Erin Thomas

October 5th, 2023

Inequalities in access to healthcare among Gypsy, Roma and Traveller communities: “it’s like we don’t exist”

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Estimated reading time: 10 minutes

Erin Thomas

October 5th, 2023

Inequalities in access to healthcare among Gypsy, Roma and Traveller communities: “it’s like we don’t exist”

0 comments | 1 shares

Estimated reading time: 10 minutes

Religious, cultural and linguistic minorities have long faced discrimination in relation to their distinctive identity. Although a great variety of minority situations exist, Gypsies[1], Roma, and Travellers (hereafter termed using the acronym “GRT”) can be described as an ‘invisible’ ethnic minority group in the United Kingdom in terms of academic and policy-making discourse, often unseen and unheard, isolated, and lacking impartial evaluation. Of course, the issue of ‘visibility’ is ironic (Clark, 2001). The invisibility of GRT communities in an academic and policy space contrasts with their hypervisibility when it comes to the widespread negative myths surrounding them, manifested through police reports of antisocial behaviour (Dobinson, 2018) or reports of numerous unauthorised encampments.

GRT populations encompass a wide range of ethnic and cultural variation, with a significant diversity of communities fitting under the GRT umbrella term. They are not just one homogeneous group but several different groups each with their own languages, lifestyles, cultures and ways of expressing their unique identities (Traveller Movement, 2022). While generalisations about the group do not always hold true, common characteristics exist concerning employment, family, and social space (Cemlyn, 2008) and, most notably, a shared history of nomadism. Certain GRT peoples are recognised as an ethnic group and defined as ‘races’ and therefore protected by the Equality Act, including Romany Gypsies, Scottish Gypsies/Travellers and Irish Travellers. Cultural travellers (which can include Show-people, New or ‘New Age’ Travellers and Boaters) who have not been recognised as ethnic groups by the Courts, however, are not protected against race discrimination under the equality act. This may have implications on their protection as a minority community and thus on their ability to enjoy these rights (Haynes, Joyce and Schweppe, 2020). Research undertaken by the Traveller Movement indicates that 76% of GRT peoples have hidden their ethnicity in order to avoid discrimination or prejudice (Sproston, 2022). Declan Henry perhaps terms the community best in his evocative description of GRT peoples as Britain’s internal refugees (Henry, 2022) shunned and abandoned by their country of birth due to their religious and cultural identity, not by war or means of torture, but through racism, prejudice and poverty. As put in a Traveller’s own words: “…it’s like we don’t exist” (Nugent, 2018).

Society has formed an understanding of GRT peoples based on media sensationalism, tabloid press releases and entrenched prejudices. Even today, persisting stereotypes depict GRT peoples as criminals (Lee, 2019). Hostility towards the community is more socially acceptable than towards other groups and is supported by the mass media (Cemlyn, 2008). On the one hand, there exists a romanticised notion of Romany wisdom, ancient roots and a life under the stars (Holmstrom, 2019), such as Charlotte Brontë evokes in her elusive Heathcliff character (Brontë cited by Drew, 2012). On the other hand, however, most narratives contain and perpetuate negative stereotypes, and the limited discussion on GRT populations is inherently flawed (Morris, 2006; Richardson, 2007) as it focusses predominantly on accommodation issues (Cemlyn et al., 2009) and neglects the other domains of exclusion experienced by members of these communities, such as health.

GRT peoples across the world continue to experience significant barriers to accessing healthcare, even when compared to other ethnic minorities (Parry et al, 2007), and they face some of the starkest health inequalities and outcomes in the United Kingdom (FFT, 2010). For example, GRT peoples have been reported to have a life expectancy that is 10-12 years shorter than the national average (Baker, 2005), and figures suggest that more than 42% of GRT peoples are affected by a long-term health condition when compared to 18% of the general population (Parry et al, 2004). Access to healthcare within the community is problematised by a range of factors. Trust in public services is low due to historical and ongoing discrimination and longstanding stigmatisation (Greenfields and Rogers, 2020). This leads to a lack of engagement with public health campaigns, resulting in GRT peoples often having a lack of knowledge about the health services available to them and their entitlements. This was evident during the Covid-19 pandemic, in which GRT peoples were ‘disproportionately’ affected (Davies, 2020). Amongst other factors, the lack of a fixed abode, non-registration with a GP, as well as the issue of health literacy can make access difficult. O’Connell et al. (2002, p.49) highlight in their work that: “[t]ravellers fare poorly on every indicator used to measure disadvantage: unemployment, poverty, social exclusion, health status, infant mortality, life expectancy, illiteracy, education and training levels, access to decision making and political representation, gender equality, access to credit, accommodation and living conditions.

The UK is held to a number of normative standards which are of particular significance to the GRT community. These are set out in the International Covenant on Civil and Political Rights, the International Covenant on Economic, Social and Cultural Rights (ICESR), the United Nations Convention on the Rights of the Child, and the United Nations Declaration on the Rights of Persons Belonging to National or Ethnic, Religious and Linguistic Minorities. The protection of the right to health is explicitly stated in these agreements. It is a fundamental human right, and the acceptance of health as a right of all is a demand to take action to promote that goal (Sen, 2008). Under Article 12 of the ICESR, notably General Comment No. 14, the right to health purports to prohibit and eliminate racial discrimination in all its forms, guaranteeing the right of everyone, without distinction as to race, colour, or national or ethnic origin, to equality before the law. In principle, minorities are entitled to equal access to those rights contained in domestic and international law, including the protection of their existence as minorities as the right to health as outlined above. Yet GRT peoples stand as a significantly vulnerable minority within society, as they are exposed to a confluence of extreme poverty, ill-health, exclusion from civil and political rights, and constant discrimination and harassment. Despite supposed legal protections, it is thus contended that the right to health of GRT peoples has been impeded by a lack of access to healthcare services.

Further work is needed to explore these barriers and inequalities, considering the ways in which they might be resolved in order to make the GRT community more visible within legal, academic and policy contexts. Whilst there may be pockets of improvement in some areas it is clear that there is a need to invest more in research into the health of GRT peoples, including research into intervention to address the significant health inequalities that have long prevailed. A general belief in GRT peoples’ inferiority prevails, yet GRT communities have survived despite such discrimination – albeit at a great cost to their distinct identity. Understanding the lived experiences of public health issues for such communities will have wide impacts on supporting the progressive realisation of human rights in the United Kingdom.

[1] The usage of the term ‘Gypsy’ is contentious due to its often derogatory and racist employment. The acronym ‘GRT’ is used throughout the article to describe persons with nomadic and/or Roma heritage, as it is the term used in policy, legal and official public circles, as well as by groups such as The Traveller Movement.


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About the author

Erin Thomas

Erin Thomas is a doctoral researcher and Research Associate at Cardiff University School of Law and Politics. Her background is in public health law, particularly in Welsh health law, with her current focus being on human rights law, discrimination, and the Traveller and Roma minority. She is also an ambassador of the Showmen's Mental Health Awareness Charity and a qualified ballet teacher.

Posted In: Culture | Discrimination | Health

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