Maltreated gypsy children: Social and health risk factors and high-priority health care needs

Objectives To determine the prevalence of maltreated gypsy children admitted to centers of protection, as well as their demographic characteristics, type of maltreatment, frequency of associated social and health risk factors, frequent health problems and whether there are differences between these children and the general population of maltreated children. Patients and methods We performed a retrospective cross-sectional cohort study over an 8-year period (1995-2002). The social and health reports of the maltreated children admitted to protection centers were reviewed and those belonging to the gypsy ethnic group were included. Information collection, definition of concepts and health assessments were performed according to nationwide methodologies, studies and directives. A descriptive and comparative statistical study was performed. Results During the study period, 873 children were admitted, of whom 74 were from the gypsy ethnic group (a prevalence of 8.5%, 1.7 times higher than that expected). Demography: mean age: 6.9 years (5.7 SDU); age group 0-5 years age: 56.7%; females: 51.3%. No significant demographic differences were observed in gypsy children compared with the general population of maltreated children. However, factors that were significantly more frequent in gypsy children were the prevalence of passive maltreatment (p = 0.0133; odds ratio [OR]: 2.4; 95% confidence interval [Cl]: 1.2-4.9), belonging to families with more than one social and health risk factor (p = 0.0000; OR: 30.5; 95% Cl: 9.4-99.1) with problems of delinquency (p = 0.0000; OR: 11.7; 95% CI: 6.3-21.7) and with a history drug/alcohol abuse (p = 0.0000; OR: 3.4; 95% CI: 1.9-6), presenting at least one health problem (p = 0.0000; OR: 6.9; 95 % Cl: 2.7-17.3), absent or incomplete immunizations (p = 0.0000; OR: 4.9; 95 % CI: 3-8.1), disabilities (p = 0.0012; OR: 2.9; 95% Cl: 1.5-5.9) especially of neurological origin (p = 0.0000; OR: 4.8; 95% CI: 2-11.4), psychomotor developmental delay in children younger than 6 years (p = 0.0330; OR: 2.4; 95 % CI: 1-5.3) and behavioral disorders in adolescents (p = 0.0005; OR: 4.7; 95% CI: 1.8-12.1). Conclusions There is a significant association between maltreatment of gypsy children and the presence in their family of social and health risk factors such as delinquency and mental health problems related to drug addiction/alcoholism. The health status of these children is significantly different from that observed in maltreated children from the general population, with a greater incidence of neurological disabilities and problems and diseases related to chronic neglect and/or abandonment of the child's health, socio-educational and psycho-emotional needs. These children are admitted to centers of protection more frequently than their theoretical risk would predict.