Traveller community and health practitioner stories of self and each other: a poststructural narrative analysis

Abstract

Research attention to Gypsy and Traveller health has grown in recent decades and highlights significant inequalities in health and access to services experienced by these groups. Existing work in this area tends to prioritise consideration of how Gypsies and Travellers speak from a position of belonging to their particular ethnic or cultural group, often producing fixed and universal claims about the health beliefs and experiences of Traveller Communities. Little research explores the social production of Gypsy and Traveller health identities, or how ethnicity may intersect with wider identity positions in Traveller Community accounts of health. In addition, health practitioner and Traveller Community accounts have rarely been considered alongside one another, and the ways health practitioners construct identities in relation to their work with Traveller Communities has largely evaded the gaze of health and sociological research. This thesis sought to contribute to understanding of these areas. It examined the identity positions Traveller Community members and health practitioners project for themselves and each other, and where these identities collide or coalesce in stories of health interactions. Poststructuralist informed narrative inquiry guided interviews with Romany Gypsies, Irish Travellers and health practitioners working with these groups. This approach was chosen for its view of identity as multiple and shifting, and as it enables concurrent attention to both the discourses governing possibilities for talk about Traveller Community health, and how actors work within these constraints to give accounts of themselves. An analysis of participant narratives reveals two overarching areas of potential concordance or dissonance in the identity positions claimed by health practitioners and Traveller Community members. The first contrasts the ‘body work’ practitioners undertook to downplay ‘professional’ identity and position themselves as close to community members, with Gypsy and Traveller requests for greater access to professional advice and medical screening. The second concerns divergence in the extent to which Traveller Communities were presented, and presented themselves, as future-oriented in relation to their health. Drawing on poststructuralist theory, I argue that representations of Gypsy and Traveller orientations to time and space are central in the positioning of these groups as compliant or resistant to health advice, and to understanding relations of power and resistance in health interactions. The thesis generates insights for communication between health workers and Traveller Community members, suggesting a need for attention not only to cultural or structural barriers, but reflection on how practice is influenced by the stories we tell about Traveller Communities, the identities practitioners claim for themselves in relation to their work with ‘disadvantaged’ groups, and the interests these serve.