At the beginning of 2024, Public Health France published an epidemiological study on the health situation of travelers in New Aquitaine.
“This is the first time that we have such concrete elements which scientifically demonstrate what we observe on the ground, namely that the living conditions of travelers are unfavorable to their health”, notes Annette Marsac, president of the Ma Camping 87 association, which has been supporting travelers in Haute-Vienne in accessing rights since 1993. In 2023, the structure will support more than 1,000 people, adults and children.
Vulnerability accentuated by living conditions
Examples of data collected in this study: 22% of the families surveyed did not have access to running water, 24% were not connected to an electricity meter and 41% were not equipped with sanitary blocks with shower and W .-C.
Concerning location, 43% of households lived less than 200 meters from a major road or rail route, 20% near an industrial site and 9%, a recycling center or landfill.
“If in our department, living conditions are less bad than elsewhere, they nevertheless remain sometimes problematic,” underlines the manager of Ma Camping 87. When there are no places in the reception areas – a model which does not suit everyone – illegal parking takes place on wastelands without water or electricity and when families buy land, it is not buildable and therefore cannot be connected. »
This environment increases their vulnerability, according to the survey where it is specified that the life expectancy of Travelers is on average ten years lower than the rest of the European population. (read below).
A mediation to be developed
In addition to a call to act to improve living spaces, for example by first assessing the impact on health of any new establishment proposed by public authorities, Public Health France encourages the development of health mediation. In Haute-Vienne, this mission has been carried out since 2018 by Aïcha Halimi.
Trained as an advisor in social and family economics, the health mediator, whose position is financed by the regional health agency, acts on several fronts, such as access to rights with pregnancy declarations, the attachment of newborns , the request for Supplementary Health Insurance (CSS) in partnership with the primary health insurance fund.
Appointment making is very often electronic. And to see a specialist, you have to send a prescription by email. Digital technology is a barrier and a reason for giving up care
Aïcha Halimi, carried out nearly 1,200 administrative procedures in 2023.
The mediator also provides physical support (thirty-eight times last year). “My goal is to reach out and create a link between travelers and health professionals, to create a relationship of trust. Among some travelers, there is a fear of not understanding, an anxiety about going to a doctor's office. There is educational work to be done with a traveling public who live in immediacy and with caregivers to fight against discrimination. »
Because the observation was also made by State services: “The families in greatest difficulty still have difficulty consulting, understanding the language of caregivers and the constraints imposed on them by monitoring care.”
Collective workshops in reception areas
In addition to this individual support, group workshops are offered, focused on prevention. “With the mother and child hospital, the vaccination center, the PMI, Family Planning and the department's centers, actions are carried out “outside the walls”, directly in the reception areas. Even if they take place in not always ideal conditions, under a tent, it is a work of openness which bears fruit. »
Tobacco, diet, sleep, methods of contraception, endometriosis, dental hygiene, etc.: the themes covered come from requests made by families or needs identified by professionals. “It’s a space for exchange where we build a relationship of trust. »
So many interventions for which health mediation has become essential, but which are today threatened, according to the association, by the financial difficulties that the structure encounters in operating.
More common chronic diseases
The study was conducted by Public Health France in partnership with the National Federation of Solidarity Associations for Action with Gypsies and Travelers (FNASAT) and ARS Nouvelle-Aquitaine, between November 2019 and March 2022. It initially concerned all departments before being targeted on four: Gironde, Creuse, Charente and Charente-Maritime. The participants are 1,030 adults and 337 children aged 7 to 13.
This shows in particular a greater frequency of chronic diseases:
– more obesity and overweight (37% of adults, compared to 17% in the general population),
– more diabetes (14% versus 4%),
– more hypertension (25% versus 15%),
– more asthma (17% versus 3%).
In terms of mental health, more than 14% of adults had a major depressive episode (compared to less than 10%). Finally, 50% of participants declared that their state of health was “fair, poor or very poor” (compared to 32%).
Half of adult travelers had given up treatment within the year (compared to 25% in the general population). Among the reasons, lack of time, knowledge, delay and sometimes also refusal of the health professional.
Helene Pommier
