Jozef has advanced ankylosing spondylitis, a condition that inflames the spine and joints. “A Romani man in the mines, you know how it is,” he told TEC. “It took a long time before they figured it out and before anyone started taking it seriously.” He's still waiting for biological treatment, but the late diagnosis has already caused irreversible damage.

Meanwhile, Jozef struggles to pay for daily taxi rides to the hospital for dressing changes. “Add the high cost of medicines and I’m facing expenses that, as a disability pensioner, I simply can’t afford.”

Jozef is far from the only Romani man struggling with health problems. Roma and Traveller life expectancies are 75.6 years for women and 69.2 for men on average – that's up to eight years less than the average European, according to a survey by the EU Agency for Fundamental Rights (FRA).

Unequal treatment

For Tomas de Jong of the European Public Health Alliance, part of the Roma Health Network, the reason for the gap goes beyond healthcare: poor housing, unhealthy living conditions, and social exclusion play a role.

More than 12 million Roma and Travellers live in Europe, and they are often disproportionately affected by poverty.

But de Jong argues poverty alone cannot explain the health gap. Antigypsyism – structural racism towards Roma, Sinti, and Travellers – shapes the conditions that influence health, including housing, education, employment, and access to services.

About one in three Roma and Travellers feel discriminated against in different areas of life, according to a 2024 FRA survey, including health. Research by human rights organisations on Roma rights in Slovakia, Bulgaria, and Hungary found discrimination in maternity wards, including segregated rooms and mistreatment and abuse from healthcare staff towards Romani mothers.

Lucie, 30, experienced degrading treatment from doctors in Czechia during pregnancy. “Even though I had a high-risk pregnancy, the staff wanted to move me down to a worse place in the examination queue,” she told TEC. “That only changed when I showed that I understood the system, knew my rights and knew what I could ask for.”

Slovak Roma rights expert Mikuláš Lakatoš, a health policy specialist, describes his own, similar experience navigating the healthcare system as a Romani man. He says discrimination in doctors’ offices today is often subtle.

“You go to a doctor and they speak to you as if you were a five year old, slowly. They prioritise patients from the so called ‘first category’ ahead of you, and I have seen cases where the care provided was simply not good enough,” he said.

These experiences, Lakatoš argues, can directly undermine Roma people’s trust in the healthcare system. Another reason why many fear going to the doctor is intergenerational trauma rooted in racism.

Harmful housing

According to the European ERGO Network, which has long focused on Roma health, Roma families across Europe live in overcrowded housing with damp walls, mould, leaking roofs, unreliable water and sanitation, and environmental hazards. These conditions are directly linked to respiratory disease, repeated infections, chronic stress, and poor child development.

“Romani children grow up in hazardous conditions, among bedbugs, and often without running water in winter,” Zdena, a social worker at the Brno-based organisation IQ Roma Servis, told TEC. She spent many years living in a hostel herself. “The children are set up for health problems from birth. And most of the clients I work with do not even have a general practitioner.” Many cannot afford even basic medicines, let alone dental care or long-term treatment.

Informal or precarious work makes matters worse: when people get injured, they often avoid the doctor because sick leave would mean losing the income their families depend on.

What needs to change?

To address these conditions, Lucie Fuková, the Czech Government Commissioner for Roma Minority Affairs, started a pilot programme of Roma health support mediators. “They go to families and help provide information about healthy lifestyles, including nutrition, mental health, preventive check ups, and addiction issues,” Fuková said.

Lakatoš thinks the overall societal position of the Roma is the root cause that has to change. “Healthcare at the end of the street will not secure 100% life expectancy. 80% is everything around us,” he said. “We need systemic changes in education, employment, and housing.”

Though the FRA found modest improvements in employment, housing, education, and access to healthcare in its 2024 Roma Survey, these changes are limited and uneven. Poverty, discrimination and exclusion remain widespread, and without stronger action, European countries are unlikely to meet their Roma inclusion targets by 2030.