The University of California, San Francisco will be celebrating National LGBT Health Awareness Week on Tuesday, March 26, 2013 with an information table, free chair massages, blood pressure screenings, and a raffle to promote health and wellness!
If you’re hosting an events this week, please feel free to shoot us an email (firstname.lastname@example.org), or post on our facebook page!
By Simone Koehlinger, Psy.D.Public Health Institute of Metropolitan ChicagoChicago, IL
“Not So Second City”
It’s important to keep us queers and our health needs on people’s radars. I often brag about Chicago’s passionate community activists, dedicated providers, and our health department. With one of the last offices of LGBT Health in the country, the Chicago Department of Public Health makes us proud. Strong partnerships and governmental support are invaluable in making a dent in health inequities.
Another reason I am proud to be from the Windy City: Last month, the health department unveiled a LGBT action plan. This roadmap outlines 22 strategies to address the health and healthcare needs of the LGBT community. As the first companion document to Healthy Chicago, the city’s public health agenda, this release puts queer health front and center.
How’s THAT for government saying our health matters?
Being a glass half-full kind of girl, I really like that the health agenda acknowledges our strengths as a community. I’m also inspired by the plan’s shared responsibility — there is a role for all (community folks, medical providers, government officials, teaching institutions, etc.) to advance LGBT health.
Congratulations to all the organizations and people involved in creating this health blueprint. And here’s to a collective rolling-up-of-our-sleeves to ensure its plans become a reality.
Blogging Scholarship Winner
Reporting from Creating Change
The exhibition booths at the Creating Change Conference look great. I stopped by a couple of them to ask some questions. I asked Dave Reynolds, Project Director from the Safe & Healthy LGBT Youth Project, what his plans are for creating change in 2012. He would like to see the LGBT movement grow to rural areas of the US in the Midwest and the South. He travels to places like Alabama and Oklahoma. The LGBT movement is dramatically distinct from California and the East Coast. Our LGBT brothers and sisters from these rural areas are dealing with barriers such as empoyment discrimination and even face threats from the community. He went on to say that he would love to see the LGBT movement expand and grow in every state.
I also spoke to Tres Watson, Executive Director with Canvass for a Cause and he had two plans for 2012. The first is to double their efforts in California. Canvass for a Cause is dedicated to Queer politics sucha as marraige equality and voter engagement. His second plan is to see the scope of his work expand to rural areas and politically conservative that traditionally exclude Queer issues.
Gustavo Torrez, Program Manager
The Network for LGBT Health Equity
Reporting from the National Coalition for LGBT Health Annual Meeting
I am currently in Washington DC for the National Coalition for LGBT Health’s Annual Meeting. There has been a an amazing line up of speakers today from the Secretary of Health and Human Services, Kathleen Sebelius, to the Administrator of SAMHSA Pamela Hyde along with many distinguished leaders in the LGBT Health Movement from across the country.
During the opening keynote address, HHS Secretary Kathleen Sebelius noted “as a result of your work, today, we have a far better understanding that LGBT Americans face real and significant health disparities – another terrible consequence of discrimination, oppression, and social stigma.” The tireless efforts of you all is really making a difference. Understanding the disparity leave opportunity to combat the issues our communities face with federal support.
President Obama directed HHS to follow up with additional recommendations for action along with concrete steps to improve the lives of LGBT Americans. This direct call for action showed that our current administration understands that there is not only a disparity, but an understanding that there is work to be done to address the issues our communities face. One major step was LGBT inclusion in the Affordable Care Act. Secretary Sebelius notes ”The Affordable Care Act may represent the strongest foundation we have ever created to begin closing LGBT health disparities.” Many of you have been involved in this act, and we all understand that this has been a battle most have been fighting for, but the fight is not over.
Overall, doors are opening, work is being conducted, and the climate is changing for LGBT communities. Now more then ever we have a partner in the federal government. The administrations commitment is remarkable, and we know there is still more to be done but the doors are open. Secretary Sebelius summed this up perfectly stating “I know most of you have been fighting these battles for a long time. And you may not have always had active partner in the federal government. But that is changing.“
We are in a much better place today then we were 10 years ago. And again we know there is still so much that needs to be done. Our work for LGBT inclusion is far from over, but in a better place as we move forward with our movement.
In closing, I want to leave you all with Secretary Sebelius closing remarks which sum up the essence of her speech.“We have begun to push open doors that seem to be shut forever. Looking ahead, the future gives me real hope. And I’m looking forward to working with you to make it as bright as possible”
Click here for a copy of Secretary Sebelius’ speech.
I am in Washington DC, at the National Coalition for LGBT Health’s annual meeting. I had the joy of listening to Pam Hyde, Administrator of SAMHSA this morning. Pam talk was poignant, as she spoke as both the head of SAMHSA and an out lesbian working in the field for over 30 years. She began her talk today pointing out that it is only in the last 2 yrs, in this administration for the first time, that she has been asked to speak about LGBT issues. She referenced an earlier group that had formed many years ago to look at the LGBT population and she was not asked to participate in it. In fact, she wasn’t disturbed by that. While she always kept a picture of her partner and their child on her desk, the old system was a quiet version of Don’t Ask Don’t Tell. It was OK that she was a lesbian, but no one ever asked her about her family or her holiday plans. She remembers when DADT was seen as progressive. She was welcome as long as she kept quiet.
She gave a quick run down of LGBT health disparities in mental health and substance abuse and made very clear that these are a result of social conditions, the difficulties of growing up LGBT and the mental health difficulties that are the result of discrimination.
The bulk of her talk was about the great changes that are underway in SAMHSA incorporating LGBT population and mental health issues in multiple initiatives. The work being undertaken in multiple diverse areas, including LGBT data collection, LGBT-owned businesses, new precedents in LGBT hiring, foster care, etc.
She stressed that the White House absolutely recognizes that there is still more to do. She pointed out that SAMHSA RFA’s are becoming explicit about being LGBT-inclusive and, where appropriate, LGBT-focused. Which actually serves as a model for other gov’t agencies.
She concludes that the real impact of these initiatives is not just in changes in the laws and programs, but that effort put forth by Secty Sebelius and the White House are beyond acceptance of LGBT people. She feels like LGBT people and issues are being welcomed and embraced, with the acknowledgement that there is still a lot to be done.
With that being said, despite these good intentions and commitments, she predicts that the budget is going to get far worse before it gets better. This means we have to advocate more, and keep our efforts on the forefront and keep the movement alive. The positive results of the administrative commitments will be more apparent when the budget and economy Improves which gives us all hope for the future.
The Network is pleased to report that Tomorrow, Wednesday, June 29, 2011 There will be a Stakeholders Call where Garth Graham , Deputy Assistant Secretary for Minority Health and Sherry Glied, Assistant Secretary for Planning and Evaluation will make an important announcement regarding how the U.S. Department of Health and Human Services is proposing to improve data standards and collection in LGBT communities. In an ongoing effort to help reduce health disparities, through the goals of the Affordable Care Act, tomorrow’s stakeholders call is sure to be another milestone in our efforts to further collect data on our communities. We encourage you all to please participate, and prepare questions you may have as there will be a brief questions and answer session following the announcement.
WHEN: Wednesday, June 29, 2011, 1:30 pm ET/10:30 am PT Call in number: 888-220-3088 Passcode: Health Care
Deputy Assistant Secretary for Minority Health
Assistant Secretary for Planning and Evaluation
Center for American Progress
As you may be aware, Dr. Scout announced huge gains last week in his blog post titled: Backstory, win, & work ahead: Secty Announces HHS Will collect LGBT Data. His post outlines the history, and efforts which lead to tomorrows call. There is a lot of work that has been done and much more to come. Every step forward is progress, no matter how small, it’s a success. Lately, I feel we are making huge strides, and look forward to what the future holds.
Director, Network for LGBT Health Equity
A project of The Fenway Institute in Boston, MA
**Wanna cut to the news? Skip down to Today’s News section**
Have we mentioned data yet?
Folk know how we’ve been part of the science advocacy block asking for LGBT data collection for years now. Way back in 2008 we first prepared our Surveillance Briefing Paper marshaling the evidence to help states and feds add LGBT measures to their surveys (that paper was developed at the request of West Virginia no less). Excerpts from that paper have been asked for by feds as recently as yesterday. Then we actually ran a big project to cognitively test possible T-inclusive surveillance questions at the behest of Minnesota (who balked at adding just LGB questions to their surveys, kudos them!).
Well since then, we’ve been bold in continuing to speak up and endlessly meet with federal officials from CDC to the White House and ask for data collection. We’ve prepared more briefing papers on the subject; created many talking point sheets for feds; submitted plenty of testimony; helped states add LGBT questions; announced when the National Center for Health Statistics started testing questions; set up meetings with their staff and community experts; advised HP2020 staff on data issues; ran a community petition with Join The Impact; helped plan and execute joint data advocacy efforts with the most excellent National Coalition for LGBT Health and New Beginnings Initiative; helped with a widespread community effort to add T questions to YRBS; co-hosted the recent Williams Institute Gender Identity Surveillance Roundtable; and ran plenty of action alerts telling folk when and how to speak up. (It still makes me chuckle to think of the time years ago when HHS called on Friday to request a LGBT data briefing paper for the White House by Monday. Weekend data geeks unite!)
You probably saw CDC just recently sent a letter in response to our action alert on data collection at Creating Change. Then just two weeks ago, we worked with National Gay and Lesbian Task Force to do something we haven’t even mentioned yet, create a health data cover letter for their 60k signature Queer the Census Petition and submit it all to Secty Sebelius. (Proud of that).
So, suffice it to say, data’s been on our mind for a while. And a few others too…
Who are some of the many leaders and allies in this push?
The National Coalition for LGBT Health has been an early and stalwart leader in pushing LGBT data collection (kudos to Rebecca Fox, Kellan Baker and Hutson Innes). NGLTF and the New Beginnings Initiative (yay Bradley Jacklin) have jumped in with strong focus on this issue (and inspired work around the Census, thank you Jaime Grant). Of course Gary Gates from The Williams Institute is happily everpresent in data discussions. Other excellent individuals and organizations have done great work here, including Judy Bradford and other scientists at our own Fenway Institute. The gaydata founder, Dr. Randy Sell, famously said he’d retire when the feds finally collected LGBT data (we’ll all have to visit him on whatever FL golfcourse he chooses). Special shout also to Allison Gill and GLSEN for starting the big community push that got a T question added to YRBS. And I would be remiss if I didn’t also give thanks to the efforts of the many non-LGBT internal allies at the state and federal level who have really gone to bat to add LGBT data (many of whom I bet would prefer to stay low profile). So have our five sister tobacco disparity networks, the 4 racial/ethnic disparity networks and the poverty network. In fact, overall, of special note are the many non-LGBT racial/ethnic disparity leaders who have really stepped up and helped advance this issue. The Network for LGBT Health Equity is honored to work with each and every one of you.
Why is data so important?
Why? I could give you plenty of reasons, but the most profound is back around 2002, when Dr. Rosie Henson, the then head of Office on Smoking and Health at CDC (now she’s all fancy and moved pretty far up the ladder), came to several of us at the first LGBT Tobacco Summit and said (something like) “Please come testify about how LGB* needs to stay in the tobacco section of Healthy People 2010, because without data from the major surveys you might be kicked out as a disparity population.” (*=T wasn’t in then).
Well, with plenty of evidence even back then that we smoke at rates that are from 35% – almost 200% higher than the general population, that plea really drove it home… there’s scientific evidence, then there’s scientific evidence the government will accept. And in order to get in the second group, you need to have LGBT data collected on major surveys.
The wins and the work still needed
There have been many tangible outcomes from all this work, in fact I should really go through and document them in detail. But some fast ones that come to mind are: we obviously stayed in HP2010, and with plenty of work with them, we got much bigger focus in HP2020; data collection was called for in CDC recent disparities report; in the National Partnership for Action Plan to Eliminate Disparities; in the Tobacco Action Plan; they even added LGBT measures to the National Tobacco Survey; and they started testing measures for inclusion in the National Health Interview survey last year. But while that’s all well and good, we still don’t have those measures on any other federal instruments.
Working with our friends & new(ish) media
Well, last week we jumped up our game a little more. With the help of our old friend (and staunch tobacco control advocate) Mike Rogers, we got to the LGBT Pre-Con to the big Netroots Nation conference (aka #NN11LGBT). This conference is all about creating social change through online action. As I reported earlier, it was great that we got to be in the room with a bunch of LGBT bloggers, esp when they asked, “what isn’t being covered?” Well, obviously we stood up and said, health, tobacco, and right now in health the data collection issue is hot. Well, it was great that by the end of that event, Chris Johnson of the Washington Blade said he’d be happy to do a story on data collection. Score! (I know, I know, next to marriage we’re practically overrun with stories about LGBT data collection, right?) But the wonderful news doesn’t stop there. Yesterday Chris, in a burst of amazing efficiency just stood up at the White House in front of Secty Sebelius and asked her (with quite a lot of intelligent detail), what she was doing about LGBT data collection.
This all gets us to our delightful denouement (or climax for us english speakers). When Chris asked that Sebelius went on record saying:
“We fully intend to collect LGBT data… So it is definitely a commitment. We will be adding data questions to the National Health Surveys.” – HHS Secty. Kathleen Sebelius
Full stop. *please take a moment to breathe deep, savor the beauty of this, and thank the buckets of friends and allies who helped this happen*
On behalf of the Network for LGBT Health Equity and in fact, every single LGBT person who is affected by health, thank you Secretary Sebelius. You are the first of the many cabinet members being asked who has publicly committed to ending our invisibility, which is probably the largest single step that can be taken to ending discrimination against us.
Full stop, another deep breathe. Wonderful really.
Secretary Sebelius, we will assist you in every way possible to make this commitment a reality.
What will make it a touchdown?
Now, without one iota of disrespect to the magnitude of that step, we’d also like to say the following. You know the health and lives of the most discriminated against LGBT people literally hang in the balance as we wait for more federal efforts to eliminate our health disparities. So, we look forward to hearing the real plans for how and when this LGBT data collection will begin.
And be sure to see the excellent Washington Blade story by Chris Johnson on this all.
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.
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
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.”
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.
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.
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.”
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.