Inclusion Health

Inclusion health is an approach to prevent and address extreme health inequalities resulting from severe disadvantage and deep social inclusion.

People experiencing social exclusion have significantly worse health than the general population, while simultaneously facing barriers to accessing healthcare. Multiple adversities in life combine and contribute to multi-morbidity, extreme health inequities and barriers to accessing care, compounded by stigma, discrimination and invisibility in data. The inclusion health approach works across disciplines and stakeholders. With the input of people with lived experience of exclusion, the goal is provision of health services which are accessible, person-centred, trauma informed and holistic.

The Department is developing an Inclusion Health Framework. The department has contracted Inclusion Health Research Group (IHRG) in the College of Medicine and Health, UCC, to undertake a consultation process to inform the development of the Framework.

The Roma Health Action Plan is currently being developed by the Department in close consultation with the Roma Community and the HSE. This fulfils a strategic objective of the National Traveller and Roma Inclusion Strategy Action Plan 2024 – 2026 and the goal of the Plan is to enable the Roma Community in Ireland to achieve the highest attainable standard of health.

The Department of Health’s mandate in relation to homelessness is the provision and funding of health and social care supports for people who are homeless. The Department of Health has oversight responsibility for the health policy for people who are homeless and other socially excluded groups. Responsibility for the provision of health service falls under the HSE’s National Office for Social Inclusion, which works to improve access to mainstream health services for all people living in homeless accommodation settings.

People who are homeless are also more likely to die prematurely. These health inequalities are rooted in the social determinants of health, as being homeless worsens physical and mental health and increases the risk of problematic drug and alcohol use.

Delivering Homes, Building Communities 2025 - 2030 includes actions to support the health needs of people who are homeless and to achieve better health outcomes for them, including a reduced incidence of premature death. Work is underway on each of these actions:

• Expansion of the Housing First programme by over 50% to 2,000 tenancies to support rough sleepers and long-term users of emergency accommodation with secure housing and health supports.
• Implementation by the Department of Health and the Department of Housing, Local Government and Heritage (DHLGH) of an agreed funding approach to support the provision of quality health services to people in homeless accommodation, ensuring that there is nationwide equitable access to appropriate health services aligned with the Sláintecare principles.
• Provision of increased health supports to homeless households through the implementation of the HSE National Strategic Plan to Improve the Health of People Experiencing Homelessness.

The National Traveller Health Action Plan (NTHAP) 2022-2027 launched in November 2022 and seeks to address inequalities in Traveller health. The plan has 4 goals, 9 strategic objectives and 45 actions. The HSE recently conducted a mid-term review of the NTHAP. The Mid Term Review of the National Traveller Health Action Plan recommends that for the remaining two years (2026-2027) regional implementation plans need to be strategic, prioritise achievable goals and specific groups, and to review and align with regional structures. More information can be found below.

The National Traveller Health Implementation Group (NTHIG) was established to drive implementation of the NTHAP, to support and monitor implementation and report to NTHIG.

Review of Primary Health Care for Travellers Projects (PHCTPs)

Primary Healthcare Traveller Projects are partnership projects between the HSE and Traveller organisations that provide ongoing support for Traveller families on the ground, acting as a link between mainstream health services and Travellers.

Recently a review of Primary Health Care for Travellers Projects was undertaken by the HSE and supported by the Department of Health, in line with actions in the HSE service plan and the National Traveller and Roma Inclusion Strategy. The aim of the review was to assess the role, value, and impact of the Primary Health Care for Travellers Projects (PHCTPs) and to inform how these projects can be strengthened and sustained into the future. More information can be found below.

The Department of Health has also funded a number of initiatives to improve Traveller health including:

• A programme to support Traveller Women who are experiencing or who are at risk of homelessness (in conjunction with the Women's Health Action Plan),
• A programme to address the social determinants of Traveller health (through the Slaintecare Healthy Communities Programme),
• Mental health services for Travellers (in line with Sharing the Vision)
• Traveller child health initiative (in line with the Brighter Beginnings project, with support of the HSE National Healthy Childhood Programme)

The Minister for Public Health, Wellbeing and the National Drugs Strategy Jennifer Murnane O’Connor provided €1 million in recurring funding for improving Traveller child health across Budgets 2025 and 2026. More information can be found here and here.