Traveller Health Needs Assessment: COUNTY CLARE TRAVELLER AND ROMA CENTRE I nequality of access is embedded “ in our current system and creates barriers and perverse incentives that stand in the way of doing the right things for patients that need care. Moreover, wider health inequalities persist among some groups of the population. SLÁINTECARE, 2018 ” Traveller Health Needs Assessment: COUNTY CLARE Good health requires a universal, “ comprehensive, equitable, effective, responsive and accessible quality health system. But it is also dependent on the involvement of and dialogue with other sectors and actors, as their performance has significant health impacts. WHO, 2012 ” Contents Foreword ....................................................................................................................................................................................................................................2 Executive summary ...............................................................................................................................................................................................................3 SECTION 1: INTRODUCTION / BACKGROUND ..........................................05 1.1 National context to Traveller health ...................................................................................................................................06 1.2 Policy context: Traveller health .............................................................................................................................................06 1.2.1 Traveller health: A National Strategy (2002-2005) ....................................................................................................................................06 1.2.2 Our Geels: All Ireland Traveller Health Strategy (2010)............................................................................................................................07 1.2.3 National Traveller and Roma Inclusion Strategy (2017-2021) ..............................................................................................................07 1.2.4 Alignment with National Health Policy and Frameworks .......................................................................................................................08 1.2.5 Regional Context: THU Mid West ......................................................................................................................................................................08 1.2.6 Local Context: County Clare ...............................................................................................................................................................................09 1.3 Traveller health needs assessment: County Clare .............................................................................................................09 1.3.1 Overview ....................................................................................................................................................................................................................09 1.3.2 Purpose of the Needs Assessment ....................................................................................................................................................................09 1.3.3 Principles ....................................................................................................................................................................................................................10 1.3.4 Process ........................................................................................................................................................................................................................10 1.3.5 Methodology ............................................................................................................................................................................................................10 SECTION 2: DEMOGRAPHIC INFORMATION .............................................11 2.1 Traveller population in County Clare ....................................................................................................................................12 2.2 Age structure ..............................................................................................................................................................................12 SECTION 3: TRAVELLER HEALTH AND WELL-BEING ...................................13 3.1 Self-reported health ................................................................................................................................................................14 3.2 Access to health services ........................................................................................................................................................14 3.2.1 Barriers to accessing services identified by Travellers ................................................................................................................................15 3.3 Morbidity/illness ......................................................................................................................................................................16 3.4 Medication use ..........................................................................................................................................................................16 3.4.1 Trust and quality of service .................................................................................................................................................................................16 3.5 Mental health ............................................................................................................................................................................17 3.6 Lifestyle ......................................................................................................................................................................................18 3.7 Perinatal health .........................................................................................................................................................................19 3.7.1 Folic acid intake and frequency .........................................................................................................................................................................19 3.8 Children’s health .......................................................................................................................................................................19 3.8.1 Children’s access to health services .................................................................................................................................................................19 3.8.2 Ongoing health issues for children ...................................................................................................................................................................20 3.8.3 Diet and exercise .....................................................................................................................................................................................................20 3.8.4 Child development .................................................................................................................................................................................................21 3.8.5 Traveller parents’ rating of their child’s health status ...............................................................................................................................21 3.8.6 Health screening .....................................................................................................................................................................................................21 3.9 Sources of health information ...............................................................................................................................................21 SECTION 4: SOCIAL DETERMINANTS OF HEALTH ......................................23 4.1 Accommodation .......................................................................................................................................................................24 4.1.1 Social and living conditions ................................................................................................................................................................................25 4.1.2 Access to and use of public services ................................................................................................................................................................26 4.1.3 Fire safety ..................................................................................................................................................................................................................26 4.1.4 Selected findings from Traveller-specific accommodation ......................................................................................................................26 4.2 Education....................................................................................................................................................................................27 4.3 Economic status ........................................................................................................................................................................27