Inventing our future Collective action for a sustainable economy

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mortality rate which is more than twice the average. Overall the evidence suggests that many of
the health inequalities experienced by BME groups are explicable in terms of material deprivation;
and the correlation between areas of the Region in which the ethnic population is relatively large
and levels of deprivation are acute (see Figure 3.9) is a strong one. In addition, however, BME
groups experience inadequate access to quality health services and this is a further contributory
factor to poor health outcomes. 22
3.15 Prisoners, ex-offenders and young offenders are vulnerable in terms of health outcomes. Within
the East of England there are 14 prisons – a significant proportion of the national estate. The
prison population is growing and it has a very high incidence of mental ill health. Hence there are
complicated and important dimensions, including those linked to the rehabilitation of offenders.
3.16 Another vulnerable group is Gypsy and Traveller communities such as English Romany Gypsies,
Scottish and Welsh Travellers, Irish Heritage Travellers, Showpeople, New Travellers, Circus People
and Bargees. A national study found that Gypsies and Travellers have significantly poorer health
and more self-reported symptoms of ill-health than other UK-resident, BME groups and economically
disadvantaged white UK residents. 23 Within this group, maternal health and infant health are especially
problematic. Institutional barriers have been identified in terms of access to preventative health
services, but these are compounded by a reluctance to engage with services, an anticipation of
hostilities and a culture of self sufficiency. 24 Within the East of England, the Gypsy and Traveller
population is relatively large.
3.17 Refugees and asylum seekers within the East of England face a further set of health issues. These
people are inherently vulnerable, having been forced to leave their country of origin, frequently
because of persecution. Once in the UK, many are living in poor accommodation with insufficient or
limited access to services and in many neighbourhoods they are viewed with hostility, suspicion and
prejudice. In seeking to improve the health of people within the East of England and to reduce health
inequalities, the issues facing refugees and asylum seekers need to be taken into account fully.
3.18 Finally, it is important to comment on migrant workers. Migrant workers are defined by the
Organisation for Economic Co-operation (OECD) as ‘foreigners admitted by the receiving State for
the specific purpose of exercising an economic activity remunerated from within the receiving country’.
The term ‘migrant workers’ embraces a great variety of situations and hence the health issues faced by
migrant workers will also vary substantially. That said, access to health (and other) services can be an
issue and some migrant workers find themselves living in poor accommodation, working very long
hours and facing isolation and exclusion. 25
22 Ethnicity and Health Inequalities INpho Briefing papers on topical public health issues September 2002, Issue 2.
23 The Health Status of Gypsy and Travellers in England G Parry and P Van Cleemput (2004), University of Sheffield – for the DH.
24 Gypsy and Traveller Communities: Accommodation, Education, Health, Skills and Employment – An East of England Perspective Study completed
by Camille Warrington and Sherry Peck, for EEDA (March 2005).
25 See, for example, http://www.gyros.org.uk