Like all forms of health inequality in the United States, an important part of the puzzle is the identity (socioeconomic, race, gender, sexual orientation) intersections that might disproportionately harm a person from any given group. A new study published in the American Heart Association’s journal Circulation identified some troubling trends in cardiovascular health issues about LGBTQ people — nothing that these outcomes can relate to these individuals “experiencing some form of discrimination, including the use of harsh or abusive language, from a health care professional.”
According to the statement, 56 percent of LGBTQ adults (and 70 percent of transgender or gender non-conforming individuals) reported experiencing such discriminatory behaviors and actions in a health care environment. These numbers follow previous research about about heart health outcomes in LGBTQ people — where it was noted that Lesbian, Gay and Bisexual adults were “36 percent less likely to have ideal cardiovascular health, based on seven leading risk factors, including smoking, body-mass index, physical activity, diet, blood cholesterol, blood pressure and blood sugar.”
For researchers, these insights are helpful for assessing how best to improve cardiovascular health outcomes in these communities and looking at how access to care and resources can fit into the larger puzzle of health disparities in the United States. It also helps for researchers to better understand how larger traumatic social stressors that marginalized people experience (violence, discrimination, dysphoria, etc) might contribute to the “bad habits” (smoking, binge drinking, poor diet, lack of exercise) that they might otherwise be scolded about.
“This is particularly important now, at a time when there is increased awareness of health inequities related to unequal treatment and discrimination in the U.S.,” says Billy A. Caceres, Ph.D., R.N., FAHA, chair of the writing group for the statement and an assistant professor at the Columbia University School of Nursing in New York City. “LGBTQ individuals are delaying primary care and preventative visits because there is a great fear of being treated differently. Being treated differently often means receiving inadequate or inferior care because of sexual orientation or gender identity.”
Ultimately, the organization makes recommendations that health care professionals find ways to respectfully navigate providing care for people in these communities and for medical schools to ensure more of their graduates feel suitably knowledgeable and prepared to provide care for them.
“Health care systems need to play a significant role — to enact policies to encourage and support researchers and health care professionals to ask these questions in a respectful manner and to implement structures that emphasize the clinical importance of understanding the many layers related to caring for people with a minority sexual orientation or gender identity,” Caceres said.
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