The term ‘Gypsy, Roma and Travellers’ is a collective term that describes a number of individual an of distinct ethic groups including UK Romany Gypsies, European Roma and Travellers of Irish descent that while sharing many aspects of a common culture, have separate ethnic identities as well as different languages (Source: Parry et al 2004).
Gypsies and Travellers experience, and are being held back by, some of the worst outcomes of any group, across a wide range of social indicators including health, safety and educational attainment (Source: Progress report by the ministerial working group on tackling inequalities experienced by Gypsies and Travellers).
It has been estimated that Gypsy Traveller women live on average 11.9 years less, and Gypsy Traveller men 9.9 years less, than those in the non-Traveller population. Gypsy, Roma and Travellers are twice as likely to be affected by a long-term condition compared with the general population (prevalence of 42% compared with 18% nationally) and report the highest level of perinatal infant mortality of all ethnic minorities.
(Sources: The Travellers' health status study: vital statistics of travelling people, 1987 and Improving access to health care for Gypsies and Travellers, Royal College of General Practitioners).
In 2011 just 12% of Gypsy, Roma and Traveller pupils achieved five or more good GCSEs, including English and mathematics, compared with 58.2% of all pupils. Illiteracy is a significant issue for many. This educational disadvantage is 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.
(Source: Department for Education).
Insecure accommodation and poor living conditions of Gypsies and Travellers also significantly contribute to poor physical and mental health. Along with poor living conditions and education, loss of traditional employment and poverty as well as social isolation and discrimination are other factors that negatively impact the health and wellbeing of this community.
(Source: Impact of insecure accommodation and the living environment on Gypsies’ and Travellers’ health. NIHB 2016)
According to surveys, barriers to heath care for Gypsy Travellers include; expectations of racism and prejudice due to previous bad experiences, reluctance of GPs to register Travellers or visit sites, practical problems of access whilst travelling, and mismatch or misunderstanding of attitudes.
Gypsy, Roma and Travellers’ health beliefs and attitudes to health services also prove a barrier. Studies show that there is a significant cultural pride in self-reliance demonstrated by traveller groups. Fatalistic attitudes to illness are also expressed; that is, illness is often seen as inevitable and medical treatment seen as unlikely to make a difference. There is often more trust in family carers rather than in professional care.
(Source: The Health Status of Gypsies & Travellers in England, DoH 2004).
As of January 2015, there were 40 caravans on authorised sites within the boundaries of Slough Borough Council, all of which were socially rented caravans. No caravans were found to be on unauthorised sites, this compares to an average of 13% of caravans on unauthorised sites nationally. The number of caravans on sites in Slough has halved since 2013.
(Source: Department for Communities and Local Government).
The percentage of school children who are of Gypsy/Roma heritage or Irish Traveller heritage in Slough is 0.78% compared to a national average of 0.37%. This represents a total of 186 school children in Slough. Of the school aged children from Slough who are of Roma or Traveller heritage, the majority (over three quarters) are from Gypsy/Roma groups with only a quarter of Irish Traveller background.
(Source: Department for Education).
While local intelligence on the local health needs of those in Gypsy, Roma and Traveller communities is limited last year the Beehive Foundation in cooperation with Slough Healthwatch undertook a brief survey of Roma children attending an oral health workshop at Chalvey Community Centre which showed that less than 5% of the children surveyed had access to toothbrush.
(Source: Improving dental hygiene in Roma children from Chalvey, Slough).
Slough has a traveller community that, while living in settled and authorised sites and therefore having greater accommodation security than many others experience, are likely to have significant health and wellbeing needs that are not currently being met due to poor engagement with services.
The aspects of health that show the most marked inequality between traveller and non-traveller communities are self-reported anxiety, respiratory problems including asthma and bronchitis, chest pain and arthritis. These are related to disparities in rates of smoking and alcohol consumption.
To improve health outcomes for Gypsies and Travellers, we need to adopt a more integrated approach, focused on the life course and the wider determinants of health.