Concept of Health and Sickness of the Spanish Gypsy Population: A Qualitative Approach.

The Roma community (RC) has poor health indicators, and providing them with adequate healthcare requires understanding their culture and cultural differences. Our objective was to understand the concept of the health and sickness of the RC in Spain, and for this, a qualitative study was conducted. A content analysis utilizing an inductive approach was used to analyze the data. Twenty-three semi-structured interviews were performed, and four main categories were obtained after the analysis of the data: perception of the state of health, the value of health, what was observed, and causal attribution. The inter-relations between the categories shows that the RC have a dichotomous worldview split between non-sickness (health) and sickness mediated by causal attribution. Their worldview is polarized into two values: not sick/sick. When not sick, optimism is prioritized along with happiness, and these two emotions are highly valued, as they also play a physical and social function. When a person becomes noticeably sick, this is understood as being in a negative and severe state, and when there are visible physical implications, then the need to act is made clear. When faced with the need to act, the behavior of the RC is mediated by causal attributions, influenced by nature and religion, timing, concealment by not mentioning the disease, and the origin of the healthcare information. For the organization of an adequate health response for the RC, it is necessary for healthcare systems to be able to merge culture and health care.