Health and Health Care Among Travellers

Abstract

Travellers, or Gypsies, constitute a minority group with its own culture and traditions for whom access to health care can pose problems. A study of Traveller women and children showed that the sites where they lived were often lacking in facilities and provided a poor environment in terms of cleanliness and safety. Perinatal mortality was above average, and was especially high on sites with inadequate facilities and among the more mobile families. Immunisation and preventive care of children were both inadequate, especially among the more mobile. There continues to be a need for more, and better, permanent sites for Travellers. Other responses include allowing Traveller families to carry their own medical records, providing mobile clinics for Gypsy sites, and appointing specialist health visitors to ensure that Travellers get the health care to which they are entitled.Over the past few years there has been growing recognition that members of ethnic and cultural minorities may face particular barriers in getting access to appropriate health and welfare services. Local initiatives aimed at improving access have focused particularly on the needs of black and Asian communities (see Dowling, 1983). However, relatively little attention has been so far been given to the problems faced by Britain's oldest ethnic minority, the Gypsies, or Travellers, as they prefer to be known.The aims of the study described in this article were, firstly, to document the health problems of Traveller women and children and, secondly, to make recommendations for improvements in health and welfare services for this group of the population. Kent has a substantial population of Travellers, and so provided an opportunity for carrying out a study which would have relevance wherever Travellers share community

UNderstanding uptake of Immunisations in TravellIng aNd Gypsy communities (UNITING): a qualitative interview study

“…43 There is, therefore, a lack of accurate information about immunisation uptake in Traveller communities. A small number of local studies using parent self-report 1,[44][45][46] and NHS records 1,47 suggest low or variable uptake of childhood immunisation. These patterns mirror data for other disadvantaged groups who are more likely to be unimmunised or not up to date, significantly increasing their risk (and consequent spread) of vaccine-preventable disease.…”

“…72 Although many of the issues influencing vaccine uptake described in the literature are likely to be similar for Travellers, further research is needed to understand the specific issues affecting diverse Traveller communities to inform the development of interventions tailored to their needs and cultural context. To date, only a few studies 1,[44][45][46][47] have explored the barriers specific to immunisation uptake in Traveller communities. These identify multiple issues reflecting the difficulties in accessing wider health services experienced by marginalised, socially excluded communities.…”

“…[17][18][19][20][21]24,[73][74][75] Issues particular to immunisation include barriers to accessing primary care services (e.g. the absence of a permanent postal address for recall letters), 45 parental concerns about the safety of vaccines 46,76 and objection to immunisation arising from strongly held cultural beliefs and traditions. 18 A reluctance to 'self-identify' as Travellers for fear of discrimination 77 and the challenge of maintaining reliable health records for transient communities 19 hinder record keeping of immunisation uptake in Traveller communities.…”

“…This enabled us to identify differences and similarities in views within each community as well as draw out meaningful comparisons across the six Traveller communities, both for gender and for different vaccines (childhood and adult). A small number of studies have reported the uptake of immunisation by different groups of Travellers in the UK 1,44,45,47 and Roma communities in Europe; [108][109][110] and an extensive literature exists on Travellers' experiences of health services more generally. [17][18][19][20][21][22]24 However, there is very little research on Travellers' views on, and experiences of, immunisation specifically.…”

Increased risk of maternal death among ethnic minority women in the UK

“…29,30 The groups of particular concern are women who have recently arrived, in or after the second trimester of pregnancy, and who have no or minimal contact with maternity services. The problems described are broadly similar to those of women from ethnic minority groups as outlined above.…”