It Hurts: Prejudice in GLBT Healthcare

It Hurts: Prejudice in GLBT HealthcareCultural Competence Resources for GLBT HealthJacqueline Leskovec, MLIS, MA, RNOutreach, Planning & Evaluation CoordinatorNational Network of Libraries of MedicineGreater Midwest Region

ObjectivesParticipants will be able:To identify barriers to quality healthcare for the GLBT populationTo identify 3 specific areas of health disparities in the GLBT populationTo identify 3 culturally competent health information resources for the GLBT community

Definitionsprej·u·diceinjury or damage resulting from some judgment or action of another in disregard of one's rights; especially : detriment to one's legal rights or claimsdis·crim·i·na·tionthe process by which two stimuli differing in some aspect are responded to differently 2/18/11http://m-w.com

Non-discriminationAll College policies, practices, and procedures are administered in a manner consistent with our Catholic identity. With the foregoing understanding, Saint Mary’s College will not engage in discrimination based on gender, race, national origin, religion, age, mental or physical disability, all as provided by law. Based on our Catholic values, the College also commits to avoiding discrimination based on sexual or political orientation.St Mary’s College Employee Handbook

Who We AreThis project has been funded in whole or in part with Federal funds from the National Library of Medicine, National Institutes of Health, Department of Health and Human Services, under Contract No. N01-LM-6-3503 with the University of Illinois at Chicago.

And you?Some considerations:Student/Studies? Faculty/Department? Public?Why are you here?What is your experience/knowledge regarding GLBT/health disparities?What do you expect to take away from this session?

What are health disparities?Differences in the incidence, prevalence, mortality, and burden of diseases and other adverse health conditions that exist among specific population groups in the United StatesIncidence: probability of being diagnosed with a diseasePrevalence: likelihood of having a diseaseMortality: another term for deathCenter to Reduce Cancer Health Disparities (CRCHC)

What is culturally competent healthcare?Culturally competent healthcare means optimizing quality care by being respectful of and responsive to the cultural factors that influence patients’ attitudes and behaviors at the institutional and the individual level. The MautnerProjecthttp://www.mautnerproject.org/

Why cultural competency?Quite simply, healthcare services that are respectful of and responsive to the health beliefs, practices and cultural and linguistic needs of diverse patients can help bring about positive health outcomes.The Office of Minority Healthhttp://www.minorityhealth.hhs.gov/

The Purnell Model for Cultural CompetenceLarry Purnell, PhD, RN FAAN

Learning about cultureGlobal Society CommunityFamily PersonSpiritualityDeath ritualsPregnancyNutritionHigh-risk behaviorsBiocultural ecologyWorkforce issuesFamily roles and organizationCommunicationOverview/heritageHealthcare practitionersHealthcare practices

Major AssumptionsAll health care professions need similar information about cultural diversity.One culture is not better than another; they are just different.Differences exist among, between & within cultures.Cultures change slowly over time in a stable society.If clients are coparticipants in care and have a choice in health-related goals, plans and interventions, health outcomes will be improved.Culture has powerful influence on one’s interpretation of an responses to health care.Individuals and families belong to several cultural groups.Caregivers who can assess, plan & intervene in a culturally competent manner will improve the care of their clients.

Why GLBT health?Improve the health, safety, and well-being of gay, lesbian, bisexual, and transgender (GLBT) individuals.Reduce disease transmission and progressionIncrease mental and physical well-beingReduce healthcare costsIncrease longevityHealthy People 2020http://healthypeople.gov

A Few TermsGenderGender identityGender expressionSexual orientationLesbianGayHomosexualIntersexWPW/MSMTransgenderM2F/F2MQueerGLAAD Media Reference Guide: Lesbian, Gay and Bisexual Glossary of Termshttp://www.glaad.org

It Hurts: Prejudice in GLBT Healthcare

Some Significant Dates1969: Stonewall Riots1970s: Boston Women’s Health Collective1973: Diagnostic and Statistical Manual1977: Lesbian and Gay Health Foundation1980s: GRID, ARC, AIDS/HIV; Gay Men’s Health Crisis1997: “Yep, I’m Gay”1999: Institute of Medicine Report on Lesbian Health2001: Healthy People 2010 Companion Document2010: Healthy People 2020

ReflectionWhat was your first introduction to GLBT persons/culture/issues?How old were you?Was it positive? Negative?Was it a non-issue?

Social DeterminantsSocial stigmaRejection by family membersAbuse and violenceUnfair treatment in the legal system, state/federalHiding some or all aspects of one’s lifeLacking health insuranceShortage of culturally competent health providers

Health Disparities: A Sample30% of lesbians lack health insuranceThe largest percentage of persons diagnosed with AIDS and persons with an AIDS diagnosis who have died have been MSMEstimated 40% of homeless youth are GLBT24% transgender persons reported being denied equal treatment in doctor’s office or hospital45% bisexual women reported suicidalityGay men: increased risk of anal cancer

HIV/AIDSJune 1981: First article about AIDS in the medical literature597,499 cumulative deaths (2007)MSM largest diagnosed/died: 308,000 (2006)Misinformation regarding transmission2010: Promising research & daily pill*CDC. HIV among Gay, Bisexual and Other Men Who Have Sex with Men (MSM).

ResourcesWebsites, organizations, providers & more

Healthy People 2020HealthyPeople.govLesbian, Gay, Bisexual, and Transgender HealthWays to address health disparities in LGBT persons:Expansion of domestic partner health insurance coverageEstablishment of LGBT health centersDissemination of effective HIV/STD interventions2/18/11

MedlinePlus®Medlineplus.govhttp://www.nlm.nih.gov/medlineplus/gaylesbianandtransgenderhealth.htmlSearch function

National Institutes of HealthNational Institutes of Health: Gay/Lesbian Healthhttp://health.nih.gov/topic/GayLesbianHealthRelated TopicsMen's HealthReproduction and Sexual HealthWomen's Health2/18/11

CDCLesbian, Gay, Bisexual and Transgender Healthhttp://www.cdc.gov/lgbthealth/HIV/AIDShttp://www.cdc.gov/hiv/Includes FAQs, Stats

ACOG ACOG WEBTREATS: Lesbian & Bisexual Healthhttp://www.acog.org/departments/dept_notice.cfm?recno=20&bulletin=2519Fact Sheet: Lesbian Teenshttp://www.acog.org/departments/adolescentHealthCare/TeenCareToolKit/lesbianTeens.pdfACOG WEBTREATS: Transgender Healthhttp://www.acog.org/departments/dept_notice.cfm?recno=20&bulletin=2517

AIDS/HIVAIDS.gov: http://aids.govAIDSinfo / infoSIDA: http://aidsinfo.nih.govTwitter: @AIDSgovHIV glossary - iPhone, iPod Touch and iPadAIDSinfo MobileHomework helpGMHC: http://www.gmhc.org/

Specific PopulationsChild Welfare Information Gateway: Gay and Lesbian Adoptive Parentshttp://www.childwelfare.gov/GLSENhttp://www.glsen.org/SAGE: Services & Advocacy for GLBT Eldershttp://www.sageusa.orgLGBT aging projecthttp://www.lgbtagingproject.org/Lesbian, Gay, Bisexual, and Transgender Health Sciences Librarians MLA Special Interest Grouphttp://lgbt.mlanet.orgAmerican Academy of Pediatrics: Four Stages of Coming Outhttp://www.healthychildren.org

More…BiNet USAhttp://www.binetusa.org/Accord Alliancehttp://www.accordalliance.org/Lesbian Health & Research Centerhttp://www.lesbianhealthinfo.org/The Mautner Projecthttp://www.mautnerproject.org/

Pubmed®http://pubmed.govSearch tips: using MeSH“Gay”, "Transgender" and "intersex" are not MeSH Subject Headings. "Transgender*" returns: "transgender[All Fields] OR transgender/questioning[All Fields] OR transgender/transsexual[All Fields] OR transgender/transsexual/queer[All Fields] OR transgendered[All Fields] OR transgenderism[All Fields] OR transgenderists[All Fields] OR transgenders[All Fields]“Also try” and “Search details”

Other ResourcesProfessional/Organizations, etc.

TrainingThe Fenway InstituteLearning Modules on LGBT HealthMautner ProjectRemoving the Barriers: Providing Culturally Competent Care to Lesbians and Women Who Partner with WomenGLMATobacco use and Interventions for Lesbian, Gay, Bisexual, and Transgender (LGBT) Individuals

Professional/OrganizationsGay & Lesbian Medical Associationhttp://www.glma.org/American Institute of Bisexualityhttp://www.bisexual.org/Intersex Society of North Americahttp://www.isna.org/National Coalition for LGBT Healthhttp://lgbthealth.webolutionary.comWorld Professional Association for Transgender Healthhttp://www.wpath.org/

SubgroupsAMA GLBT Advisory Committeehttp://ama-assn.orgAmerican Academy of Physician Assistants LGBT Caucushttp://www.lbgtpa.orgAMSA Gender and Sexuality Committee & Interest Group: Gender & Sexualityhttp://www.amsa.org

Recent AdvancesAffordable Care ActImproving healthcare & fighting disparitiesRespecting the Rights of Hospital Patients to Receive Visitors and to Designate Surrogate Decision Makers for Medical EmergenciesPresidential Memorandum - Hospital VisitationDomestic Partnerships, Civil Unions, etc.Health insurance for partnersLegal protectionsHuman Rights Campaign http://www.hrc.orgLaws & Elections-State Laws

Healthcare EqualityHealthcare Equality Index 2010http://www.hrc.orgFour main policy areaspatient non-discriminationvisitation,cultural competency trainingemployment non-discrimination.Joint Commission

“You Count”MówimypopolskuEuvorbescromâneştePuhumme suomea

“Local” CentersHoward Brown Health Center/LCCPhttp://www.howardbrown.org/Chicago, ILCenter on Halstedhttp://www.centeronhalsted.org/Chicago, ILOthers near you?

Safe ZonesLGBT people are everywhereDon’t assume sexual orientationNon-gender specific language is welcomingIf you don’t know, askOffensive language or insensitive jokes hurtValidate gender expression

Coming Soon!LGBT Health Awareness Week NOW!March 28-April 1, 2011“Come Out for Health”Trans Bodies, Trans SelvesAMSAFall 2011Institute of Medicine LGBT Health ReportMarch 20112/18/11

Quiz!Name 3 social determinants /cultural factors that impact GLBT healthName 3 specific areas of health disparities in the GLBT populationName 3 culturally competent health information resources for the GLBT community

Extra point?Who is arguably SMC’s most famous lesbian graduate?

Wrap-upQuestions?Comments?Other Resources?

ThanksJacqueline Leskovec, MLIS, MA, RNOutreach, Planning & Evaluation CoordinatorNational Network of Libraries of MedicineGreater Midwest Regionleskovec@uic.eduhttp://nnlm.gov/gmr/Presentation is available on slideshare.net : leskovec (author)This project has been funded in whole or in part with Federal funds from the National Library of Medicine, National Institutes of Health, Department of Health and Human Services, under Contract No. N01-LM-6-3503 with the University of Illinois at Chicago.

It Hurts: Prejudice in GLBT Healthcare

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It Hurts: Prejudice in GLBT Healthcare