian society. The results underline the fact that short-term effects of the pandemic are borne unequally.
Arpinte, Daniel, Cace, Sorin, Mihaiu, Simona, Stănescu, Iulian, Stănescu, Simona, Țoc, Sebastian. 2020a. Pandemia și standardul de viață. Politici de protecție socială (Pandemics and Standard of Living. Social Protection Policies). Bucharest: Research Institute for Quality of Life (RIQL). Available at: http://www.iccv.ro/evenimente/ [accessed May 10, 2020].
Buffel, Tine, Patty Doran, Mhorag Goff, Luciana Lang, Camilla Lewis, Chris Phillipson and Sophie Yarker. 2020. “Covid-19 and inequality: developing an age-friendly strategy for recovery in low income communities”. Quality in Ageing and Older Adults 21, no. 4: 271−279. https://doi.org/10.1108/QAOA-09-2020-0044.
Banati, Prerna, Nicola Jones and Sally Youssef. 2020. “Intersecting Vulnerabilities: The Impacts of COVID-19 on the Psycho-emotional Lives of Young People in Low- and Middle-Income Countries”. Eur J Dev Res 32, 1613–1638. https://doi.org/10.1057/s41287-020-00325-5.
Bach-Mortensen, Anders Malthe and Michell DegliEsposti. 2021. “Is area deprivation associated with greater impacts of COVID-19 in care homes across England? A preliminary analysis of COVID-19 outbreaks and deaths”. J Epidemiol Community Health 75: 624–627. doi: 10.1136/jech-2020-215039. Epub ahead of print. PMID: 33558430.
Berescu, Cătălin, Filip Alexandrescu and Ionuț-Marian Anghel. 2021. “Vulnerable Roma communities in times of the Covid-19 negative quarantine”. Moravian Geographical Reports 29(2), 125−136. doi: https://doi.org/10.2478/mgr-2021-0011.
Davies, Alisha R., Matthew Honeyman and Bob Gann. 2021.“Addressing the digital inverse care law in the time of COVID-19: Potential for digital technology to exacerbate or mitigate health inequalities”. Journal of Medical Internet Research 23, no. 4. doi: http://dx.doi.org.am.e-nformation.ro/10.2196/21726.
Dearinger, Angela. 2020. “COVID-19 reveals emerging opportunities for rural public health”. American Journal of Public Health 110, no. 9: 1277−1278. doi: http://dx.doi.org.am.e-nformation.ro/10.2105/AJPH.2020.305864.
Epps, Fayron, Zanthia Wiley, Larissa J. Teunis, Theodore M. Johnson, Rachel E. Patzer, IghoOfotokun and Nicole Franks. 2021. “A Framework for Mobilizing Health Care to Respond to the Community Within the COVID-19 Pandemic. Prev Chronic Dis 18: 200572. doi: https://doi.org/10.5888/pcd18.200572.
Germain, Sabrina and Adrienne Yong. 2020. “COVID-19 highlighting inequalities in access to healthcare in England: A case study of ethnic minority and migrant women”. Feminist Legal Studies 28, no. 3: 301−310. doi: http://dx.doi.org.am.e-nformation.ro/10.1007/s10691-020-09437-z.
Guglielmi, Simona, Giulia M. Dotti Sani, Francesco Molteni, FerruccioBiolcati, Antonio M. Chiesi, Riccardo Ladini, Marco Maraffi, Andrea Pedrazzani and Cristiano Vezzoni. 2020. “Public acceptability of containment measures during the COVID-19 pandemic in italy: How institutional confidence and specific political support matter”. The International Journal of Sociology and Social Policy 40, no. 9: 1069−1085. doi: http://dx.doi.org.am.e-nformation.ro/10.1108/IJSSP-07-2020-0342.
Gutiérrez-Velasco, Laura, Cristina Liébana-Presa, Elena Abella-Santos, Vega Villar-Suárez, Rocío Fernández-Gutiérrez and Elena Fernández-Martínez. 2021. “Access to Information and Degree of Community Awareness of Preventive Health Measures in the Face of COVID-19 in Spain”. Healthcare (Basel) 9, no. 2:104. doi: 10.3390/healthcare9020104. PMID: 33498281; PMCID: PMC7909264.
Robert Krzysztofik, Iwona Kantor-Pietraga and Tomasz Spórna (2020) “Spatial and functional dimensions of the COVID-19 epidemic in Poland”. Eurasian Geography and Economics, 61:4−5, 573−586, DOI: 10.1080/15387216.2020.1783337.
Lee, Minjung, Bee-Ah Kang and Myoungsoon You. 2021. “Knowledge, attitudes, and practices (KAP) toward COVID-19: a cross-sectional study in South Korea”. BMC Public Health 21, 295. https://doi.org/10.1186/s12889-021-10285-y.
Marsh, Jennifer, Marilyn O'Mallon, Steven Stockdale, Steven PharmD and Danita Potter. 2020. “Caring for vulnerable populations during a pandemic: Literature review”. International Journal of Caring Sciences 13, no. 3: 2298−2303.
Mishra, Vaibhav, Golnoush Seyedzenouzi, Ahmad Almohtadi, Tasnim Chowdhury, Arwa Khashkhusha, Ariana Axiaq, Wing Yan Elizabeth Wong and Amer Harky. 2021. “Health inequalities during COVID-19 and their effects on morbidity and mortality”. Journal of Healthcare Leadership 13: 19−26. doi: http://dx.doi.org.am.e-nformation.ro/10.2147/JHL.S270175.
Nshimyiryo, Alphonse, Dale A Barnhart, Vincent K Cubaka, Jean Marie Vianney Dusengimana, Symaque Dusabeyezu, Deogratias Ndagijimana, Grace Umutesi, Cyprien Shyirambere, Nadine Karema, Joel M Mubiligi and Fredrick Kateera. 2021. “Barriers and coping mechanisms to accessing healthcare during the COVID-19 lockdown: a cross-sectional survey among patients with chronic diseases in rural Rwanda”. BMC Public Health 21, 704. https://doi.org/10.1186/s12889-021-10783-z.
OECD. 2020. Protecting People and Societies. Available at: https://www.oecd.org/inclusive-growth/resources/COVID-19-Protecting-people-and-societies.pdf [accessed April 27, 2020].
Ramirez-Valles, Jesus, Eric Breton, David Chae, Regine Haardörfer and Lisa Kuhns. 2020. “The COVID-19 Pandemic: Everything Old Is New Again in Public Health Education”. Health Education & Behavior 47, no. 4: 501−503. https://doi.org/10.1177/1090198120935067.
Sandu, Dumitru. 2013. Territorial development – solutions for lagging and leading areas, in Ionescu-Heroiu M., et al. Competitive cities, reshaping the economic geography of Romania, Romanian Regional Development Programme. https://openknowledge.worldbank.org/handle/10986/17559?show=full.
Singh, Devendra Raj, Dev Ram Sunuwar, Sunil Kumar Shah, Kshitij Karki, Lalita Kumari Sah, Bipin Adhikari and Rajeeb Kumar Sah. 2021. “Impact of COVID-19 on health services utilization in Province-2 of Nepal: a qualitative study among community members and stakeholders”. BMC Health Serv Res 21, 174 https://doi.org/10.1186/s12913-021-06176-y.
Shadmi, Efrat, Yingyao Chen, Inês Dourado, Inbal Faran-Perach, John Furler, Peter Hangoma, Piya Hanvoravongchai, Claudia Obando, Varduhi Petrosyan, Krishna D. Rao, Ana Lorena Ruano, Leiyu Shi, Luis Eugenio de Souza, Sivan Spitzer-Shohat, Elizabeth Sturgiss, Rapeepong Suphanchaimat, Manuela Villar Uribe and Sara Willems. 2020. “Health equity and COVID-19: global perspectives”. Int J Equity Health 19, 104. https://doi.org/10.1186/s12939-020-01218-z.
Shaw, James, LaPrincess Brewer and Tiffany Veinot. 2021. “Recommendations for health equity and virtual care arising from the COVID-19 pandemic: Narrative review”. JMIR Formative Research 5, no. 4 doi:http://dx.doi.org.am.e-nformation.ro/10.2196/23233.
Stanciu, Mariana, Adina Mihăilescu and Cristina Humă (2020) Stare de urgență pentru consumul populației. Recurs la reflecție asupra trebuințelor esențiale. (Emergency State for Population’s Consumption. An Appeal for Reflection on Essential Needs). Bucharest: Research Institute for Quality of Life (RIQL). Available at: http://www.iccv.ro/evenimente/ [accessed May 10, 2020].
Swinkels, Rob, Manuela Sofia Stănculescu, Simona Anton, Bryan Koo, Titus Man and Ciprian Moldovan. 2014. Atlas of Urban Marginalized Areas in Romania. Available at: http://documents.worldbank.org/curated/en/668531468104952916/pdf/Elaboration-of-integration-strategies-for-urban-marginalized-communities-the-atlas-of-urban-marginalized-communities-in-Romania.pdf [accessed February 10, 2018].
Teșliuc, Emil, Vlad Grigoraș, Manuela Sofia Stănculescu (eds.) Dumitru Sandu, Bogdan Corad, Cătălina Iamandi-Cioinaru, Titus-Cristian Man, Monica Marin, Ciprian Moldovan, Georgiana Neculau. 2016. The Atlas of Rural Marginalized Areas and of Local Human Development in Romania. Washington, D.C.: World Bank Group. Available at: http://documents.worldbank.org/curated/en/847151467202306122/Atlas-marginalized-rural-areas-and-local-human-development-in-Romania [accessed February 11, 2018].
Van Ballegooijen, Hanne, Lucas Goossens, Ralph H. Bruin, Renée Michels and Marieke Krol. 2021. Concerns, quality of life, access to care and productivity of the general population during the first 8 weeks of the coronavirus lockdown in Belgium and the Netherlands. BMC Health Serv Res 21, 227. https://doi.org/10.1186/s12913-021-06240-7.
Voicu, Mălina (ed.), Daniel Arpinte, Delia Bădoi, Alexandra Deliu, Simona Mihaiu, Simona Stănescu and Cristina Tomescu. 2020d. Pandemia COVID19 din perspectivă demografică. (COVID19 Pandemics from a Demographic Perspective). Bucharest: Research Institute for Quality of Life (RIQL). Available at: http://www.iccv.ro/evenimente/ [accessed May 10, 2020].
UNICEF (2020a) Rapid Assessment of the Situation of Children and their Families, with a focus on the vulnerable ones, in the context of the COVID-19 outbreak in Romania. Round 1. Bucharest: UNICEF Romania. Available at: https://www.unicef.org/romania/documents/rapid-assessment-situation-children-and-their-families-focus-vulnerable-ones-context-0 [accessed May 10, 2020].
UNICEF (2020b) Rapid Assessment of the Situation of Children and their Families, with a focus on the vulnerable ones, in the context of the COVID-19 outbreak in Romania. Round 2. Bucharest: UNICEF Romania. Available at: https://www.unicef.org/romania/documents/rapid-assessment-situation-children-and-their-families-focus-vulnerable-ones-context-0 [accessed May 30, 2020].
Zamfir, Cătălin and Elena Zamfir. 2020. Calitateavieții în timpul pandemiei: probleme și politici de răspuns. Un punct de vedere sintetic. (Quality of Life in Times of Pandemics: Problems and Response Policies. A Synthetic Point of View). Bucharest: Research Institute for Quality of Life (RIQL). Available at: http://www.iccv.ro/evenimente/ [accessed May 10, 2020].
How to Cite
Copyright (c) 2022 Romanian Academy Publishing House
This work is licensed under a Creative Commons Attribution 4.0 International License.