Report on Health Status of Gypsy/Travellers Published in UK

11 March 2005

In October 2004, the University of Sheffield School of Health and Related Research issued its report, “The Health Status of Gypsies & Travellers in England”. The following is a summary of the research results, as published in the report:

“Results: Health status survey
Results of the quantitative survey show that Gypsy Travellers have significantly poorer health status and significantly more self-reported symptoms of ill-health than other UK-resident, English-speaking ethnic minorities and economically disadvantaged white UK residents. Using standardised measures (EQ5D, HADS anxiety and depression) as indicators of health, Gypsy Travellers have poorer health than that of their age sex matched comparators. Self reported chest pain, respiratory problems, and arthritis were also more prevalent in the Traveller group. For Gypsy Travellers, living in a house is associated with long term illness, poorer health state and anxiety. Those who rarely travel have the poorest health.

“There was some evidence of an inverse relationship between health needs and use of health and related services in Gypsy Travellers, with fewer services and therapies used by a community with demonstrated greater health needs.

“From these results, and from comparison with UK normative data, it is clear that the scale of health inequality between the study population and the UK general population is large, with reported health problems between twice and five times more prevalent. […]

Table 5:

Numbers of Gypsy Travellers and age-sex matched comparators reporting specific illnesses and problems

Illness or Health Problem

Gypsy/Travellers

N= 260

Comparators N=260 Age-Sex Matched (p)  % difference (95% CI) 
Illnesses/problems reported after prompting        

Nerves

73 10    
Arthritis 57 25    
Asthma 56 14    
Eye/vision problems 28 9    
Bronchitis/emphysema 27 5    
Heart disease including angina 20 9    
Hearing problems 16 8    
Rheumatics 15 3    
Diabetes 11 9    
Stroke 3 2    
Cancer 2 6    
Illnesses/problems identified from specific question(s)        
Chest pain/discomfort 88 57 0.002  12 (4, 20)
Possible angina 78 51 0.008 10 (3, 18)
Chronic cough 127 43 <0.001 32 (25, 40)
Chronic sputum 119 38 <0.001 31 (24, 39)
Bronchitis 107 26 <0.001 31 (24, 38)
Asthma 168 105 <0.001 24 (16, 33)
Anxiety 100 33 <0.001 26 (19, 33)
Depression 55 20  <0.001 14 (8, 20)

"Results: Qualitative study
“[…] Accommodation was the overriding factor, mentioned by every respondent, in the context of health effects. These effects are seen to be far reaching and not exclusively concerned with actual living conditions, although these are clearly seen as crucial.

“Other issues include security of tenure, access to services and ability to register with a GP, support and security of being close to extended family, a non-hazardous environment and the notion of freedom for the children. There are also other factors aside from health considerations that come into play such as availability of work and access to education. For most respondents the ability to choose their style of accommodation and to decide for themselves whether, or how, they continue to live a traditional travelling lifestyle is of fundamental importance and crucial to their sense of independence and autonomy. The lack of choice or the intolerable conditions, mentioned by the majority of respondents, are an indication to them of the negative way in which they are viewed by the non-Traveller society. It is this feeling of injustice and persecution that is often forcibly expressed as muchas concern about the adverse effects of the conditions per se.

“In relation to Gypsy Travellers’ experiences in accessing health care and the cultural appropriateness of services provided, we found widespread communication difficulties between health workers and Gypsy travellers, with defensive expectation of racism and prejudice. Barriers to health care access were experienced, with several contributory causes, including reluctance of GPs to register Travellers or visit sites, practical problems of access whilst travelling, mismatch of expectations between Travellers and health staff, and attitudinal barriers. However, there were also positive experiences of those GPs and health visitors who were perceived to be culturally well-informed and sympathetic, and such professionals were highly valued.

"Other results
“Fewer than half of the Primary Care Trusts, Strategic Health Authorities and Public Health Observatories responding to our survey had knowledge of the numbers or location of Gypsy Travellers locally. Information on Gypsy Travellers’ use of services was more rarely available and only a fifth had any specific service provision. Only one in ten had any policy statement or planning intentions that specifically referred to Gypsy Travellers.

“Our findings confirm and extend the practice-based evidence on poorer health in Gypsy Traveller populations. There is now little doubt that health inequality between the observed Gypsy traveller population in England and their non-Gypsy counterparts is striking, even when compared with other socially deprived or excluded groups and with other ethnic minorities.

“The impact of smoking,  education and access to GP service is important. The educational disadvantage of the Travellers was extremely striking, and the single most marked difference between Gypsy Travellers and other socially deprived and ethnic minority populations. However, these factors do not account for all the observed health inequalities. The roles played by environmental hardship, social exclusion and cultural attitudes emerge from the qualitative study, and are consistent with the finding there is a health impact of being a Gypsy Traveller over and above other socio-demographic variables.” (See table on p. 74)

A team of researchers from the University of Sheffield undertook research for the report, with the assistance of Gypsy/Traveller activists, health visitors and members of Primary Care Teams. The full text of the report is available on the Internet at: http://www.shef.ac.uk.

(ERRC)

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