Action Alerts · APHA · Community Transformation Grants · Funding · LGBT Policy

Thoughts on Tobacco, Evolution, Sustainability & Strategic Planning

Scoutby Scout, Ph.D.
Director, Network for LGBT Health Equity
At The Fenway Institute

Healthcare Reform Has Started to Change Our World

It seems I’ve been a public health professional for almost a quarter of a century. (really? wow) I’ve gotta say, in those 24 years, one of the things that gives me the most optimism is the advent of health care reform. Cutting through the details, health care reform is fundamentally shifting to being more logical about our health, particularly finally investing more in avoiding problems, instead of just fixing them. When I was in school, we used to describe public health like this; if you’re next to a river and people keep coming down drowning, the doctors will pull them out and resuscitate them, but the public health officials will head upstream to help stop them from falling in. Finally now, our health care system is moving towards that upstream intervention. It took spiraling healthcare costs to spur the shift, a burden that our kids will probably have to keep paying, but at least it’s happening.

85% Is Good News for Us

A while ago folk at CDC started to throw out a startling stat, seems the analysts crunched the numbers and came up with the fact that if we do a better job of avoiding smoking, eating better, and exercising more as a country, we can cut our healthcare costs by a whopping 85%. Eighty five percent, that’s just shocking. Yes, it’ll take a boatload of changes to really shift these 3 health behaviors, but it’s numbers like this that are spurring the 3/4 of a billion dollars the government recently invested in Community Transformation Grants aimed at these three issues. This is all good news for anyone working in tobacco, or in healthy eating or exercise. As the ex-head of CDC’s Office of Smoking and Health said, “We kept saying smoking was important, finally they realized we were even more important than anyone guessed.”

Fewer Silos, More Grain

Hold on, hold on, there’s even more logic coming out of the government. (I know, we try not to expect that). Along with the shift towards more wellness/prevention work, there’s also a lot of reorganization afoot, to combine funding streams to allow more integrated work on the three areas: tobacco, exercise, and healthy eating. Yah, not only does this probably reduce paperwork for someone (not that you could tell from any of the proposals I’ve written recently), but it also just makes sense. If we’re trying to help people be healthier, do we really want several sets of people locally trying to change things, one for tobacco, another for healthy eating, and another urging folk to exercise. Of course not, the concept of pushing Wellness as an integrated focus makes the most sense.

Evolution and Pain

As most of you know, it was this shift that spurred our move about a year ago to change our name from the National LGBT Tobacco Control Network, to the less issue-specific Network for LGBT Health Equity. We knew future funding would come out with a tobacco/eating/exercise combined focus and we wanted to ensure the Network would be ready to compete in the evolving world. Unfortunately, for a group that’s always been community driven, we dropped the ball on the name change, not announcing the opportunities for input widely enough to our membership. While most everyone was very supportive of the name change, some vocal and longtime members were upset. Worrying that we would lose our tobacco focus in the shift. I hope the ensuing time has proven our continued focus on tobacco. It is after all, the only thing we’re funded to address. But I also hope we’ve showed we can be relevant to the other health issues as well, because we really do understand much of our work in tobacco can be useful to other arenas.

Sustainability & Strategic Planning

The Network for LGBT Health Equity has about 1.5 years left on our CDC contract. After that point, there’s no guarantee CDC will continue the tobacco network funding. Of course, we’re working very hard to clarify the value in having networks like ours who can keep pointing out gaps, keep tabs on what’s happening around the country, and keep the people in touch with the policymakers. Considering the new emphasis on changing health policies I believe the value of networked LGBT communities is higher than ever, because if there’s one thing our communities have built skills in, it’s policy change. But the truth remains, this Network has to become sustainable in a shifting health environment.

As always, our strength is in our people. I’m particularly grateful to the Network Steering Committee members. This group has agonized over the name change, created a media plan, is currently creating a new level of detailed best practices document, and in 2011 spent about half a year creating a draft strategic plan to help guide us through the turbulent years ahead.

Community Review & Our Network

Very soon now, this draft strategic plan will be circulated to our constituency for review and input. I hope each of you can take a few minutes to look at it and think about whether this reflects the Network you want to see. I know how hard the Steering Committee worked on this draft, every single word was agonized over. Our history, our core of tobacco work, the evolution of the arena, what we want, all these things and more were put in the hopper and fashioned into a (deceptively) short set of goals for us to use as our compass in coming years.

Some of you were there in 2003, when 60 people gathered from all around the LGBT communities to create our first tobacco action plan. That document provided the foundation for the Network development and innumerable local programs for years. I feel the development of this strategic plan is a direct outgrowth of that work. I know our world has changed since 2003, but I hope every single person out there concerned with LGBT health, tobacco, and wellness still feels the drive we did back then, to make and keep this Network as one we have built, that represents our joint goals.

So look for that strategic plan to come out for review in a few days, and I hope you’ll take at least a few moments to check it out, and help us make it the best possible guide for the Network that community members built.

 

 

 

 

Action Alerts · APHA · Community Transformation Grants · Funding · LGBT Policy

ACTION ALERT: One Month to Demand Partnership in Local Community Transformation Grants

Scoutby Scout, Ph.D.
Director, Network for LGBT Health Equity
At The Fenway Institute

Local CTG Grantees Have One Month To Modify Action Plans

Remember how (just minutes ago) we posted that leaders are urging local disparity leaders to demand partnership in the newly awarded $100M of Community Transformation Grants (CTGs)?

Well good news is, many of the new grantees are right now modifying their action plans! CDC has asked for the new plans to be submitted to them by end of January. This means right now is a perfect time to contact the people who got the award locally and urge this partnership. Clock is ticking!

Who to Contact and How

The entities below are the CTG grantees who have to submit modified action plans by end of January. We have contact information for each of them, or you can just google it and call the top person. Please email us at lgbthealthequity@gmail.com if you want the direct contact information.

Broward Regional Health Planning Council (Florida)
City of Austin Health & Human Services Department (Texas)
County of San Diego Health and Human Services Agency (California)
Denver Health and Hospital Authority (Colorado)
Douglas County Health Department (Nebraska)
Hennepin County Human Services and Public Health Department (Minnesota)
Illinois Department of Public Health
Iowa Department of Public Health
Los Angeles County Department of Public Health (California)
Louisville Metro Department of Public Health and Wellness (Kentucky)
Maine Department of Health and Human Services/Maine CDC
Maryland Department of Health and Mental Hygiene
Massachusetts Department of Public Health (to serve state minus large counties)
Massachusetts Department of Public Health (to serve Middlesex County)
Mid-America Regional Council Community Services Corporation (Missouri)
Minnesota Department of Health
Montana Department of Public Health and Human Services
New Mexico Department of Health
North Carolina Division of Public Health
Oklahoma City-County Health Department (Oklahoma)
Philadelphia Department of Public Health (Pennsylvania)
Public Health Institute (to serve the state of California minus large counties)
San Francisco Department of Public Health (California)
Sault Ste Marie Tribe of Chippewa Indians (Michigan)
South Carolina Department of Health and Environmental Control
South Dakota Department of Health
Southeast Alaska Regional Health Consortium (Alaska)
Tacoma-Pierce County Health Department (Washington)
Texas Department of State Health Services
The Fund for Public Health in New York (New York)
University Health Services, University of Wisconsin-Madison (Wisconsin)
University of Rochester Medical Center (New York)
Vermont Department of Health
Washington State Department of Health
West Virginia Bureau for Public Health

What to Ask

  • CDC urges you to address health disparities with this award. Do you have LGBT communities identified as a disparity population this CTG award will target in your Action Plan?
  • CDC requires that you have a “Leadership Team” that includes reps from disparity popuations. Do you have LGBT people on your Leadership Team for the grant?
  • CDC requires you to do extensive data collection for evaluation. Are you collecting LGBT status as part of your demographics?
  • CDC requires 50% of these funds to be regranted locally. Are you planning on funding disparity community based organizations with these regranted monies? (versus just health departments)
  • Are you integrating a full range of disparity populations in the Action Plan, Leadership Team, and regranting plans?
  • If no to any of the above – Why not? We can help you fix this, provide data, people, groups, etc. What will it take to make this change?

Talking Points

  • LGBT people smoke at rates from 35% to almost 200% more than the local population
  • If we haven’t collected local data on this disparity – why do you think the national LGBT disparity data don’t apply to us?
  • Remember, even for the exercise/nutrition components of this award, if we change the main population, but don’t integrate disparity populations into that work, this could build a new disparity.
  • LGBT people, and all of the overlapping disparity populations have the ground forces, and policy change organizing skills you need to change local health policies. AKA If you’re trying to change local policy without us, it’s like leaving some of your best racehorses in the stable.

Successful Strategies

  • If LGBT people and/or other disparity groups are not being included — shine a spotlight on this fact, get press, post a blog about it, share with your membership. If a policy gap is widely known, it’s more likely to be fixed.
  • Identify what allies you might have above the grantees, like the Commissioner of the local health department, or allies in the Governors office, etc. Telling them about this gap can also help fix it.
  • Reach out to and partner with allied disparity population leadership to approach the grantee together, remember that parable about one stick and a bundle of sticks!
  • Remember you’re trying to partner with the local grantee, ask the hard questions, ask them loudly if need be, but offer solutions, you want to be the people who can fix a problem for them. You’re trying to build a working relationship here.

When?

ASAP, the groups above to turn in their new plans by end of January! It’ll be much harder to get inclusion once those plans are turned in.

Action Alerts · APHA · Community Transformation Grants · Funding · LGBT Policy

Leaders Urge Us To Demand Partnership in Local Community Transformation Awards

Scoutby Scout, Ph.D.
Director, Network for LGBT Health Equity
At The Fenway Institute

Asking Officials How We Get Inclusion in Local CTG Awards

Excerpts from the live video of the event

Flashback to American Public Health Association (APHA) conference a few months back. This event pulls together 13,000 public healthians from every walk of life. They had a session there where they were announcing the Leading Health Indicators for HP2020. Assistant Secretary for Health Dr. Howard Koh was there, as were several other leaders in the health and racial and ethnic minority communities. Moderating the session was Dr. Benjamin, the well respected President of the APHA.

You know what we do, when they open it for questions, we’re early in the line, asking about disparities and LGBT inclusion particularly.

This time I asked about this $100M of new Community Transformation Grant (CTG) money that’s just been awarded locally. As you know, we’ve been working on this lots and LGBT inclusion in these new awards wasn’t just optional, the way the CDC guidance was written, it was downright difficult for states to justify. To put out $100M of new local funds for tobacco, exercise, nutrition and not even target our communities is a huge loss. Even more worrisome are signs some states aren’t even reaching out to their existing racial and ethnic disparity infrastructure.

How? Demand Partnership

So, that was what my question was about this time, see full transcript below. Importantly, Dr. Benjamin was really clear and almost strident; local advocates need to demand partnering with local CTG grantees. We will too often be left out until we speak up and demand to be included.

So the question is, will we?

In Their Own Words; The Transcript

APHA PRESIDENT BENJAMIN:  Thank you. Next question? 

SCOUT:  Hi. My name is Dr. Scout and I’m from the Network for Lesbian, Gay, Bisexual, Transgender Health Equity. I love that we’re using social media so much as I’m trying to livetweet this event, which definitely bends your brain.

I did my dissertation on social determinants of transgender health. I love that social determinants are in there.

But my question would be you know something? I do a lot of work with community groups. I’ve been working for many years with a set of health disparity networks in Minnesota that are doing health and wellness disparity work around the Southeast Asian populations, Latino populations, African American and African populations, and lesbian/gay/bisexual/transgender population. 

It was dispiriting to see millions of dollars come into Minnesota under Communities Putting Prevention to Work and not see overlap with those existing health disparity networks.

We worked hard that the Community Transformation Grants. Had an RFA that said please do more work with your existing disparity populations and your disparity action plans. And it was even more dispiriting to see that they got almost $5 million in the state of Minnesota and they still haven’t even reached out to the existing disparity networks.

So my question I guess and it’s probably for you, Dr. Koh, what are we thinking around plans not just to ask for disparity inclusion for all populations, but to actually monitor and ensure that it happens as we run these huge sets of new funds out across the country? Thank you.

ASSISTANT SECRETARY KOH:  Well, Scout, it’s good to see you again. You always ask me the good questions. [LAUGHTER] We have a commitment to ending disparities that I think is greater now than ever before.

And when we talk about disparities we discuss them not just with respect to race and ethnicity, but also sexual orientation and gender identity and geography and level of disability and many, many other dimensions.

We do have a dedicated action plan on reducing disparities that was unveiled some six months ago. In fact, the next session I’m speaking at in an hour is on achieving health equity.

That is perhaps the most comprehensive plan to reduce disparity that ever unveiled by the department. And also reflects the growing commitment across the country to truly make the vision of health equity come alive.

So we also have committed to monitoring progress very, very carefully. And our assistant secretary for planning and evaluation, Sherry Glied, is a valuable co-partner and leader. And her whole office is helping monitor outcomes.

This is where using the healthy people data, the leading health indicator data, implementing the national prevention strategy, and using the power of Dr. Glied’s office is going to help us track these outcomes over the future.

Your challenges that you described about the disconnects in various states is reality speaking, so thank you. Please do not give up because I think we are in a new dimension right now with public health, a true paradigm shift with respect to social determinants. And this is our opportunity to make it happen.

APHA PRESIDENT BENJAMIN:  And let me add. I think that’s a perpetual problem and we really, and that’s on us. I’m not sure it’s on them. I think it’s on us and the community to demand that we partner.

We talk about partnerships and collaborations all the time. And then we fail to collaborate and partner. So I think we’ve got to go back to our communities and demand that we do it. Just like in the early days of the HIV/AIDS epidemic.

We’ve got to demand it. We’ve got to require it. We’ve got to talk to our local policy makers. You know, beat up on us local officials. You know, I always hated that when I was a health officer.

But the truth of the matter is unless us and those of us at APHA and others demand that that happen, it’s not going to happen locally. All that kind of control is local at the end of the day.

So let’s certainly try to do that. I know that we’re obviously eager to work in all the communities and make that happen.

APHA · Data · Minnesota

American Public Health Association (APHA) Conference Reflections

 

 

 

 

Hay Network Hay,

It’s me, e.shor, sitting on a plush leather couch in the lobby of the Washington DC Convention Center at the American Public Health Association (APHA) Annual Meeting. This place is a whirlwind for a first timer, filled with fast moving sessions, lots of talk about methods, odds ratios, and limitations of research studies. Public health is growing so fast that this conference is now spread over three buildings in downtown DC with over 13,000 attendees and thousands of sessions and posters on hundreds of public health topics. One of the opening speakers was from the National Parks and talked about the positive health benefits from being active in the natural world…pretty cool huh?

There is so much good work being done by such a diverse group of public health practitioners at this conference. It really is impressive the strides and research people are doing in tobacco control, alcohol, nutrition, physical activity, cardio-vascular disease, diabetes and how different populations experience and face different health disparities. However, it was really tough to walk into the LGBT Caucus meeting to find that there were only 6 session on LGBTQ health, most of which focused on MSM (men who have sex with men) and HIV. Out of the thousands (not an exaggeration) of sessions and posters presented  only SIX sessions and about 12 posters were directly related to LGBTQ health.

This shows me exactly our place in this whole thing…

I went to a session about “Lesbian and Bisexual Women’s Health” where we covered studies dealing with mental health, substance abuse, sexual health and sexually transmitted infections (STIs). Most of the data that the researchers presented was fascinating and illuminated risk factors that are tied to sexual minority status (now that is the jargon) and that health disparities really do exist for LBQ women! At the end of this session a person asked whether data in these studies account for transgender people and transwomen in collection and analysis…most of the presenters apologized and said that they used data from large data sets like NHANES where LGB people are sparsly represented because most large, national data sets to not over-collect in LGB communities, and trans folks are virtually invisible. I call this disparities in data collection…

Good news in: Healthy People 2020 has a new initiative to address LGBTQ health disparities! One of the issues that was identified is the complete lack of data on transgender and gender non-conforming people in our communities. Thank goodness! There were a number of states that have been awarded funding from Healthy People 2020 to start working on many different projects, including LGBTQ health initiatives…to find out more about your state click here! This is an amazing opportunity to Mobilize, Asses, Plan, Implement, and Track in local communities, with local health organizations, and to collect data and find out more about the health needs of our communities. I am from Minnesota, and there is quite a bit of scandal around the use (or lack there) of our HP2020 funding and the fact that we yet to reach out to local agencies working on health disparities. When I get home I will definitely be looking into this and holding the Minnesota Department of Health accountable to me and to my communities.

I know statistics are boring sometimes, and a lot of the stuff they say at conferences like this don’t make sense to a lot of people because they are all “log odds ratios” and “95% confidence intervals,” but having the data and knowing about LGBTQ health needs and trends is so important to figuring out how to grow healthier communities. Keeping asking for it…keeping fighting for it.

Let’s talk soon,

e.shor

APHA · Cross-posting

Improving Health Disparities Research (and Integrating LGBT Health National Data Collection)

Crossposted from http://www.healthcare.gov/blog/2011/10/disparities10312011.html

 

By Dr. Howard Koh, HHS Assistant Secretary for Health

This year we have achieved important milestones in our commitments to reduce racial and ethnic health disparities, including the release of Healthy People 2020 and the National Prevention Strategy, as well as the launch of the HHS Action Plan to Reduce Racial and Ethnic Health Disparities.

Today, we are achieving yet another milestone, by implementing an important provision of the Affordable Care Act that will improve the collection of data on HHS-sponsored surveys. With this advance, we as a nation can better understand and target health disparities and ultimately move toward eliminating them.

After reviewing the more than 400 public comments we received on draft standards proposed last June, we are now publishing final standards for data collection and reportingon race, ethnicity, sex, primary language and disability status. Previously, identifying and reducing disparities has been limited by a lack of uniformity, specificity, and quality in data collection and reporting.  Now, consistent methods for collecting and reporting health data will help us to better characterize and compare the nature of health problems in targeted populations. These new data standards, required by the Affordable Care Act, represent a powerful new set of tools to move us closer to our vision of a nation free of disparities in health and health care.

Assistant Secretary of HHS, Dr. Howard Koh

With respect to race and ethnicity, we can now collect more data on key groups. For example, by adding Mexican American and Chicano/a, Puerto Rican, Cuban, and Other Hispanic Latino/a or Spanish origin as explicit categories on all HHS-sponsored health surveys, we can better capture, understand and act upon the specific challenges presented by each ethnic group — challenges that would otherwise be lost under broader terms, like “Hispanic” or “Latino.”  Such detail could possibly shed light on health problems such as initial studies that suggest the diabetes-related mortality rate for Mexican Americans and Puerto Ricans may be twice as high as that seen for Cuban Americans.

With respect to disability and primary language, this announcement also breaks new ground. These first- ever uniform disability standards will ultimately improve researchers’ abilities to monitor and track health disparities in this critical public health area. And, for the first time, we can collect in a standardized way, information of the primary language spoken by a person or in a household.

Separately, we are continuing to implement efforts that will ultimately allow integration of questions on lesbian, gay, bisexual and transgender (LGBT) health into national HHS data collection efforts.  Expanding data collection to include information on the health of the LGBT population is important to understanding and tackling disparities.

The Department’s data collection efforts under these new standards will continue to ensure privacy protection and apply all appropriate information security safeguards in the collection, analysis, and sharing of data.

All these advances collectively strengthen the critical information by which we, as a nation, identify and address disparities in the future. For more on the final data standards on race, ethnicity, sex, primary language and disability status, please visit www.minorityhealth.hhs.gov/section4302.

APHA · Puerto Rico

Are you at APHA? Happy Halloween Poster Session on Puerto Rico LGBTT Health

by Juan Carlos Vega, Guest Blogger
While attending APHA 2011 in Washington, D.C.

Greetings from cold but beautiful DC!

TODAY from 2:30 PM – 3:00 PM
LGBT Poster Presentation – Poster 8
Health profile of a convenience sample of LGBTT communities: Findings from the Community-base groups LGBTT health initiative survey of Puerto Rico from November 2009 to November 2010 by Elba Cecilia Díaz-Toro, DMD, MSD, MPH and Juan Carlos Vega, MLS.

Come by, say hello and learn about the local health survey results and how it compares to other Latino/a communities and LGBTT communities, as well as with other state surveys. We will try to create a “warm” space for all!

Thanks always for the support from the Network for LGBT Health Equity.
Gracias, Juan Carlos

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PopCtr Mtg: Panel Discussion on Probability and Non-Probability Methods

Scoutby Scout
Director, Network for LGBT Health Equity
A project of The Fenway Institute in Boston, MA

SCIENCEBABBLE ALERT – This is a meeting for scientists, despite my efforts, some of this may get technical.

411 on the issue

Probability sampling = getting a group of people for your research that is statistically proven to be a random selection from the full population of interest, thus the statistics support you being able to draw conclusions for the full population based on the info from this random subgroup. (Like if 50% of your probability sample of LGBT people parachute, you can confidently say 50% of all LGBT people parachute.)

Non-probability sampling = any non-random sample of people. (Like if you do a survey at pride, it’s a non-probability sample.) Unfortunately, the statistics then do not support being able to generalize these findings to the full population, because there’s a chance bias might have snuck in. (Like, maybe pride participants aren’t as closeted as other LGBT people, so even if 50% of your sample are in LGBT parachuting clubs, you can’t say 50% of all LGBT people are in such clubs.)

Why’s this a big issue? Probability sample data is the gold-standard for drawing conclusions, but we have much less of this for LGBT people, mostly because LGBT measures aren’t included on the monster federal surveys that are the big probability studies.

Panel Members:

  • Dan Kasprzyk, Ph.D. Vice President of NORC (which I realize is so well known as one of 2 fanciest survey shops that his bio doesn’t even say what NORC stands for… so just know, NORC=surveys)
  • Melissa Clark, Ph.D. Brown University Department of Community Health
  • Margaret Rosario, Ph.D.
  • Jeffrey Parsons, PhD. Hunter University

The Panel

Dr. Kasprzyk led the panel off talking about some of his interesting experiences as part of the Institute of Medicine committee for the recent LGBT report. He emphasized that the choice of probability or non-probability might really not be as important as the reporting and impact of any well-designed study, regardless of the methods chosen. Then he moves onto talking about the federal surveys. “If the federal gov’t added LGBT measures to the American Community Survey, then allowed oversampling, that alone would allow the community to target populations, whether it’s regional, city, rural, you name it, and we’d be much better off. But we have to go beyond NHANES, you have to get on other surveys, NHIS and especially the Labor Force Survey would be very valuable.” He emphasized how important it was to get measures on these large full-probability surveys, “because otherwise you remain invisible.”

“Probability data is very important, it is the gold standard, in Washington, that’s what people are going to listen to. I think the real advancement in healthcare policy comes from really pushing hard with the federal government to have these questions on those surveys, and that point cannot be diminished. I think it’s really important that we actually stay focused on the federal government and become part of that health policy debate.” Dr. Kasprzyk

Dr. Clark followed (that’s Melissa to you and me) and led off by echoing all of Dr. Kasprzyk’s points. She says “”That’s usually how I end every talk I give about sexual minorities, I say ‘please help us get these questions added.'” She talked about her experience at Brown University and how much she’s been working to try to get the non-LGBT researchers to include LGBT measures. Through this effort, she’s managed to take one of the IOM report recommendations and institutionalize it, “Now when there’s a new study, people have to either include sexual minorities or explain why they are not.” Kudos to Melissa, let’s hope NIH follows suit!

Next up was Margaret Rosario. She warns us that while probability samples are important, most of our real explanatory data will come from non-probability samples because they are so much cheaper they have more latitude to go much deeper into issues, explore causal models, etc. For her, the bottom line is either approach can be useful, it’s often an issue of cost, if we have the chance to do the higher costs full-probability samples, excellent, if not, let’s just do excellent non-probability studies. Lastly she also weighs in on the importance of getting LGBT measures on the large surveys, “For the probability studies, please please, whatever we can do to get questions on there, do be able to identify the population as best we can, we should definitely do that.”

The panel was rounded out by Jeff Parsons. He talked about how it always seems there’s a flavor of the day at NIH for the newest rage for sampling, some of which are just never really viable in the field. “You can’t just count every 9th person who goes in the bar and pull them for the study, it doesn’t work.” Tonda Hughes from UIC echoes that sentiment, noting that the popular method, Respondent Driven Sampling, has never worked for her in samples of women.

As the discussion opens up to audience comments, there’s an interesting suggestion from Jim McNally, a director at ICPSR (the Intra-university Consortium of Political and Social Research, probably the largest data library in the country). one of the University of Michigan (ICPSR) scientists… “We recommend people work to create a small strong full probability sample and then ask the same questions you have on the federal surveys. That way you have policy strength to compare to the federal questions.”

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Center for Population Research in LGBT Health Holds Annual Convening

Scoutby Scout
Director, Network for LGBT Health Equity
A project of The Fenway Institute in Boston, MA

My Non-Sampling Error Experience

Ok, I’ve fled from the very exciting Netroots Nation conference to get back to Boston because today and tomorrow mark the 3rd annual convening of one of The Fenway Institute’s other major initiatives, the Center for Population Research in LGBT Health. Not only does this mean I get to hang with some of my farflung friends for two days, not only does it mean the largest gathering of trans health researchers I’ve seen, not only does it mean I get to meet many upcoming researchers involved in the mentorship program, but right now, it’s also the biggest meeting about LGBT research that occurs each year.

I came a little late, so am jumping in as the head of one of the most prestigious survey centers in the country, Dan Kasprzyk of NORC, weighs in on issues related to LGBT sampling. (He was just talking about a non-sampling error experience.) So, I’m going to focus more on the actual content now… but just wanted to start off by giving you a little bit of context to the meeting, because this is a really cool project.

Abstract of Center for Population Research in LGBT Health Project

Previous studies have shown that sexual and gender minorities have higher prevalence of life-threatening physical and mental health conditions, experience significant barriers to health care quality and access, and face substantial threats to quality of life. Population-based research is necessary to more fully understand the causes of these disparities, so that effective responses can be developed. The proposed project’s long-term objective is to create a sustainable capacity for population studies and the translation of results into practice models for sexual and gender minorities. This 5-year effort will be conducted by the Fenway Institute, supported by the Research and Evaluation Department of Fenway Community Health (FCH), a Federally-Qualified Community Health Center. FCH provides comprehensive primary health care and mental health services annually to 11,000 neighborhood residents and students in nearby colleges and to LGBT persons, primarily from Greater Boston. Approximately 55% of patients self-identify as LGBT, reporting sexual or gender minority behavior and/or identity. The project has the following specific aims to develop the infrastructure for population research regarding the health of sexual minorities: (1) develop and support a multidisciplinary faculty to advance the study of sexual and gender minority populations, (2) create a shared research library, to include selected population-based datasets and findings from a large clinical dataset, and (3) disseminate the products of our work through the internet, a monograph, and peer-reviewed journal articles.  A team of researchers with diverse qualifications has been assembled to address these specific aims, with the assistance of a National Advisory Board of experienced population scientists and technical experts. The input and collaborative work of these researchers will lead to a common framework for multidisciplinary scholarship that advances understanding of sexual minority populations and how social, cultural, and institutional factors influence their health. This work will provide a foundation for culturally competent treatment approaches and behavior change models for sexual minorities.

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Breaking News! NY Hospitals Announce Mandatory LGBT Cultural Competency Trainings

Scoutby Scout
Director, Network for LGBT Health Equity
A project of The Fenway Institute in Boston, MA
Reporting from Bellevue Hospital, NY

I’m down here in NYC and very, very happy to be at the press conference where New York City Health and Hospitals Corporation just announced mandatory LGBT cultural competency training for all their 37,000 employees! They also debuted the excellent new LGBT cultural competency video created by our friends at the The National LGBT Cancer Network. The Cancer Network created the full training to be administered to every NYC hospital employee, both the trainings and video are available for purchase or replication. (Don’t forget, the National LGBT Cancer Network is also our collaborator in our brand new LGBT Wellness NYC Marathon team.)

To have the head of all NY public hospitals reinforce that LGBT cultural competency trainings are a mandatory part of good healthcare is historic, let’s hope other cities and hospitals soon follow! See their press release here.

L to R: NYC Councilman Daniel Dromm; Liz Margolies, ED of National LGBT Cancer Network; NYC HHC President Alan D. Aviles, NYC Deputy Mayor Linda Gibbs, and HHC doctor.

Even HHS Secty Sebelius weighed in on what a big deal this is:

“I applaud the New York City Health and Hospitals Corporation for its leadership in ensuring LGBT patients are treated with the respect and dignity we all deserve. HHC has offered a path to a fairer America and HHS looks forward to seeing other efforts from care providers from around the country toward that same goal.”

We were also live-tweeting from the event with all play-by-play tweets on @lgbttobacco and @lgbthlthequity with some major help from friends on the ground @cathyrenna and @RennaComm, so check out updates there.

The video shown features the stories of several LGBT people who have experience bias in hospitals and in the healthcare system. You may have already seen an article about these trainings in Huffington Post, and an excerpt of the powerful video can be seen here:

Let’s hope the news spreads fast and other hospital systems follow suit.

See more press about this in:

  1. Advocate Magazine: NYC Hospitals Adopt LGBT Competence Training
  2. DNAinfo.com: New Hospital Program Addresses LGBT Health Woe
  3. New York Times Blog: For Public Hospital Employees, New Training on Gay Patients
  4. NY1: New Program Attempts To Eliminate Barriers For LGBT Patients
  5. Rainbow Access Initiative: Breaking News! NY Hospitals Announce Mandatory LGBT Cultural Competency Trainings
  6. University of Arkansas for Medical Science: Center for Diversity Affairs to Sponsor LGBT Cultural Competency Strategies Webinar
APHA

APHA Field Reports: Opening Plenary – The Church of Cornel West

By Jaime Delavan
Reporting for the 2010 American Public Health Association Meeting in Denver Colorado

The opening for the 138th annual American Public Health Association (APHA) meeting and expo, focusing on social justice and public health, provided an impressive line-up. I mean no disrespect but I am not going to list them all. There were impassioned statements about health care reform, the number of people without health insurance and the need for a public option. There were strong words around changing our sick care system to a health care system. There was a challenge to collectively find our public health voice. There were thoughts shared about the lack of health care available for the people (a large number who are immigrants) who put food on our table, sweep our floors, and help keep us safe. There was talk of available funding for things (and people) “we” are comfortable with.  And a group shout of the word “racism”. A resounding acknowledgement of it’s existence in America, and not just among Euro-Americans. There was reflective mention of Tuskegee and the hurt and distrust that formed from that bad (really bad) moment in public health history. And how that bad helped shape the world of community-based participatory research that we see today. A world where the IRB process which, while it can be worrisome and time consuming, is present to protect individuals and communities from exploitation. It was a call to be mindful in our work. More on this later in the piece on co-opting.

But there is nothing like the church of Cornel West. I was fortunate to hear him last January in Boise when he was the keynote for the MLK human rights celebration. He was no less impressive this day. You may be familiar with him through his influential book, “Race Matters”. If not, pick it up. It’s a worthwhile read and has been credited with changing the discourse on race. Or maybe you are more familiar with him from the movie the “Matrix”. I’ve read that he had a hand in the development of the storyline as well as a recurring role in the film. I must confess, I haven’t seen the movie.

West, referencing Curtis Mayfield, Billie Holiday, Sly Stone, John Coltrane, Bootsy Collins, and Curtis Mayfield while talking about social justice, had everyone clapping and shouting. It was like church without the fans. “Social justice, it’s like the blues”, he declared. “It’s personal catastrophe expressed lyrically.” It sheds light on “Everyday People”, and “Strange Fruit”. It is “Love Supreme”. But in America, we like to deodorize the discourse. We like to focus on success and ignore “the basement”. It’s time to stop deodorizing and focus on the “funk”.  Cornell West challenged the audience to think socratically. To ask the tough questions and challenge modes of thought. West shared the story of telling President Obama that he will be a socratic supporter. He will ask the tough questions. And again advised us to ask the tough questions and not get discouraged but “Keep pushing on”.

West asked, “So if the banks are too big to fail does that mean the poor are too small to help?”. Interesting socratic question. It was a perfect kick-off to a few days of social justice and public health conversation.

You can make a living or make a life. You can live the good life or live a life of good. Many of us are wounded healers, working with passion and compassion. The time has come when we need to put the accent on courage. Too many people are used to injustice. The wretched of the earth, their humanity is just as important as anyone else’s. It’s time to invest in human health and spirit – Cornell West

Also, check out a video of Cornel’s talk below!