Concept of Health and Sickness of the Spanish Gypsy Population: A Qualitative Approach
2. Materials and Methods
2.3. Data Collection
2.4. Ethical Considerations
2.5. Data Analysis
2.6. Validity and Reliability/Rigor
3.1. Perception of the State of Health
“I’m extremely well” JH1.
“Good, thank God” UH5.
“My health is good, it’s just the sugar” UH4.
“If you are sick […], maybe you are healthy but something doesn’t work, it doesn’t mean that your health is not good because you have some sickness” LM2.
3.2. The Value of Health
“Well, I know that everyone will value health equally, but I know that in the gypsy community, one of their… I don’t know, of their foundations is health and freedom, which in the gypsy language, it is “sastipen tali” LM1.
“Your house, live happy with yours, for me, this is health” LM1.
3.3. What is Observed
“[…] Because […] says; he’s sick, pff. I don’t like it, I don’t like that word, for them to say he’s sick, that’s what it is, I don’t like saying it. However unwell someone is, you don’t tell him he’s sick. In my point of view, (saying) one is unwell, but sick… For me it is a harsh word” UM3.
“Being healthy is having good eyesight, being strong and having a good face color (appearance)” UM1.
“The gypsy has suffered few illnesses, but as soon as he becomes unwell, he dies” JH1.
(Interviewer) How is your health?
(Interviewee) Good, but apparently, it hurts once in a while, because it seems that it is hereditary […]. As for the rest, I don’t have any complaints about anything. UH9.
“I believe that when they get a shot (of insulin) and they are ok, they will say I’m fine now, I don’t need a shot, that’s what I think… they let themselves go a bit, and when they are unwell again, they get a shot again, and so on” UH2.
3.4. Causal Attribution
“Life is like, it is a thing that is nature ” […] “I don’t understand that” […] ”Yes, yes, not that, not that, it’s just whatever has to happen, happens” UM3.
“What are they going to do? As if God was not the only one…” UH9.
“(To be healthy) I don’t do anything. It stays like this and that’s it” UM1.
“And another thing, because God wants it. It’s just that… I don’t know what else to say.” LM1.
“I don’t know many who get x-rays or analysis, because for us, the less we know, the better, about the illnesses” […] “I don’t know, and I don’t want to know” UH2.
3.4.2. Worry vs. Acting
“I see them worry a lot (the non-gypsies) due to many circumstances of life. What happens? When a person worries, he is preparing his mind for something bad to happen. It is completely the opposite of being an optimist. It is pessimistic. Worrying is a synonym of pessimism, and this creates stress in many of them […] The gypsies, well, we have a greater optimism. If something happens, we solve it, and that’s it. We take care of the circumstance, but we never think that something bad is going to happen to us” […] “The non-gypsy has too many worries, and does not act” JH1.
3.4.3. Temporal Sequence
“With the belly, they fell” […] “part of the mouth becomes destroyed” UM1.
3.4.4. Origin of the Information
“They say that a glass of wine daily is good, I’ve heard this from people” UH2.
“The thing is, I asked the pastor of my church and he detected it, he says that I don’t have depression, it’s a bit of anxiety; doubts and fears” LM1.
“The current drive for the gypsies to massively turn to religion and all is leading the gypsies to abandon themselves to nature” UH4.
Conflicts of Interest
|Perception of the state of health||---||- Optimism for health:|
“I am excellently well” JH1
“I’ve never been bad” UM2
“well, thank God. What is sugar, sugar, right now, sugar and a little cholesterol” UH5
“health, I’m fine, it’s light stuff, it’s blood pressure, women’s problems” UM5
“I health very well, just sugar” UH4
“(cholesterol) was a little high” UM9
- Disease within health
“if you have a disease […], maybe you are healthy but something is wrong, it doesn’t mean that maybe because you have a disease it’s because your health is going very badly” LM2
- Vital optimism:
“The gypsy himself is usually a happy person, because the more ignorant you are, the happier you are. That’s true, that’s how it is. In their ignorance the gypsies are happy because they are satisfied with little, they live a day” […] “but that the gypsies in themselves are usually happy people, animated people” UH8
|The value of health||---||- High social desirability:|
“man, I know that everyone will value health equally, equally, but I know that the gypsy community one of its… I who know, its foundations is health and freedom, which in Romani is often called “sastipen tali”“ LM1
“Most important of all is health” UM4
“So you’re in a good position, a good house, if you’re bad, what good is it to you? Not at all. UM4
“I health. Nothing more. That’s it. More than that word, they don’t take any more words, there are too many words” […] “health, more than money. […] because if you have millions and you are sick, why do you want money? Would you like to have a lot of money, a lot of it and be sick? What do you want better money or health? […] that’s it, there’s no more” UH5
“(health) Well, it’s everything in life. It is the maximum. Because a person who is healthy can walk around the world and look for his life and enter, leave, move, see your children to your grandchildren. I think that’s the greatest thing that exists today, more than money, more than anything!” UH9
- Health for the family:
“Right now I feel like I’m fine, those in my house are fine right now” UM1
“your home, live happily, live with yours, for me that’s health” LM1
“Because a pot of whatever it is […] is made in the family, it is not made alone, because you cannot grill it, it impregnates feelings of loneliness in you, and even […] you feel bad, but when there is a paella and you share it, the smile comes to you as soon as you see it…” JH1
|What is observed||● Negative||“Where am I going to go? What am I going to do? Concerns that, that… that cause you that discomfort” UH1|
“For they enter into a deep sadness, let’s say, if they have no inducement… they suffer it, they live it within themselves…” UH1
“[…] because he says; he’s sick, poof. I don’t like it, this word I don’t like, they say it’s sick, that’s what I don’t like to say. No matter how bad it is and everything, you don’t say it to a person. To me it seems, (to say) that it is bad, that… but sick… For me it is a strong word.” UM3
“That person is going to go into depression. That’s what I wouldn’t want him to say to his face (the doctor he’s sick to). Or they are… there are a lot of doctors who are very abrupt” UH9
|● Physical consequences||“you get very dry”, “you swell with the medications you take, with everything “UM2|
“Not being able to do what you want or what you need. In other words, unable to do what you must” UH1
“to be healthy is to have good eyesight, to be strong, to have good face color” UM1
|● The severity||“When a person is ill, he carries a high blood pressure […] he is quite serious. Call the doctor that there is a person who is ill, and who cannot wait” UH10|
“The gypsy has suffered very few illnesses but it was getting sick and dying” JH1
“I have never been bad or anything I have not had anything operated on, I have had normal deliveries. UM1
“(Being in the hospital) and I heard him say: no, no, but you tell me, what is it, but is it good or bad? The doctor was talking to you, you’ve got this! And they summed it up but it’s good or bad. They sum up in that no, nothing happens to you that this is not going to die, then it’s not bad, is it? […] It’s all in a word that defines how healthy they are, you know?” UH8
|● Health, the opposite of sickness||(Interviewer) How is your health?|
(Interviewee) Good, apparently, it does hurt from time to time, because you can see that it is hereditary […]. I don’t complain about anything else. UH9
|● The tangible and the need to act||“And when it comes like that, diseases like these (measles outbreak), you know it’s going to get infected because we get the vaccine, we get vaccinated” UM5|
“I believe that when they prick themselves (to put insulin) and they are well, they will say they are already well, I do not need to prick me, I say… They are already left a little and when they are bad again, they prick again and so on” UH2
“I think a doctor is there for you when something happens to send you medicine and try to cure you” UH9
“They know that if they eat other things, for example; salt, which harms him, or if they are diabetic things of, of, so sweet and that, can also harm them… but:: don’t think about it! Or if they think about it later with the medicine they see that nothing happens” UH9
“when there’s a close case is when, let’s say, that’s the information that directly reaches the soul because they know… what happens! They don’t see it as something far away that you tell them “UH8
|Causal attribution||● Nature, inexplicable, hazardous and its connection with God (and the consequences)||“Life is like that, it’s a thing that is nature” […] “I don’t understand that” […] “That, that, that, no, that, no, that’s what has to happen, happens” UM3|
What are they going to do? As long as God is not the only one… UH9
“I don’t know why” UM2
“things of nature” UM1
“bad because God wants” […] “the majority who get bad is because it is written like this” […] “you are bad because God sends it to you” UH3
Passivity in preventive action:
“(to be healthy) I do nothing. It’s just like that and that’s it” UM1
“To be healthy? Follow as I go” UM2
“I also had an ulcerative colitis disease, but I believe in my God for my health… and I’m perfect right now. […] God is going to save me, he can do it” LM1
- Understanding the disease:
“I don’t know that you have to get sick, but I haven’t stopped to think why, I don’t know.” UM4
“and that’s another thing, because God wills it. I don’t… I can’t tell you anything else” LM1
|● What is not mentioned does not exist||“I don’t know many who take x-rays or analyses, because the less we know the better, the diseases” […] “I don’t know, and I don’t want to know” UH2|
|● The temporality|
- Worrying vs acting
- Temporal sequence
|- Worrying vs. Dealing|
“I see them that they are very overwhelmed (to the general people) by many circumstances, of life. What happens? When a person worries, he is preparing his mind that something bad is going to happen to him. It’s the complete opposite of being optimistic. It’s pessimistic. Worrying is synonymous with pessimism and that causes them a lot of stress. […] the gypsies, because we have a greater optimism. There comes a circumstance, well, we give him the solution and that’s it. We deal with the circumstance but we never have in mind that something bad is going to happen to us. “The general people has many worries, not occupations” JH1
“The general people thinks of sickness, of evil, and the Gypsy does not. The gypsy doesn’t even remember that” UH3
“If it’s something that you already feel bad about, that bothers you a lot, the most normal thing is to go to the doctor” UH9
“It’s just that imagining long-term life for a gypsy is complicated.” UH8
“[…] “part of the mouth is destroyed” UM1
“now with the pregnancy I’m being stung a little bit some molars” LM2
“my grandfather knew it was wrong, wrong, wrong, because he did things he had never… done before” UH2
|● Source of information||- Mouth to mouth|
“Now the glass has broken from here below and they say that it goes up more if you put them on with the broken glass” […] “I have heard say that the children do, because they say that the blood is compatible and the children go out badly, well it can be” UM5
“They say a glass of wine every day says it’s good, I’ve heard that from people” UH2
“It is that I do not know the system of the problem that <…> they say that they are hot, that they do not feel strong <…> it is that they do not:: I do not know it” UH1
“I’m consulting the pastor of my church and he detects it, says it’s not depression what you have, it’s a little anxiety, it’s fears and fears
”However, there is a polarized discourse with the figure of the shepherd. It conveys a feeling that things depend on God and therefore control does not depend on you and therefore you must not do anything special to get health.
“this of now of the gypsies massively turning over to religion and such, is also making the gypsy abandon himself to nature” UH4
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|1||UM1||43||5||No||4th year BE *||Yes||56 min|
|2||UM2||22||1||No||1st year BE||No||48 min|
|3||UM3||43||4||Yes||2nd year BE||Yes||59 min|
|4||UM4||43||3||No||6th year BE||-||1 h 05 min|
|5||LM1||41||3||Yes||Vocational training||Yes||55 min|
|7||UM5||35||3||Occasional||3rd year BE||Yes||49 min|
|8||UM6||67||3||Retired||Illiterate||Yes /Little||35 min|
|10||JM1||47||4||Occasional||5th year BE||Yes||59 min|
|11||LM3||56||5||No||2nd year BE||Yes||1 h 15 min|
|1||UH1||47||4||Yes||4th year BE||Yes||60 min|
|2||UH2||18||0||Student||4th year BE||Yes||59 min|
|3||UH3||75||4||Retired||Reads and writes||No||47 min|
|4||UH4||57||5||Occasional||BE||No||1 h 03 min|
|5||JH1||39||3||Yes||Vocational training||Yes||1 h 19 min|
|6||UH5||74||5||Retired||Reads and writes||No||50 min|
|7||UH6||52||3||Occasional||5th year BE||Little||56 min|
|8||UH7||24||0||None||3rd SE **||No||39 min|
|9||UH8||35||1||Pensioner||4th SE||No||1 h 03 min|
|10||JH2||46||2||Occasional||5th year BE||Yes||58 min|
|11||LH1||59||4||Pensioner||2nd year BE||Yes||1 h 02 min|
|12||UH9||52||3||Occasional||5th year BE||Yes||55 min|
|Perception of the state of health||---|
|The value of health||---|
|What is observed|
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Ramos-Morcillo, A.J.; Leal-Costa, C.; Hueso-Montoro, C.; del-Pino-Casado, R.; Ruzafa-Martínez, M. Concept of Health and Sickness of the Spanish Gypsy Population: A Qualitative Approach. Int. J. Environ. Res. Public Health 2019, 16, 4492. https://doi.org/10.3390/ijerph16224492
Ramos-Morcillo AJ, Leal-Costa C, Hueso-Montoro C, del-Pino-Casado R, Ruzafa-Martínez M. Concept of Health and Sickness of the Spanish Gypsy Population: A Qualitative Approach. International Journal of Environmental Research and Public Health. 2019; 16(22):4492. https://doi.org/10.3390/ijerph16224492Chicago/Turabian Style
Ramos-Morcillo, Antonio Jesús, César Leal-Costa, César Hueso-Montoro, Rafael del-Pino-Casado, and María Ruzafa-Martínez. 2019. "Concept of Health and Sickness of the Spanish Gypsy Population: A Qualitative Approach" International Journal of Environmental Research and Public Health 16, no. 22: 4492. https://doi.org/10.3390/ijerph16224492