Health-related beliefs and experiences of Gypsies and Travellers: a qualitative study

Abstract

Objective: To illuminate findings of the survey of the health status of Gypsies and Travellers by exploring their health-related beliefs and experiences. Design: Qualitative study of a purposive subsample from in-depth interviews using framework analysis. Setting: The homes or alternative community settings of the participants in five geographically dispersed study locations in England. Participants: 27 Gypsies and Travellers with an experience of ill health, purposively sampled from a larger population participating in an epidemiological survey of health status. Results: The experience of poor health and daily encounters of ill health among extended family members were normalised and accepted. Four major themes emerged relating to health beliefs and the effect of lifestyle on health for these respondents: the travelling way; low expectations of health; self-reliance and staying in control; fatalism and fear of death. These themes dominated accounts of health experience and were relevant to the experience. These themes add richness to the health status data and inform our understanding. Conclusions: Among Gypsies and Travellers, coherent cultural beliefs and attitudes underpin health-related behaviour, and health experiences must be understood in this context. In this group, ill health is seen as normal, an inevitable consequence of adverse social experiences, and is stoically and fatalistically accepted. The provision of effective healthcare and improvement of poor health in Gypsies and Travellers will require multi-agency awareness of these issues.

Outreach programmes for health improvement of Traveller Communities: a synthesis of evidence

“…37,39 Poor health expectations, fear about potential diagnoses and structural constraints resulting from eviction or difficulties in finding appropriate stopping places have all been suggested as factors leading to a lack of prioritisation of preventative health care and services such as screening. 39,40 In addition, the literature highlights cultural beliefs of Traveller Communities that govern the body and have a bearing on health practices and which are important for health advisors to be aware of, albeit with the proviso that cultural beliefs and practices may vary across different Traveller Communities and the individuals within them. Okely 41 demonstrates the ways in which beliefs about pollution and associated rituals around washing, eating, use of space and placement of objects enacted serve to reinforce a distinction between Travellers and settled communities.…”

“…6 A move into housing often impacts negatively on the mental health of Traveller Communities. 39 In addition to housing being an undesirable form of accommodation for many Traveller Community members, settlement in housing has also been highlighted as a costly solution, as a consequence of increased need for social and financial support for families who were previously self-supporting. 161,162 A tension is therefore evident between policies of enforced movement or settlement of Traveller Communities that impact on the social support networks of Traveller Communities, and policy drivers to recognise community assets and support resilience.…”

“…42 Access to services Traveller Communities face practical challenges in accessing mainstream services owing to discrimination faced on registering with services, lack of a permanent address and high levels of illiteracy. 6,39 Peters et al 26 report that only 69% of Traveller Communities were permanently registered with a general practitioner (GP) compared with ≥96% of Pakistani Muslim, African Caribbean and white participants. By contrast, findings on Traveller Community access to services in Ireland suggest that Travellers do access preventative screening 42 and have similar use of GP services to comparators among the general population (unadjusted rates of 74.2% vs. 75.3%).…”

Developing the Cultural Competence of Health Professionals Working with Gypsy Travellers

“…Where specialist workers were provided, Travellers expressed an appreciation; however, the expressed need was to experience service on par with other users. Th ere is evidence (Hawes, 1997;Parry et al, 2004;Van Cleemput et al, 2007) suggesting that one of the reasons Gypsy Travellers fail to access health services in a timely fashion is the expectation and past experience of poor treatment. Th e marginalization of Gypsy Traveller communities is deep-rooted, and although laws legitimizing discriminatory treatment, imprisonment, and even execution for being a Gypsy were largely repealed during the 19th century, the Commission for Racial Equality (CRE; 2006) describes Gypsy Travellers as continuing to experience the last "respectable" form of racism.…”

“…Th e health status of Gypsy Travellers is consi derably poorer than other English-speaking minority ethnic groups (Cemlyn, Greenfi elds, Burnett, Matthews, & Whitwell, 2009;Doyal, Cameron, Cemlyn, Nandy, & Shaw, 2002;Parry et al, 2004; Royal College of Gynaecologists, 2001;Van Cleemput, Parry, Th omas, Peters, & Cooper, 2007). Th e reasons for this disparity are generally attributed to poor accommodation, poor access to health services and education, discrimination, and racism, both actual and perceived (Facione & Facione, 2007).…”