As the first known study into Showmen’s health and well-being, the In Fair Health? pilot study marked a significant milestone in understanding and advocating for the healthcare needs of this very visible, but frequently overlooked community who travel extensively to bring fairground rides and entertainment to communities the length and breadth of Britain.
Showmen have long been recognised as a discrete and close-knit community related to Gypsy Traveller and Roma populations but with very distinct characteristics and employment patterns (operating travelling fairgrounds). However, other than passing reference in a few Gypsy Traveller Accommodation and other Need Assessments, no extant research exists pertaining to this group, despite the fact they are estimated to be similar in number to the Sikh community in the UK.
Showmen were included for the first time in the 2021 Census, and it is acknowledged by bodies including Public Health England, ONS and the Department for Levelling Up, Housing and Communities 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) of Showmen, and best practice and support provided by health professionals to the Showman community, focusing on two pilot areas, Cambridgeshire and Greater Manchester.
Members of Showman communities were involved throughout the project, from design to delivery. This included co-production in creating surveys, collaborative design of questions for focus groups, and identifying arts-based interventions aimed at identifying work-related health issues.
The findings highlighted a number of challenges that the communities face in accessing healthcare, for example difficulties with collecting prescriptions for chronic conditions due to long distances between their working locations (fairgrounds where a group will often only remain for a few days at a time) and their registered yard (site), financial constraints associated with being self-employed, and a lack of accessible healthcare services including maternity care, when travelling.
Without collaboration with trusted Showmen researchers and 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.
Project aims
The project was 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 exists 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?
Project objectives
The objectives of this project were 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. Specific objectives 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.
