All Ireland Traveller Health Study Our Geels - Department of Health ...

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All Ireland Traveller Health Study For the Adult Health Status and Service Utilisation questionnaires, the reported responses represent the direct responses combined with the proxy responses, for those variables that were asked in the proxy questionnaires also. The main results of the census and survey are given in the body of this report in tabular form. Sociodemographic data are presented first. Though the main survey was of Traveller ‘families’ this data is based on the individuals documented within the Traveller families and gives a picture of the entire Traveller population. All demographic factors are analysed separately by sex and age group and by ROI and NI. Please note that the percentages add across the table with the total sample size (n) for that category/sub-category presented in the last column. For the demographic tables the n represents individuals. The remainder of the tables presented in this report is based on the Traveller families surveyed, or on the sub-groups surveyed for the Child or Adult sections. Again, tables are broken down by age, sex and by ROI and NI. The questions are presented in the running order of the questionnaire and are numbered based on the question numbers in the actual questionnaire. The titles of the tables reflect the actual question asked of the survey population, edited as needed for clarity of reading. A full (paper) version of the questionnaire is given in the Appendix to the 3 AITHS Technical Reports. Because of the large number of variables obtained, and the sample size, multiple statistical comparisons with testing of hypotheses were not considered appropriate. However, some relevant cross-tabulations are provided and a comparison of some key variables is included. Analysis Strategy for the Contextualisation of the AITHS Census and Health Survey Data A comparison section follows the presentation of the census and health survey main report, where comparable population-level data is abstracted and presented in tandem with the AITHS findings, in order to provide context and richness to the understanding of the Traveller condition. Choice of Comparative Data The items used for data collection in the AITHS were derived primarily from a number of existing survey instruments that had been used for data collection in Ireland. The results of these surveys were therefore used as appropriate comparators for the AITHS results. Items were derived from such survey instruments as used by the SLAN (Survey of Lifestyle, Attitudes and Nutrition) 2002 and 2007 surveys (Kelleher et al., 2002; Morgan et al., 2008), the National Longitudinal Study of Childhood/ Growing up in Ireland study (NLSC/GUI) (Williams et al., 2009), the Lifeways Cross-Generational Cohort Study (O’Mahony et al., 2007) (hereafter also known as Lifeways), the Health Behaviour in Schoolaged Children (HBSC) study (Nic Gabhann et al., 2006), Krieger et al. (2005), KIDSCREEN (KIDSCREEN/ DISABKIDS questionnaire, 2010), INSIGHT ‘07 (2007), and the Continuous Household Survey in NI (2008-2009). The aim of this section is to consider the key variables noted in the AITHS and compare the Traveller social, economic and health position with that of the general Irish population, and where possible, specifically with the position of the Irish population of social class (SC) 5 or 6 (from 64
Health Survey Findings the classification used by the Irish CSO, where SC 5 or 6 means that the present or last occupation of the person is in either the semi-skilled or non-skilled occupational categories) or medical card users. It is acknowledged that the Traveller community is not homogeneous, and that as a distinct minority community it has characteristics that set it apart from the general Irish public in significant respects. Nonetheless because social inequality is one possible contributory feature to the health status of its population it is appropriate to control or adjust for that possibility insofar as possible. Description of the Data Sources Accessed Lifeways is a cross-generational cohort study of 1,000 Irish families funded by the Health Research Board, in which data was collected from family members including mothers, fathers, grandparents and children (O’Mahony et al., 2007). Two subsets of the Lifeways population were used to obtain the data for this comparison. Firstly, a dataset was created using baseline survey data from all adults in the study (mothers, fathers and grandparents, n=2,158 persons). Of this adult dataset, 510 persons had a medical card, and were therefore included in the analyses. For the second dataset, data were taken from the 5-year follow up child examination from Lifeways, affording direct comparison to 5-year-old Traveller children. These questions focused on the index child, with whom the mother was pregnant at the Lifeways cohort inception. There were follow up data on 68% of children, of whom 199 had mothers who had reported having a medical card at baseline. Despite the fact that Lifeways recruitment focused on pregnant women, subsequent studies have shown that the Lifeways cohort can be used as a representative sample of the general Irish population (Niedhammer et al., 2009). INSIGHT ‘07 is a study of consumer satisfaction with health and social care services. Data were collected by means of a survey of a nationally representative sample of Irish adults identified through the 2002 census, with supplemental sampling of the over 50 age group. The final sample was 3,517 respondents, of whom 1,282 had medical cards. SLAN 2002 is a population-based survey of Irish adults. These data have been received through the Irish Social Science Data Archive (ISSDA). SLAN 2002 gathered data on 5,992 participants, 1,645 of whom held medical cards. For this analysis, the data relating to persons who held medical cards were retained. SLAN 2007 is a population based survey of adults aged 18 and over, living in private accommodation, identified through the GeoDirectory. The SLAN 2007 raw data relating to medical card holders (n=3,445) has been made available to us through Dr Karen Morgan of RCSI. Results from SLAN 2007 were also gathered from the published reports, and in this case, comparisons with the AITHS group were made with published results relating to SC 5 and 6. Of the SLAN studies, SLAN 2007 comparisons were preferentially included as the most current data, although comparisons with SLAN 2002 were included if the equivalent data item was not available in SLAN 2007. The HBSC study 2006 is an EU linked survey of school-going children in Ireland, coordinated through NUI Galway. Data was collected on 9-year-old, 10-11-year-olds, 12-14-year-olds and 15-17 year-olds. Collaboration was agreed with Dr Saoirse Nic Gabhann of NUI Galway, and the HBSC team undertook to supply the data needed to make complete comparisons. Data was gathered from the child as first respondent, and reference to this is made in the text of this paper where appropriate. Comparisons were made with the subset of children in SC 5-6 (n=333 9-year-old, and n=907 12-14-year-olds). 65
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