It is acknowledged by public bodies that there is limited evidence of the healthcare needs of the Showmen community. To address this, a co-produced study led by ARC East of England’s collaborator Professor Margaret Greenfields, researchers at Anglia Ruskin University and Showmen’s Mental Health Awareness charity have explored their health and well-being needs for culturally competent healthcare.
New research published in a recent report has found that Travelling Showman (Fairground) communities face numerous challenges in accessing healthcare services, which has led to limited awareness of risk factors associated with commonly reported health conditions such as diabetes, arthritis and cardio-vascular disease and low participation in preventative screening associated with their highly mobile lifestyle. The report highlighted that there is a lack of professional knowledge of the population’s lifestyle and their absence from healthcare datasets exacerbates these disparities, resulting in significant inequalities in healthcare outcomes.
Researchers at Anglia Ruskin University, in partnership with the Showmen’s Mental Health Awareness Charity, co-produced the In Fair Health? study to investigate the mental and physical health status of the Showmen/Fairground communities and propose practical solutions aimed at overcoming barriers to access and improving health outcomes for this population. The study has been conducted in two pilot areas: Cambridgeshire and Greater Manchester.
Sheldon Chadwick (pictured right), The Showmen’s Mental Health Awareness Charity, describes the background to this research.
“My initial interaction with Professor Margaret Greenfields began with the goal of addressing the huge void in the literature on Showmen’s Mental Health. There is a lack of awareness of mental and physical health within and outside of the Showmen community. There were no statistics available to understand the prevalence of any health conditions.
Sheldon Chadwick continues, “This ultimately leads to a lack of provisions to provide culturally competent healthcare to my community. Through this conversation, we both acknowledged that a study was necessary to fill this void.”
Healthcare knowledge about this group is extremely limited, with Showmen being included as a discrete population for the first time in the UK Census in 2021. Public bodies such as NHS England, The Office for National Statistics and the Department of Levelling Up, Housing and Communities all recognise that there is a clear gap in evidence for the needs of the Showmen community. As the first known study into Showmen’s health and well-being, the In Fair Health? research marks a significant milestone in understanding and advocating for the healthcare needs of this community.
The project involved members of Showman communities throughout its entirety, from design to delivery. This included co-production in creating surveys with members of the Showman communities, designing questions for focus groups and arts-based interventions aimed at identifying work-related health issues. Their involvement highlighted a number of challenges that they face in healthcare access, such as collecting prescriptions for chronic conditions due to long distances between their working location (fairground) and their registered yard (site), financial constraints associated with being self-employed, and a lack of accessible healthcare services when travelling. Without involving Showmen communities, this valuable information would not have been known and effective and simple approaches to addressing some of these barriers could not have been identified.
Professor Margaret Greenfields (pictured left), the lead researcher of the study, reflects on the study and the impact that it is already having.
“It has been an exceptional pleasure and privilege to be able to work collaboratively with the Showmen’s Mental Health Awareness Charity and other members of the research team, gaining insight into the health and social care use and needs of the Showmen community. We are already seeing the benefits of this research in terms of the level of engagement from health practitioners who have taken part.
Professor Margaret Greenfields continues, “A number of health professional participants have indicated that they feel far more informed about the communities and now recognise that their needs and experiences are very different from those of other travelling populations, with whom they were often confused.”
The study’s findings have prompted a number of recommendations to overcome the inequalities that Showmen communities face. These initiatives aim to increase appropriate preventive healthcare for the Travelling Showman community and raise awareness of the culture and needs of Travelling Showmen among healthcare professionals. Proposals include the need for co-produced training and resources for healthcare professionals, interventions with the Showman community about risk factors for commonly experienced conditions and improving the accessibility of data so healthcare professionals can access relevant information across the country to coincide with travelling patterns.
The project team consists of Professor Margaret Greenfields, Sheldon Chadwick (Showmen’s Mental Health Awareness Charity), Sophie Coker (Doctoral Student) and Dr David Smith. The research team would like to thank the Showman community, including the Showmen’s Guild, for supporting this study, which was co-designed and delivered with The Showmen’s Mental Health Awareness Charity.