Hector Martinez
Blogging Scholarship Winner
Reporting from Creating Change
January, 2012
Baltimore, MD
Daylong Institute: Building an Anti-Racist LGBT Movement
I wanted to share my thoughts on a couple of issues I discovered at the end of first Day-Long Institute at the Creating Change National Conference on LGBT Equality. The first is health inequality and the LGBT movement. I heard several stories from people about health disparities among LGBT people and especially LGBT people of color. One story was about from an African-American gay man who has struggled to get proper healthcare. He went on to say that how is he ecpected to recieve the same healthcare benefits as others? His story made me ask myself some questions. Why do LGBT people and people of color receive inadequate healthcare? How can we expect to have lower rates of alcohol and tobacco use in our communities with so many barriers? The end of the session was hopeful. The speaker reminded us: Individuals and communities do grow and change. There is HOPE! He gave us an exercise to recreate a conversation to upper management at our agencies demanding change. It was a powerful exercise and I learned much from those that shared. For my second thought, I would like to share my evaluation form comment to the organizers. The name of this institute is Building an Anti-Racist LGBT Movement! My idea is to change it to Building Racial Justice. I feel that the word anti-racist attracts and is focused on racism. Would love to hear your thoughts.
Hector Martinez
LGBT HealthLink, The Network for Health Equity 
What information we have about the elevated level of risk behaviors; smoking, alcohol and drug use, unprotected sex, and exposure to violence in our community, shows that all these risks begin early in life, usually in adolescence, for LGBTQ people, and directly correlate with our exposure to childhood trauma, abuse, neglect, and rejection, especially by intimate family members and authority figures. In other words, our health risks begin long before health disparities caused by health care provider hostility, incompetence, insensitivity, and denial of care have the opportunity to make an impact. If there is the additional minority stress of belonging to a racial, ethnic, or religious minority compounding the impact on children the incidence of risk behaviors also goes up, in a very dose dependent relationship. More minority stress equals more risk behaviors later in life. Chronic exposure to multiple types of minority stress from an early age induces many complications and adverse health sequelae, including endocrine dysfunction and metabolic derangement that leads to degenerative disease.
Socioeconomic hardship that is suffered disproportionately by POC, especially LGBTQ POC, further derails recovery from risk behaviors by denying people access to treatment and the opportunity to minimize the damage wrought by this persistent minority stress. Inevitably, for most people the consequences of minority stress progress to chronic disease, often bringing disabilities, early morbidity and mortality. Once someone can no longer work, access to quality health care is reduced even further, speeding their downward spiral into irreversible illness and unnecessary, premature death.
There is only so much health care providers, no matter how well intentioned, can do to alleviate the health impairments imposed by minority stress. Even in countries where universal access to health care is mandated and long term efforts have been made to equalize access and quality of care, disparities in health outcomes persist. In the UK, for example, since previous efforts to equalize care have not prevented disparities in outcome, they are now turning to investment into addressing the social determinants of health; primarily income inequality, which appears to create and fuel the greatest disparities in health outcomes.
Our public health message must turn away from the simplistic claim that smoking, drinking, and drug use cause health disparities, to the deeper truth that suffering relentless injustice and stress, especially during early life, predispose us to debilitating illness, and shorten our lives. We must not join others in “blaming the victim”.
We must change our society, political priorities, and create justice in environment, education, employment opportunity, share the wealth and have a robust social safety net if we want to add the years of health, well being, productivity, and human dignity that our community deserves. The emphasis must be on providing the young, going all the way to prenatal care, with the best possible care and nurturing, so they will never develop the health risks that are so very difficult to extinguish once they are established and have had the time to damage adult life. That and cultivating cultural competence and sensitivity in our health care providers will begin to level the playing field.