Get Adobe Reader

Reducing LGBT Health Disparities

Why We Want to Reduce LGBT Health Disparities

The Lesbian, Gay, Bisexual and Transgender (LGBT) community faces an overwhelming number of physical, mental and social health disparities that the healthcare system is only beginning to recognize, enumerate and address. The LGBT community is diverse and often faces complex health needs related to gender identity issues, social stigma, discrimination and culturally incompetent care.

Providing more complete care will lead to better health outcomes for this community, but this requires a top-down approach to understanding what this community needs and wants, as well as training for all staff at all levels of an organization.

Work Within New Jersey Hospitals

In the summer of 2017, NJHA surveyed its member hospitals to gauge the extent to which hospitals collect, store and update SOGI (sexual orientation and gender identity) data. There are currently no set guidelines for asking SOGI questions of patients, and NJHA hopes to assist hospitals in improving their communication with LGBT patients and data collection about the population.

Even though the response rate was small, NJHA was able to draw some conclusions from the results. First, there are a small percentage of hospitals asking SOGI questions of their patients, and an even smaller percentage are asking the questions correctly. In addition, few N.J. hospitals train their staff on what SOGI data is and why it is important.

NJHA realizes there is still work to be done with member hospitals to encourage them to be comfortable asking these questions and ensuring all staff are appropriately trained to collect and understand SOGI data; however, NJHA believes that New Jersey can become a national leader in providing care to the LGBT community with education, a top-down approach, and dedication from all staff.

View NJ LGBT data by county View NJ 2010 Census LGBT data

Goals for Understanding the Patient Experience

Healthcare workers should practice patient-centered care with all patients; however, it is important to be especially patient-focused with the LGBT community because of the health disparities they face. Staff should be collecting sexual orientation and gender identity data from all patients for a more complete understanding of the whole person at the patient level and more comprehensive data collection of their patient population.

Patients may be guarded in providing sensitive information– subsets of this population that may be especially vulnerable are LGBT elders and teenagers. New Jersey hospitals should strive to create a safe, welcoming, compassionate environment for the LGBT community to be able to work with their healthcare team..

Background and Context: “Do Ask, Do Tell: High Levels of Acceptability by Patients of Routine Collection of Sexual Orientation and Gender Identity Data in Four Diverse American Community Health Centers”.
Example videos highlighting the patient experience:
LGBT Voices The Oregonian

Resources

Best-practice leaders in this space provide training guidelines, webinars, education and benchmarks for culturally competent care. Hospital administration are encouraged to use the Human Rights Campaign (HRC) Health Equality Index (HEI) criteria to assess their hospitals’ policies and practices relating to their LGBT patients, as well as LGBT visitors and staff. By participating with HRC, hospitals have the ability to access free education with CME/CEU credits, and if hospitals receive a maximum of 100 points on the evaluation criteria, they carry the distinction as a “Leader in LGBTQ Equality.”

Guidelines, Position Statements and Policies:
Human Rights Campaign (HRC) Health Equality Index (HEI)
GMLA: Gay & Lesbian Medical Association:
Guidelines for Care of Lesbian, Gay, Bisexual and Transgender Patients
The Joint Commission:
Advancing Effective Communication, Cultural Competence, and Patient- and Family-Centered Care for the Lesbian, Gay, Bisexual, and Transgender (LGBT) Community, A Field Guide
American College of Physicians:
Lesbian, Gay, Bisexual, and Transgender Health Disparities: Executive Summary of a Policy Position Paper From the American College of Physicians
Fenway Institute:
Policy Resource Page
The Centers for Medicare and Medicaid Services:
A Practical Guide to Implementing the National CLAS Standards: For Racial, Ethnic and Linguistic Minorities, People with Disabilities and Sexual and Gender Minorities
Training and Toolkits:
Resources for Clinical Staff Training:

The following educational materials from the Fenway Institute teach participants about the barriers to care that many LGBT people face, describe the inequity in health outcomes for LGBT people and detail both how and why to collect SOGI data in electronic health records.

Fenway Institute Training Center

Courses Include:
  • Addressing Social Determinants of Health for LGBTQ People
  • Pre-Exposure Prophylaxis (PrEP) for HIV: The Basics and Beyond
  • Same-Sex Domestic Violence: Considerations, Suggestions, and Resources
  • Collecting and Reporting Sexual Orientation and Gender Identity Data: Stories from the Field
  • Collecting Data on Sexual Orientation and Gender Identity: Data Integrity and Quality Improvement
  • Do Ask, Do Tell! Collecting Data on Sexual Orientation and Gender Identity in Health Centers
  • Training Frontline Staff to Collect Data on Sexual Orientation and Gender Identity
  • Achieving Health Equity for Lesbian, Gay, Bisexual, and Transgender People
  • The Affordable Care Act: Building Health Equity for LGBT People
  • Ten Things: Providing an Inclusive and Affirmative Health Care Environment for LGBT People
  • Understanding Bisexuality: Challenging Stigma, Reducing Disparities, and Caring for Patients
Educational Resources for Patients and Families: