An Cathaoirleach Gníomhach (Senator Malcolm Noonan): On the agenda for today's meeting of the committee is an engagement with our witnesses to discuss Traveller health. The witnesses are Dr. Patricia Fox and Dr. Kate Frazer of the School of Nursing, Midwifery and Health Systems at UCD, and Dr. Julie Broderick of the UCD School of Public Health, Physiotherapy and Sports Science....

Dr. Patricia Fox: I thank the committee members for the invitation to discuss the research evidence and related matters regarding Traveller health. I am an assistant professor at the UCD School of Nursing, Midwifery and Health Systems. I am accompanied by my colleague, Dr. Kate Frazer, who is an associate professor in the same school, and Dr. Julie Broderick, who is an associate professor in the UCD School of Public Health, Physiotherapy and Sports Science. By way of background, we have led on or participated in various research studies related to Traveller health. Dr. Frazer was a researcher on the All-Ireland Traveller Health Study 2010, which was led by UCD Professor Cecily Kelleher. Dr. Broderick was a lead researcher on "Scoping review on Physical Health Conditions in Irish Travellers", which was published in 2023. I recently led a study, "Cancer Awareness and Attitudes among the Traveller Community in Ireland", which was commissioned and funded by the HSE national cancer control programme, NCCP. This was a co-designed study led by UCD in collaboration with Pavee Point Traveller and Roma Centre, the NCCP and the HSE national social inclusion office. It was published last Thursday, 4 December 2025. Dr. Frazer was a researcher on this team. Our backgrounds are in nursing and physiotherapy and collectively, our academic and research expertise includes cancer, public health, epidemiology, social inclusion and health equity...

Modifiable risk factors for cancer persist. For example, 36% of Travellers smoke compared to 21% of the general population. Smoking prevalence was higher among men, at 44%, than women, at 32%. Weekly alcohol consumption was 22% versus 44% in the general population. Sun protection behaviour among adults is moderate, with the use of sunscreen at 63%, but only 2% reported taking no sun protection measures for their children. Fewer Travellers consumed the recommended five or more portions of fruit and vegetables daily than in the general population, 11% versus 44%. Similarly, low numbers of Travellers were aware of dietary components as a risk factor for cancer. For example, just 20% noted the lack of whole-grain consumption as a risk factor. Participation in screening at least once was high for breast and cervical screening among those who received an invitation. The relevant percentages were 84% for breast screening and 88% for cervical screening. Uptake for bowel screening was lower, at 60%, as is the case for non-Travellers, although the numbers were small so it is difficult to have certainty here. The requirement for an ethnic identifier was also underlined so that Travellers can be identifiable within research to determine health outcomes and equity....

Deputy Dessie Ellis: I thank the witnesses very much. We have had a lot of people before the committee and there is a lot of research and delving into problems. In the case of the witnesses, we are talking about cancer awareness and attitudes. We talked about the study in 2010. We have gathered so much information but from what I see on the ground the actions are very limited. Did we get any sort of an indicator on whether cancer has increased between 2010 and the recent study in 2023 on cancer awareness and attitudes? That was not the aim of the study but is there evidence of any description to say that we can see that cancer has increased, decreased or otherwise in the Traveller community?

Do we see a similar effect in the mental health services between 2010 and 2023? Even through Covid huge numbers of people were presenting with mental health problems. I am curious about that.

The outreach of public health nurses is extremely important, in particular on Traveller sites, and where people are not in ordinary housing, as we call it. Do we do enough outreach? It is quite difficult to get someone to go to a satellite clinic, a health centre or otherwise. People have fears about that. They do not like being out of their community.

The other issue that is not mentioned in this study relates to drugs and alcohol. We do not get a picture about it. We are talking about awareness and attitudes but there is also a big problem with drugs and alcohol. The drugs situation is probably worse in the Traveller community. I am not sure whether the witnesses agree with that but it appears to me that is the case....

Dr. Patricia Fox: We did not look at the drugs and alcohol aspect. This was mainly focused on cancer. However, some of our interviewees among the primary healthcare professionals talked about the fact that drugs were an increasing problem. We know Pavee Point is doing some excellent work. Mayo Traveller health workers are leading some of those projects around drugs and alcohol. I was speaking to one of them last week. It is something they are very much focused on.