Economic Repercussions Prove Powerful in Stopping Hateful Public Health/Quality of Life Laws

It’s hard to keep up with the regressive state laws that threaten the people’s health and quality of life. Women, LGBT individuals, and people of color are popular targets. There may be a silver lining though. Just this morning, the NY Times reported corporate sponsors are thinking twice as groups mobilize to #dumpTrump, demanding that corporations separate themselves from Trump and the Republican National Convention. Coke already shrunk its $  substantially. More sponsors are expected to join in. Kind of makes me hungry for a Coke, all that sugar and all. This is special.

Economic boycotts have also been announced following North Carolina’s passage of the egregious HB2, which eliminates all new LGBT protections.  Although it’s been oversimplified into the “bathroom bill”because it disallows transgender people from entering bathrooms of the gender they identify with,it is more wide-reaching, and also takes away legal protections for LGBT individuals in the state. Last February, Charlotte NC passed a nondiscrimination ordinance. That will be made moot with NC Governor Pat McCrory signing the law.

New York State, Vermont, Washington, the City of Seattle, have announced boycotts against the state, and by the time you read this, we’ll see many more. The City of Atlanta has come out punching, saying the NBA’s All-Star Game should be moved out of Charlotte to Atlanta. Tourism, sports money are at stake.

North Carolina is already facing economic woes as a result of its outrageous positions on abortion rights. The Women’s Right to Know Act, passed in 2011, forced women opting for abortions to listen to a narrated ultrasound within 4 hours of a scheduled abortion. The good news is that the State lost a Federal lawsuit to stop this, and they now must pay out $1 million from savings in an emergency fund for legal fees, according to a News & Observer report.

Economic sanctions are proving  a lever for change, for getting corporations on the side of the people’s health. Interestingly, Atlanta was at risk of losing rights to the upcoming Super Bowl, given fair warning that passage of its regressive anti-LGBT bill would have repercussions. Then, last week, that bill was not signed into law, a victory for the people of Georgia, and LGBT health and safety.

I always think about the people in states proposing regressive legislation. The Moral Monday movement in North Carolina has been out front for quite awhile objecting to these horrendous laws that harm the public’s health. I applaud the movement. Although I wish that there was a better way than boycotts, I have to say I am delighted that people have been organizing successfully, that businesses are taking note, and that we just might stem the tide of the nasty rhetoric and legislation afoot in many parts of this nation.

Do you have thoughts on how we can restore protections now endangered? Please join the discussion below.

 

 

 

 

 

 

 

At Last, Sexual Orientation Question is Added
To CDC’s Youth Risk Factor Behavior Survey

On the heels of LGBT Pride events last weekend, PatientPOV.org takes a look at efforts to include LGBT individuals in health services research, health planning, and systems of care. Efforts to reduce disparities did not end with the defeat of the Defense of Marriage Act, bans on gay conversion therapy, and transgender individuals coming into focus –all very wonderful events that occurred in the past year. Much more needs to be done to build a more inclusive health care system and improve the health and well-being of LGBT individuals. This post is the first in a series that take up critically important work now underway that hopefully will reduce health disparities for LGBT-Q individuals. Today’s post focuses on improving the science, getting good data on the health and risk status of lesbian and gay adolescents.

At first blush, data may seem like a deadly topic for many readers, but collecting health data forms the basis for determining and reducing health risks, funding prevention and intervention programs, and ultimately improving the health of groups under study.

In early June, the Centers for Disease Control and Prevention finally agreed to incorporate survey questions on sexual orientation (LGB) into its standard annual Youth Risk Factor Behavior Survey. Advocates see this as a tremendous advance because sexual orientation has never been included routinely in many national health surveys paid for by our tax dollars.

The Youth Risk Factor Behavior Survey monitors six types of health risk behaviors that contribute to the leading causes of death and disability among youth: behaviors contributing to unintentional injuries and violence; behaviors that contribute to unintended pregnancy and sexually transmitted diseases, including HIV; alcohol and other drug use; tobacco use; dietary behavior; and inadequate physical behavior.

Why is this important?

Caitlin Ryan, Director of the Family Acceptance Project, San Francisco State University, San Francisco, CA, put this change into perspective.  “It took nearly 60 years of research on sexual orientation plus years of advocacy and the Institute of Medicine Report on LGBT Health,” she said. “We are past the tipping point. I think of the difference it will make to have accurate data on health risks for LGB youth and hopefully soon for transgender youth in these jurisdictions.” (Many advocates believe that asking about transgender gender identity is so new that it is premature to incorporate).

“Up until now, it was too politically challenging to ask about sexual orientation, but the need to ask these questions is huge,” said Donna Futterman, MD, Director of Adolescent AIDS Program, and Professor of Pediatrics, at Children’s Hospital of Montefiore, Bronx, NY. “We need to include sexual orientation because bullying, violence, suicide, homelessness, HIV, and sexually transmitted infections are higher in LGBT groups. Getting real numbers is important in ramping up prevention and intervention programs.”

homeless gay youthPatrick Paschall, National Gay and Lesbian Task Force, praised the change in the Youth Risk Factor Behavior Survey: “Adding a sexual orientation question to the Youth Risk Factor Behavior Survey is a huge step toward identifying and ultimately eliminating disparities LGBT youth face,” he said. “This will yield a level of data that we have not ever seen. Perhaps more importantly, this question will now appear on the standard set of survey questions for the foreseeable future, producing updated youth risk data annually.  The significance of this step will not be fully realized until the data is released in 2016, but make no mistake – this will change the way our society and the government addresses the needs of LGBT youth for decades to come.”

Look at it as a parallel to “don’t ask, don’t tell.” If you don’t ask about sexual orientation, the people you are surveying don’t exist, they are not included in society. It’s a notion that needs to be buried. Here’s hoping that more inclusive changes in health survey data continue to move forward.

 

 

 

 

 

 

LGBT Healthcare: Out of the Closet in New York

Credit: To Treat Me, You Have to Know Who I am, National LGBT Cancer Network, NY

LGBT healthcare took a giant step forwards in New York City last week, with the announcement that New York City’s Health and Hospitals Corporation (HHC), AKA the City’s public hospital system of 11 hospitals, community health centers, and rehabilitation centers, will immediately adopt a program devoted to providing respectful, patient-centered, and culturally competent care to thousands of lesbian, gay, bisexual, and transgender patients. Working with the National LGBT Cancer Network, all of HHC’s 39,000 staff will be required to go through training that would sensitize employees to medical conditions and risk factors, which may be more common based on the gender identity or sexual orientation of the patient.

Liz Margolies, founder of the National LGBT Cancer Network, says that “previous negative experience in the health care system means that many LGBT people avoid coming in for needed health care tests and care. We want to right this wrong right out of the box.” According to Margolies, one in five transgender people are turned away from healthcare facilities. They need similar safe and welcoming care.”

LGBTpeople do not require specialized attention, but risk factor differences include higher rates of alcohol, tobacco, and drugs from an early age. “Medical providers need to be made aware of these risks and be sensitive to the fears of discrimination that prevent LGBT people from even attempting to get care,” said Margolies.

HHC President Alan Aviles, said that each employee would participate in a 15-minute orientation before they work in the system. Department will have more detailed, 1-hour train-the-trainer sessions.

Visitation, Research Needs of LGBT People Recognized

The announcement follows other gains in putting LGBT healthcare needs up front across the United States. In April 2010, President Obama extended hospital visitation and participation in medical decision making to LGBT partners.

Release of an Institute of Medicine Report on the Health of LGBT People at the end of March put the spotlight on the critical need to reach out, incorporate, and study LGBT people in healthcare research. As the report states: “researchers need more data about the demographics of these populations, improved methods for collecting and analyzing data, and an increased participation of sexual and gender minorities in research.”

Margolies said that since the video was released, other hospitals have contacted her, aiming to use it to develop programs, similar to HHC’s.  People expect that the Joint Commission on Accreditation of Health Care Organizations (JCAHO) will soon put standards in place to demonstrate that they are sensitive to the cultural needs of gay, lesbian, bisexual, and transgender people.

“It’s not necessarily outright bigotry, but widespread and pervasive ignorance on the part of medical staff on how to recognize and treat diverse patients,” said Margolies. “If we don’t educate them, who will?”