Addressing Health Inequalities in Community Care

Life-course and structural determinants of positive subjective health amongst older adult Travellers and homeless people: A voice-led approach to addressing health inequalities in community care

Principal Investigator: Professor Kieran Walsh

Host Institution: National University of Ireland, Galway (NUIG)


The aim of the research is to investigate life-course and structural determinants of positive subjective health amongst older Traveller and older homeless (OTOH) people, with a view to centralising the voice of these groups in effective, ethical and rights-based models of home care delivery.


The objectives are to:

  1. Systematically review existing relevant international knowledge and literature,
  2. Contextualise and chart social and primary care provision for OTOH individuals in Ireland, identifying potential individual- and structural-level risk factors for health inequalities and health inequities, informal practices for addressing such disparities, and key on-the-ground knowledge deficits,
  3. Capture the lived experiences, expectations and needs of a diverse group of OTOH individuals,
  4. Facilitate and advance the voice of OTOH individuals to highlight ‘insider’ perspectives on meanings of home and successful strategies for securing positive health biographies, and adapting to challenges with respect to homecare (HC) utilisation,
  5. Harnessing learning from OTOH individuals, develop policy recommendations and practice-relevant tools to inform the development and implementation of forthcoming older adult HC structures, helping to ensure their applicability to the needs and preferences of OTOH individuals.

The research project will assess the broad applicability of positive ageing (and the related healthy ageing concept) to vulnerable older populations. It will help shape more focused practice and policy debates concerning improving, and legislatively underpinning, HC services for older people in Ireland.  It is hoped that this will enhance HSE awareness of OTOH inequities embedded within the care system and provide the basis for improving public services in regard to HC.