Irish Travellers suffer a disproportionate burden of physical health conditions, review finds

In a review published in the open access journal BMJ Open Trinity researchers, led by Dr. Julie Broderick, head of discipline of physiotherapy, school of medicine, have presented findings showing that Irish Travellers suffer a disproportionate burden of physical health conditions with common conditions like metabolic syndrome, asthma, bronchitis, and tuberculosis 2–3 times more prevalent in Travellers compared to the general Irish population.

For the first time, all available evidence across published reports and peer-reviewed journals, along with gray literature was pooled, reporting physical health conditions of Mincéiri or Irish Travellers, up to 4 April 2023.

Eleven unique studies (20 reports) were included in this scoping review, including n=7,397 participants. One study took place in England and Wales, while the remaining studies took place in Ireland, North and South.

Dr. Broderick said, "Pooling the available evidence together 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."

"We very much valued the input of a member of the Traveller community, Amy Ward who co-authored this work. Amy provided important direction, ensuring that the Traveller voice was integrated throughout the entire review process, which has enhanced the relevance and real-world impact of this work."

Amy Ward, member of the Traveller community, said, "I really see the value of collating this information which makes an important contribution to our knowledge of health in Travellers. 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."

Key findings

• Conditions like metabolic syndrome, asthma, bronchitis and tuberculosis were 2–3 times more prevalent in Irish Travellers compared with the background population.
• In Travellers under 65 years there was a higher rate of intentional injuries and a lower rate of unintentional injuries compared to the general population.
• Travellers over 65 years had higher rates of injury compared to the general population, highlighting their vulnerability.
• Unique health considerations of Travellers should be noted. Although numbers were small, some rare conditions were described within this review, such as type 2 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 modernization is not fully known.
• Common conditions like cancer and arthritis were minimally reported within this review, so more data is needed on the prevalence of these in Travellers.

Implications of these findings

This review indicates a significant health disparity between Travellers and the general population.

Researchers suggest that providers of care for Travellers should be aware of the unique and disproportionate burden of physical health conditions experienced by this group.

Current health care provision needs to be more responsive to the needs of Travellers, and more broadly needs to address prevention strategies and address the social determinants of health such as housing, education, employment and income which are strongly associated with poor health.

Dr. Broderick concluded, "Providers of care for Travellers should be aware of the unique and disproportionate burden of physical health conditions experienced by this group."

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

"We very much valued the input of a member of the Travelling community, Amy Ward who co-authored this work. Amy provided important direction, ensuring that the Traveller voice was integrated throughout the entire review process, which has enhanced the relevance and real-world impact of this work."