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Purpose--This paper aims to compare the health status of Roma in Europe and Aborigines in Australia, examining access to health care (both primary and long-term), administrative and communication problems, environmental risks associated with location of residences, women's health, substance abuse and mental health. Design/methodology/approach--The paper discusses issues generated by cultural practices by both health care providers and the target groups. Findings--Both Roma and Australian Aborigines have significantly poorer health status than the majority of the societies they are embedded in, and are clearly amongst the most disadvantaged members of their respective societies. Nevertheless, affirmative action programs for Aboriginal people over the last 40 years have produced some significant changes, with Aboriginal doctors and nurses, and culturally appropriate service provision being found in many areas. Originality/value--Although there are considerable similarities between the health status and situation of Romanies and Australian Aborigines, clearly, there are also substantive differences. The paper suggests possible culturally appropriate service provision for Roma, based on Australian Aboriginal experiences and models. [ABSTRACT FROM AUTHOR]

Objectives: Using the concept of avoidable mortality, international studies suggest that healthcare has been effective in reducing mortality. This paper provides an analysis of avoidable mortality in Australia and compares trends with those of Western Europe. Methods: Using unit-record mortality data, we calculated avoidable mortality rates in Australia for 1968-2001. We partitioned avoidable causes into three categories: those amenable to medical care; those mainly responsive to health policy; and ischaemic heart disease. We used Poisson regression to model the trends. We compared trends with those of nine European countries using published data. Results: Total avoidable death rates fell by 68% in females and 72% in males. The corresponding non-avoidable death rates fell by 35 and 33%. The annual declines in avoidable mortality rates were: 3.47% [95% confidence intervals (CI) 3.44-3.50%] in males and 3.89% (95% CI 3.86-3.91%) in females. For non-avoidable mortality rates, the annual declines were 1.09% (95% CI 1.05-1.13%) and 0.95% (95% CI 0.92-0.98%), respectively. In females, declines in death rates from causes amenable to medical care contributed 54% to the decline in avoidable mortality rates, ischaemic heart disease contributed 45%, and causes responsive to health policy intervention contributed 1%. In males, the corresponding contributions were 32, 57 and 11%. These rates, and the declines between 1980 and 1998, were comparable with selected European countries, with Australia's ranking improving over the period. Conclusion: Trends in avoidable mortality in Australia suggest that the Australian healthcare system has been effective in improving population health. Australia's experience compares favourably with that of Europe. [ABSTRACT FROM AUTHOR]