Our research team breaks down this week’s top healthcare news.
In an age of unprecedented change, staying current has never been more important. Our team at Chartis is curating news most relevant to the healthcare industry and tracking the topics that are trending on seven key issues: high reliability care, digital and advanced technology, financial sustainability, health disparities, the health ecosystem of the future, partnerships, and the provider enterprise. Each week, we break down what’s happening and why it matters.
This week marks the beginning of Pride Month, a time to come together and show support for and honor the LGBTQIA+ community. We would be remiss to celebrate Pride Month without acknowledging the health disparities that the LGBTQIA+ community face and what can be done to address those inequities. Multiple studies released last month highlight severe disparities that need attention.
The Trevor Project, the world’s largest suicide prevention organization for LGBTQIA+ people, conducted a survey on youth mental health with nearly 35,000 participants and found that more than 40 percent of participants had seriously contemplated suicide in the past year. COVID worsened many respondents’ mental health status, often due to stressful living situations with family members who were not LGBTQIA+-affirming. Many LGBTQIA+ youth of color, who may have faced discrimination across both race and sexual orientation or gender identity, had higher rates of attempted suicide. 12 percent of white and Asian American and Pacific Islander (AAPI) youth attempted suicide, while 31 percent of Native and Indigenous youth, 21 percent of Black youth, and 18 percent of Latinx youth attempted suicide.
Chronic conditions and COVID-19 outcomes:
Drawing on data from 2017-2019, the Centers for Disease Control and Prevention (CDC) last month released a report that showed higher self-reported rates by LGBTQIA+ individuals of conditions that are known to lead to worse outcomes from COVID-19, including asthma, cancer, heart disease, obesity, kidney disease, and stroke. The CDC report notes that discrimination “can increase vulnerabilities to illness and limit the means to achieving optimal health and well-being.”
Barriers to access:
The Trevor Project study noted that while a significant portion of LGBTQIA+ youth were facing severe mental health issues, nearly half of those surveyed did not have access to mental health care. An Included Health study with more than 1,000 LGBTQIA+ employees from Fortune 100 companies shared that almost half of participants had experienced some form of healthcare discrimination. A 2009 study from Lamba Legal showed that 27 percent of transgender and gender-nonconforming individuals were refused needed care. Many LGBTQIA+ individuals choose to postpone or forgo much-needed care to avoid experiencing discrimination in the healthcare setting.
Last month the Department of Health and Human Services (HHS) took first steps to protect gay and transgender people in healthcare. President Biden’s executive order and HHS Secretary Beccerra’s statement noted that the Affordable Care Act provision that prevents healthcare discrimination on the basis of sex does encompass discrimination against someone on the basis of their sexual orientation or gender identity in healthcare. This is a first step towards health equity, but there is much more to be done.
Eliminating disparities for the LGBTQIA+ population also requires acknowledgement of the intersectionality that exists with race, gender, or ethnicity for many in the community, leading to greater inequities and differing healthcare needs. As the CDC study noted, “Persons who are members of both sexual minority and racial/ethnic minority groups might experience a convergence of distinct social, economic, and environmental disadvantages that increase chronic disease disparities.”
Disparate groups under the LGBTQIA+ acronym may face different inequities or different severity of discrimination, thus it is important that the data is disaggregated by group to understand the impact on each. Research must also take these varying populations into account. Much of the health research for the LGBTQIA+ community has focused on gay men and has been specifically related to HIV. This narrow scope must be broadened to include all those who fall within the LGBTQIA+ population across all areas of health.
Additionally, data collection by sexual orientation and gender identity is severely lacking. While some LGBTQIA+ persons are hesitant to share that information because of historical discrimination, in many cases it is simply not being asked. Without measuring the disparities, they are significantly more difficult to address. The data that does exist shows LGBTQIA+-affirming and inclusive spaces and policies consistently lead to better health outcomes. A greater investment in data and research can lead to better policies and supportive programs, which can in turn result in better health outcomes. This must be a focus not just during Pride Month but all months.
Decades of research provides ample evidence of the worsening problem of health disparities in the United States. What will it take for healthcare organizations to promote social justice and reduce health disparities in the communities they serve? Our new report, maturity model, and original analysis highlight what healthcare organizations can do to work toward eliminating these disparities.
The pandemic has only exacerbated the U.S. behavioral health crisis, but deploying digital behavioral health affords an opportunity to re-think the delivery of behavioral healthcare in a way that addresses the growing access issue.
Health disparities continue to be a pervasive problem within the US healthcare system, leaving healthcare leaders with the question: Are we advancing the ball or taking steps backward? Our Chief Physician Executive Dr. Roger Ray talks about how to thoughtfully move toward health equity for all in this excerpt from Creating a New Healthcare.