Corey Prachniak is an LGBT rights, HIV policy, and healthcare attorney. He serves on the Steering Committee of the Network for LGBT Health Equity and tweets @LGBTadvocacy.
Even most casual observers know that the President’s budget proposal, released yesterday, is unlikely to become law (so much so that Senate Democrats won’t even vote on it this year). But budgets are really just outlines, anyway – even a passed budget needs separate laws to dole out the promised money – and in this way, it’s the symbolism of budget proposals that’s most important.
So it should be comforting to those of us who care about LGBT issues to see that the White House released a fact sheet dedicated to explaining how the President’s budget helps our community. What’s more, LGBT health (and other aspects of LGBT life that impact health) were front and center in the report.
The fact sheet has a whole section on disparities, noting that it “supports community effort to focus on prevention, including using evidence-based interventions to address tobacco control, obesity prevention, and better nutrition and physical activity.” It also supports expanding health care services, which will hypothetically benefit all groups with health disparities, and increase data collection. The budget also maintains funding for the Affordable Care Act and, as touted by AIDS.gov, expands access to care and housing assistance for people living with HIV. These points cover quite a few of the health disparities that I recently outlined as plaguing the LGBT community.
What’s more, the budget addresses several types of violence that have a disproportionate effect on the LGBT community – in terms of both the physical harm that befalls individuals, and the greater social and emotional harm that afflicts LGBT people who live in a culture of violence. (Recent research, noted on the Network’s new HuffPo LGBT Wellness page, has confirmed that just living in a community that is homophobic can take years off an LGBT person’s life, so this latter point shouldn’t be ignored.) What are these types of violence? Well, there’s domestic violence, which the budget addresses by funding the Violence Against Women Act (VAWA), a law that Republicans in Congress have attempted to keep exclusive of the LGBT community despite the high rate of domestic violence we face. Closely related is the problem of hate crimes, which the budget addresses by providing funding for the Justice Department to prosecute offenders.
Then there are a few more social types of violence that nonetheless can have a major impact on LGBT health. Civil rights violations and homelessness are both problems that are targeted by the budget, and are also problems that – if left unaddressed – greatly diminish the chances of LGBT people having good health. We might not think of homelessness as a health or violence issue, but as someone who works with homeless individuals, I have personally found that it is extremely difficult for someone to stay on their medication and keep doctors’ appointments when they have nowhere to live. And that’s to say nothing about the psychological and nutritional toll, as well as the risk of disease, exposure, and harassment one faces by having to sleep outside. Kicking someone out of their house is a form of social and economic violence, and as many as 40% of homeless youths identify as LGBT.
Let’s face it, this budget won’t become law. But it does show that the administration does a pretty good job of “getting it” when it comes to systemic problems that plague the LGBT community. That’s not to say there isn’t more that we can do as a society to improve LGBT health outcomes, but it’s a good start. And it serves as a reminder that we have to think broadly about LGBT health and dig into underlying social problems (as well as get some government funding) if we want to end disparities.