Background
‘Showmen’ have long been recognised as a discrete community related to GTR populations but other than passing reference in a few Gypsy Traveller Accommodation and other Need Assessments no extant research exists pertaining to this group. Showmen were included for the first time in the 2021 Census and it is acknowledged by bodies including Public Health England, ONS, Department for Levelling Up, Housing and Communities: formerly MHCLG, that there is a lacuna in evidence pertaining to the needs and circumstances of this group.
This pilot study consisted of an investigation into the health status (physical and mental) and best practice and support provided by health professionals to the Showman community; focusing on two pilot areas, Cambridgeshire and Greater Manchester.
Project Aims
The project had been designed to incorporate mixed and creative methods (including photo-elicitation activities), documentary analysis, surveys and focus groups to respond to the following research questions:
- What level of health care need exist for Travelling Showmen populations and how do they access health care when resident in Yards or travelling for employment?
- What are the most commonly identified health conditions experienced by the communities?
- How do health professionals engage with the populations and what level of cultural understanding do they have of the health care needs of this group?
- How can Showmen and Health Professionals collaborate to enhance understanding of health conditions and risk factors and enhance health literacy for the populations?
- What is required to enhance and increase levels of culturally appropriate health care support provided to the populations and reduce barriers to access to care. and h needs/barriers to accessing support and mutually?
Objectives:
To ascertain the health status, needs, trends in self-reported conditions, barriers and solutions to accessing accessible, effective, culturally competent health care for members of the Showmen/Fairground communities.
The objectives of the study were to:
- enhance awareness of the health needs and status of Travelling Showmen both amongst the communities themselves, and also for health professionals,
- make recommendations for practical solutions to enhance access to care and screening for this population (particularly when travelling)
- identify gaps in health literacy knowledge amongst Showmen
- identify levels of knowledge and support the development of cultural competence for health care providers and commissioners supporting the Showmen community.
Project Activity
Following ethics approval from the School of Education and Social Care Research Ethics Panel in the Faculty of Health, Education, Medicine and Social Care at Anglia Ruskin University (Reference: ESC-SREP-21-202) (May 2023) a scoping review of the very limited literature on Showmen was undertaken and engagement with key agencies including the Showmen’s Guild per accessible data had taken place (nb Census 2021 data on Showmen will not be made available until 2023).
To date, an online survey for health professionals was disrupted. The survey explored their knowledge of and experience in supporting Showmen as well as any perce tions of particular health conditions prevalent amongst the population. 71/80 surveys and 9/20 interviews with Showmen divided fairly equally across the two localities have been undertaken (September 2023).
Focus groups (in one locality) have been completed (separately) with Showmen and Health Professionals with a discussion group bringing together health workers and Showmen planned.
Mirror focus groups were planned for the second locality. Photo-elicitation workshops (1 per locality) were taken during the project and this explored the narrative pertaining to representations of work-life amongst the community on Yards and Fairgrounds. All fieldwork is anticipated to be completed by end November 2023.
In Greater Manchester, completed the Photo-Elicitation workshop which bought together Showmen and Health Professionals to share findings (Autumn 2022) and discuss how the images represented the community and physical/mental health stressors pertinent to their lives as Travelling Showmen. In East Anglia/Cambridgeshire, one focus group with Health Professionals and a joint Group discussion between health professionals and Showmen was held, alongside a photo-elicitation workshop as above, to enable us to finalise the data collection phase of the study.
Anticipated Impact
We produced a report and briefing paper for health care professionals, and a minimum of two academic and practice focused journal articles.
Preliminary conversations had taken place in one study area with health policy specialists working with commissioners with regard to preliminary findings from a focus group with health workers. This responsive interest created scope to feed into the community partner working to develop training for health professionals working in localities with a large number of Showmen’s Yards specifically in relation to outreach, developing cultural competency for health professionals, and raising awareness of the prevalence of particular conditions amongst the communities.
The team explored the potential for the development of culturally appropriate health education materials to be co-designed and distributed to the populations in response to identified trends and prevalence of particular conditions.
Preliminary findings indicated that there were concerns when Showpeople are ‘on the road’ in some localities in relation to access to some health services. We developed recommendations that are low cost or fiscally neutral to support improved access to health for travelling members of the community. Further proposals with regard to accessible health information outreach and screening opportunities will be developed.
Papers and resources
Read the related report. Entitled ‘In Fair Health? A Pilot Study of the Health and Wellbeing Status of Travelling Showpeople in Two Locales. First-Phase Summary Report (October 2023)'
For more information about this research, read the ARC East of England article
View the photographs of Showmen and their lives