Here is an interesting article by the New York Times related to doctors and the L.G.B.T. Community

“Medical Schools Neglect Gay and Gender Issues”

Main Points

• “When it comes to caring for patients who were transgender, we [Doctors] are lost.”
• Medical students receive little training on how to approach the L.G.B.T. issue.
• L.G.B.T. patients tend to be more isolated and have higher rates of chronic diseases like diabetes and high blood pressure. And because of the discrimination they face and fear, many also have difficulty gaining access to care and thus face an increased risk of suicide, substance abuse and unaddressed domestic violence. Just “seeing the doctor” can be fraught with tension, as it entails coming out to one’s physician.
• Patients need to feel that they can tell their doctor they are gay and that their doctor will accept them
• More than a quarter medical students characterized what their school taught in regards to L.G.B.T. patients as “poor” or “very poor,” and almost half called their offerings only “fair.”
• Due to this honest review of school teachings regarding L.G.B.T., hopefully schools might already be making plans to improve what they teach

Lesbian, gay, bisexual, and transgender (LGBT) health is emerging as a national health concern due to the increasing amount of evidence of health disparities experienced by the LGBT community. On the evening of November 7, 2009, by a vote of 220 to 215, the House passed the Affordable Health Care for America Act, H.R. 3962. This act includes several key LGBT provisions that would allow for an increase in the quality of health and access to health care for members of the LGBT community.

To begin with, the bill specifically designated LGBT individuals as a health disparities population. This will allow for LGBT health issues to be specifically known and addressed through LGBT specific data and research.  Also, the bill incorporated the Early Treatment for HIV Act. This act allows states, through Medicaid programs, to cover early HIV treatment instead of withholding treatment until AIDS is developed.   This will allow the quality of life for low-income people with HIV to increase and reduce the transmission of HIV.   Moreover, the bill prohibits health care workers to discriminate against members of the LGBT community. This will help protect LGBT individuals from discrimination in the health care system.  In addition, the bill provided funding for comprehensive sex education programs to focus on reducing sexually transmitted diseases instead of the former abstinence only teaching method.  This will provide LGBT students with the necessary tools to making healthy choices.  Furthermore, the bill places the unjust taxation of employer-provided domestic partner health benefits to an end through the Tax Equity for Health Plan Beneficiaries Act. This will allow more people to afford employer-provided coverage for their families.

The goal to ‘eliminate health disparities’ is one of the two overarching goals of the document Healthy People 2010.  Healthy People provides a comprehensive set of national 10-year health promotion and disease prevention objectives aimed at improving the health of all Americans. As the year 2010 approaches, a new document, Health People 2020, is being formed.

Healthy People 2020 will continue in the tradition of its predecessors to define the vision and strategy for building a healthier Nation and will still include the overarching goal of achieving health equity by eliminating disparities. The U.S. Department of Health and Human Services (HHS) is currently seeking public input from communities across the country on the draft set of proposed objectives for Healthy People 2020. To voice your ideas CLICK HERE.

Better-educated people are healthier. This statement is supported by the Centers for Disease Control and Prevention (CDC), which declares that people with higher levels of education have not only better health than those with lower levels of education, but are more likely to obtain basic health information and take advantage of the available sources needed to make appropriate health decisions. People with lower levels of education are associated with fewer years of life and higher levels of health risks such as obesity, substance abuse, and violence.

In response to this, it is important to realize the value of education. Education should begin at a young age and continue on for the duration of one’s life. Educational strategies, as suggested by the document Healthy People 2010, should include efforts to increase health awareness through the school setting, working setting and community setting.

Schools are the main focal area that can reduce health-risk behaviors and improve the health status of youth, due to the fact that they have more influence on the lives of young people than any other social institution besides the family and allows for the norms that govern behavior to be developed and reinforced. As school settings are the natural setting for reaching children and youth, work settings are where the majority of adults can be reached, and the community setting is how older adults can be reached. Health clinics can also help educate the public and teach responsibility for people to be advocates of their own health through gaining knowledge about prevention, early detection and treatment.

The United Nations Development Program (UNDP) recently published a report  that ranked countries and regions by their Gini coefficient. This Gini coefficient looked at income inequality worldwide where zero denoted absolute equality and 100 denoted absolute inequality.  The U.S. earned a Gini coeffiecent of 40.8 which ranked it number three in the list of countries of biggest gaps between the rich and the poor.

According to a study done by Wolfson and colleagues, the existence of inequalities in income has a greater negative impact on an individuals’ mortality than their own individual-level relation between mortality and income. In other words, it is the impact of a country’s inequality of income, not a persons’ own individual poverty alone that negatively affects an individual’s health.

To Read More About this Topic CLICK HERE.

Sexual Orientation refers to a person’s sexual interest. This includes lesbians, gays, bisexuals and those who are transgendered (LGBT). According to the National Coalition for LGBT Health, LGBT youth are more likely to attempt suicide than heterosexual youth, LGBT people are more likely to have poor health due to their reluctance to seek care from health providers, and gay men and lesbian women are at an increased risk for certain cancers such as lung, cervical, breast, and anal cancer, due to a higher prevalence of smoking and inadequate risk assessments. Furthermore, HIV/AIDS continues to wreck havoc among the LGBT population. These are just some of the health disparities experienced by the LGBT communities.

In response to these disparities the Healthy People 2010 Companion Document for LGBT Health was developed. This document stated specific health-related policy recommendations in the hopes to reduce the disparities experienced by the LGBT communities. Some of these recommendations included that of prohibiting federal funded organizations from discriminating against LGBT individuals, incorporating LGBT cultural competence into the training of all health professionals, designating the LGBT population as a “special population” of concern by federal health agencies, targeting the LGBT population in regards to smoking cessation health promotion campaigns, and increasing national surveys in regards to health to better identify the LGBT populations’ health status, among other things.

Asian Americans account for about 3.6% of the U.S. population. According to the Office of Minority Health, by the U.S. Department of Health and Human Services, Asian Americans have three times the incidence rate of liver cancer, 24 times the incidence rate of tuberculosis, and are 1.2 times as likely to have Hepatitis B than White Americans. Asian American women suffer not only from rates of cervical cancer that are five times higher than White women, but also from rates of stomach cancer that are three times higher than White women. Asian American men are twice as likely to die from stomach cancer as compared to the White population.

Asian American health quality is challenged with language and cultural barriers, the lack of health insurance and infrequent medical visits, due to the fear of deportation, among other factors. So what can be done?

There are several organizations whose purpose is to change the existing disparities of the Asian American people. These include the Two Reasons I Find the Time to Prevent Diabetes: My Future and Theirs program, the National Women’s Health Information Center Stomach Cancer Program,and the Cervical Cancer Screening: What Vietnamese Women Should Know program among others.

Native Americans account for about 0.9% of the U.S. population. According to the Office of Minority Health, by the U.S. Department of Health and Human Services, Native Americans are 2.3 times more likely to be diagnosed with diabetes, 1.8 times as likely to have stomach cancer, 1.3 times more likely to have high blood pressure and are 1.2 times as likely to have heart disease, in comparison with White Americans. Native American babies are twice as likely to die from sudden infant death syndrome (SIDS) and 30% more likely to die from complications related to low birthweight or congenital malformations than White Americans. Native Americans are also 60% more likely to be diagnosed with asthma and 60% more likely to have a stroke in comparison with White Americans. Native American women are 40% more likely to have kidney/renal pelvis cancer and all Native American are more likely to die from liver cancer and be diagnosed with tuberculosis than White Americans.

These numbers are significantly higher due to the fact that Native Americans frequently contend with issues that prevent them from receiving quality medical care. These issues include cultural barriers, geographic isolation, inadequate sewage disposal and lower income rates. These disparities also exist due to the fact that Native Americans are 1.6 times as likely as White adults to be obese, are 1.4 times as likely to be current cigarette smokers and are 3.7 times as likely to not receive prenatal care.

So what can be done? There are several organizations whose purpose is to change the existing disparities of the Native American People. These include the I Can Lower My Risk for Type 2 Diabetes: A Guide for American Indians program, the Protect the Circle of Life: Immunize Our Nations, and the American Indian and Alaska Native People: Be Active for Your Heart, among others.

          African Americans account for about 12% of the U.S. population. According to the “HHS Fact Sheet of Minority Health Disparities At A Glance” African Americans are more likely to develop cancer than any other racial group.  For example, African American women are 34% more likely to die of breast cancer than white women. African Americans are also more likely to have cardiovascular disease, diabetes, HIV/AIDS and stroke than Whites. For example African Americans are twice as likely to have diabetes as Whites and 10 times as likely to die of AIDS than Whites. These are just a few of the existing health disparities experienced by African Americans, but why do these disparities exist?

These disparities exist due to a variety of contributing factors. These factors include African Americans, in comparison with Whites, have a lower income, have higher rates of smoking, have no knowledge or awareness about cancer symptoms, have reduced access to cancer screening services, are less likely to have insurance, and are more likely to be overweight or obese. According to the Cancer Facts & Figures for African Americans 2007-2008, 24% of African Americans live below the poverty line, in comparison with 10% of Whites, 20% of African Americans are uninsured, in comparison with 11% of Whites, and 76% of African American adults are considered overweight or obese.

So what can be done? Body & Soul is a wellness program for African Americans, created by the National Cancer Institue and numerous churches, that exists to encourage people to participate in a more healthy lifestyle. This is just one example of a program that promotes African Americans to be advocates of their own health.

          Hispanics account for about 14% of the U.S. population. According to statistics from the Cancer Facts & Figures 2009, by the American Cancer Society, Hispanics have higher rates of Uterine Cervix Cancer, Liver Cancer, Gallbladder Cancer and Stomach Cancer than any other race. For example, the incidence rates of a Hispanic to have liver cancer is almost twice as high in comparison with Whites in America. Hispanics are also 1.5 times as likely to have diabetes than Whites and are 60% more likely to be diagnosed with AIDS than Whites. These are just a few of the existing health disparities experienced by Hispanics, but why do these disparities exist?

          These disparities exist due to several contributing factors. Hispanics are more likely to be poor, as 21% of Hispanics live below the poverty line compared to 10% of whites, are more likely to lack health insurance, as 34% of Hispanics are uninsured in one year in comparison with 14% of whites, and have fewer years of education. Hispanics are also less likely to be fully immunized in comparison with non-Hispanic white children and are more likely to be diagnosed with cancer at later stages; the later of stage cancer is diagnosed, the less likely a person’s chance of survival is. Mexican Americans, who make up the largest share of the U.S. Hispanic population, suffer in greater numbers from overweight and obesity than whites which is a major contributor to several health ailments.

          So what can be done? There are several existing movements to not only raise awareness about these existing health disparities that Hispanic Americans are subject to, but also programs to assist Hispanic Americans overcome these disparities. One example of such a program is Más que comida, es vida. (It’s more than food. It’s Life.),which is the National Diabetes Education Program. This program exists to help Hispanics manage their type 2 diabetes by making healthy food choices without giving up the traditional foods they love.