Background Roma are the largest minority ethnic group in Europe. They have faced ongoing discrimination and persecution, with reports of large and widening social and health disparities between Roma and non-Roma. Most analyses of the policies that aim to improve the situation for Europe’s Roma compare the pros and cons of proposed solutions. They do not reveal the assumptions that shape how the “problem” of Roma health and wellbeing is understood in policy proposals and how this influences the solutions that are – or are not–put forward. The aim of this study is to explore the conditions that have allowed certain representations of the “problem” of Roma health-and-wellbeing to acquire dominance/suppression during the 1980–2015 period of economic transition and successive eastward EU expansion.

Methods Five oral history interviews were conducted with European policy specialists to provide accounts of the development of European policy relevant to Roma health and wellbeing and to map key documents produced by EU decision-making institutions (the Parliament, Council and Commission). Further documents were located through catalogue searches. All retrieved items were mapped/categorised before five policies relating to pivotal shifts in the way Roma health and wellbeing has been understood as a policy problem were selected. Analyses drew on Bacchi’s “What’s the problem represented to be?” post-structural analysis framework to explore: 1) underlying frameworks of thought that shape problem representations; 2) the conditions that allowed shifts in problem representations to occur; and 3) how these problem representations shaped the different solutions that have been proposed.

Results Since the 1980’s policies produced by the main EU institutions have situated the concern for Roma health and wellbeing within a wider drive for economic growth. A perceived low productivity among Europe’s Roma populations is attributed to their low educational attainment and subsequently reduced employment opportunities. Inadequate housing/living conditions and low uptake of health care services are seen to compound the “problem” leaving Roma prone to poor health that further limits their productivity. The proposed solution is to remove the barriers that are perceived to prevent Roma from accessing mainstream health, education, employment and housing.

Conclusion With a perceived increase in the size and mobility of its Roma populations, recent EU policy has framed “Roma health” as a barrier to economic development. Policy solutions frame improvements in Roma health as a means to improve overall productivity of the region, rather than as an end in itself.