Travellers in Ireland suffer ‘disproportionate’ burden of physical health conditions, study finds

Common conditions including bronchitis and tuberculosis two to three times more prevalent in Travellers than in general population, TCD researchers find

Travellers may not present themselves to care settings to have minor injuries treated and may be more inclined to self-treat or present late for care, the researchers said
Photograph: Dara Mac Dónaill
Travellers may not present themselves to care settings to have minor injuries treated and may be more inclined to self-treat or present late for care, the researchers said Photograph: Dara Mac Dónaill

Travellers in Ireland suffer a disproportionate burden of physical health conditions when compared with the general population, a study has found.

Common conditions such as metabolic syndrome, asthma, bronchitis and tuberculosis are two to three times more prevalent in Travellers than among the general Irish population, according to the findings of Trinity College Dublin (TCD) researchers, which were published in the journal BMJ Open on Tuesday.

The study states that among Travellers aged under 65 there is a higher rate of intentional injuries – those caused by self-harm or violence perpetrated by another person – and a lower rate of unintentional injuries. This trend was linked to a mental health crisis among Travellers, with the suicide rate six times higher than that of the general population.

“The true intentional injury rates may in fact be higher as Travellers may not present themselves to care settings for minor injuries and may be more inclined to self-treat or present late for care,” the researchers said.

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Travellers aged over 65 had higher rates of injury compared with the general population, highlighting their vulnerability.

The All Ireland Traveller Health Study cited the home as the most likely location for an injury, and the study says this “may be due to poor living environments”. This was, the review states, in accordance with a recent report, which highlighted grossly inadequate living conditions among Travellers”.

Dr Julie Broderick, of the TCD School of Medicine, led the research team. Eleven studies involving 7,397 participants were included in the scoping review. One of these was carried out in England and Wales, while the others took place in the State and Northern Ireland.

It is the first time that all available evidence, up to April 4th last, reporting physical health conditions of Irish Travellers across published reports, peer-reviewed journals and other sources has been pooled. Dr Broderick said the exercise had “really highlighted marked health disparities between Travellers and comparable figures from the general Irish population”.

“The prevalence of a number of respiratory and cardiac conditions was two to three times higher in Travellers. Some rare conditions were described and there was a high injury profile in Travellers,” she said.

Amy Ward, a member of the Traveller community and co-author of the report, said she could “really see” the value of collating the information. “I’m hopeful that this will be a springboard for a broader piece of work that could eventually see tangible improvements in the lives of the Traveller community,” she added.

Although the numbers were small, some rare conditions were also described within the review, such as type two hyperprolinemia and leukoencephalopathy with brain calcifications and cysts.

Some findings suggested the possibility of health benefits associated with a distinct gut microbiome linked to the traditional Traveller way of life, although how this has changed with modernisation is not fully known.

Researchers have suggested that care providers for Travellers should be aware of the “unique and disproportionate burden of physical health conditions experienced” by the group.

“While it was outside the remit of this review to make specific recommendations, it would appear that current healthcare provision needs to be more responsive to the needs of Travellers,” Dr Broderick said. “More broadly, the social determinants of health should be targeted such as housing, education, employment and income which are strongly associated with poor health.”

Ellen O’Donoghue

Ellen O’Donoghue

Ellen O'Donoghue is an Irish Times journalist