This paper explores the perceptions of illness causation and health inequalities of Travellers, an ethnic minority group who experience considerable social and health disadvantages in Ireland.In order to allow for subjective meanings to emerge, a qualitative methodology with purposive sampling was employed. Participants in the study were invited to respond to a vignette in a focus group setting. Forty-one Traveller women were recruited to the focus groups through community projects or adult education initiatives. The study not only illustrates the complexity of lay perceptions of ill-health and health inequalities, but raises important questions about the prevalence of depression and of domestic violence in the Travelling community. These Traveller women were very willing to discuss the structural factors that contributed to their health status, attributing ill-health to social and environmental factors, such as accommodation, hardship and discrimination. Further, they broadly rejected behavioural explanations of the heart disease described in the vignette. Traveller women's understandings of health and the factors that determine it are deeply embedded in the social context of their lives and their ethnic identity. These findings are discussed in the context of social identity and ethnicity, and contribute to theoretical debates about the role of that identity in recognising inequality. The study revealed that Traveller women see many shortcomings in health service provision. They need service provision to be culturally sensitive and responsive to their needs. (c) 2005 Elsevier Ltd. All rights reserved.