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INTRODUCTION In several European countries, Roma communities face institutional, juridical, social, economic, and cultural obstacles in the course of their access to appropriate, effective, and high-quality healthcare. In their migration from Eastern to Western European countries, Roma migrants experience these obstacles on a daily basis, which are exacerbated by a lack of attention to their specific social and cultural background that prevents the enhancement or improvement of their health. In Italy, the Romas’ poor health status is strongly connected to the community’s lower levels of education and literacy, limited socio-economic opportunities, and inadequate living conditions in marginalized and isolated urban areas. These drivers, together with strong prejudice and generalized mistrust against the Roma communities foster the discrimination that the Roma people face while accessing health services. Although access to healthcare is universal in Italy, not all Roma communities can access health services to the same extent as the rest of the population. Public health authorities and healthcare providers are often unable to overcome their rigid bureaucratic limits and offer low-threshold health services to vulnerable ethnic minorities, such as the Roma communities. Roma people frequently face institutional, juridical, social, economic, and cultural obstacles in the course of their access to appropriate, effective, and high-quality healthcare. In Italy, Roma people experience difficulties such as cultural constraints and discrimination while accessing health services. For this reason, in recent years, public healthcare institutions have been experimenting with innovative approaches aimed at overcoming inequalities and discriminations associated with the access to health care through cooperation between private and public health and the active involvement of the Roma communities. The implementation of low-threshold services have specific requirements such as; a strong commitment toward public health at the national, regional, and local levels; joint local networks of well-trained healthcare professionals, non-medical personnel, and civil society organizations; tailor-made projects addressing Roma with respect to the public health facilities; monitoring the access to the healthcare facilities of Roma; promoting direct interaction between healthcare providers and Roma; cultural mediation; actively involving Roma communities in overcoming the mistrust of and prejudice toward healthcare providers and medical facilities; promoting a healthy lifestyle in Roma households by fostering routine screenings, immunization, and medical appointments and respecting medical pharmacological therapies. To improve the Roma communities’ health in Italy, we have proposed a culturally-oriented model that offers a methodological approach beyond prejudice to improve access to healthcare.

Migration, Public Health, and Low-Threshold Health Services in Italy: A Culturally-Oriented Approach for Roma Communities