By Emilia Dunham
Program Associate, National LGBT Tobacco Control Network
This morning I had the privilege of attending the Keynote address of Fenway Health’s Population Center‘s presentations by Brian DeVries “LGBT Persons in the Second Half of Life” followed by a Lisa Iezzoni talk on “Disabilities and Chronic Conditions.
From Brian’s talk, I learned that though there are over 2 millions LGBT elderly, many are closeted largely due to their experience of discrimination and violence. It seems that stigma as well as unequal laws has dramatic effects on LGBT elderly. As a result, many LGBT people have depression and are more fearful for dying in pain alone or receiving discrimination. Unsurprisingly, they are also more likely to use alcohol and tobacco, however they are more likely to suffer from cancer perhaps due to less access to validating health care. Compared to the general population, GLBT elderly are more likely to rely on friends rather than family or spouses for end of life treatment in part because loss of familial contacts as a result of coming out.
Some of Brian’s recommendations are to include questions on age, sexual orientation and gender identity in national surveys, have more studies on LGBT elderly and ask the same questions of LGBT as the general population.
After Brian’s talk, Lisa Iezzoni led a provocative talk on “Disabilities and Chronic Conditions” where she addressed the commonly ignored Elephant-in-the-Room topic of disabilities. Most people will know of a friend of loved one who is or will have a disability, yet there is little knowledge of the subject. Even with the protective American with Disabilities Act, many bus drivers and building managers ignore persons with disabilities rather than installing a ramp.
Interestingly, the issue of disabilities have changed over time. For instance in the early part of the 20th century, the use of a stethoscope created distance and allowed physicians to become the arbiters of who was eligible for social services. Around this time, disabilities was seen as a problem of the individual much like sexual orientation, but by the 60s and 70s disability was seen as a societal human rights problem.
There are known health disparities for people with disabilities in that they are less likely to be asked by health providers about contraception, mammograms, pap smears, or smoking history (smoking is considered to help alleviate stress of their conditions). Yet, people with disabilities are 37% more likely to die from lung cancer because are less likely to be encouraged to access preventative surgeries.
Her recommendations were to correct problematic terms like “confined to a wheelchair” and “wheelchair bound” but switch to more appropriate term of “wheelchair user.” Beyond the individual level, public transportation as well as health centers should add proper equipment, which would also reduce long-term costs.
In both presentations, I noticed experience through the generations has formulated opinions and behaviors on health. For instance, growing up in the “Baby Boomer” generation has led to a strong, independent attitude making it difficult for elderly people with disabilities to not reach out for help. Similarly, for LGBT people, living through several generations where being gay was criminal and a psychiatric condition led to increased stigma, loss of family connections. Invited Respondant Lisa Krinsky of the LGBT Again Project echoed the historical perspective’s need for including LGBT aging in current conversations and made the connection that both persons with disabilities and LGBT people are ignored and not served.