Author: Joanne

The phrase "We are proud everyday" sits above a rainbow wave and the tag @PSLGBTQ
| Joanne

It’s June, y’all… HAPPY PRIDE!

This month we’re celebrating Pride, the LGBQTQ+ community, and our lab of amazing LGBTQ+ and allied health researchers.

One of the main Pride events is kicking off in Columbus, Ohio this week, so we thought it was the perfect time to share a short introduction to Pride and why it’s important to public health.

What is Pride?

Pride is a month focused on celebrating lesbian, gay, bisexual, transgender, and queer (LGBTQ+) community and history. The first Pride marches were held in New York City, Los Angeles, and Chicago on the one-year anniversary of the Stonewall riots – a series of spontaneous demonstrations that erupted in New York City on June 28, 1969 when police raided the Stonewall Inn, a gay bar.

At the time, “masquerade” or “cross-dressing” laws deemed that “men” and “women” must wear a specific number of clothing items that matched the gender on their state-issued ID. These laws were used to raid drinking establishments and arrest transgender and gender non-conforming individuals. Just after midnight on June 28, 1969, police raided the Stonewall Inn as they had before. But this time, Stonewall patrons fought back.

As Shane O’Neill, film producer of the New York times mini-documentary, “The Stonewall you know is a Myth. And that’s O.K.” noted,

“Stonewall was about people reclaiming their own narratives…”.

Pride Month is a time to celebrate LGBTQ+ community, identity, and culture. It’s an opportunity for LGBTQ+ folks and allies to show up, en masse, and just “be”. During Pride, we celebrate our progress in advancing civil rights for LGBTQ people. During Pride, we draw attention to the reality that LGBTQ+ civil rights and lives are under attack.

How does public health connect to Pride?

For public health practitioners and scientists, Pride is a time to assess what we are doing to address the social conditions that threaten the health and safety of LGBTQ+ people in our communities.

In 2023, 491 bills targeting LGBTQ+ individuals have been introduced in state legislatures.

  • 130 bills target access to LGBTQ+ healthcare. These bills limit access to medically-necessary health care, like Medicaid and other insurance coverage, for transgender people. Many ban gender affirming care for young people and create criminal penalties to those providing gender affirming care.
  • 228 bills target education. They prevent trans students from participating in school sports activities and use bathrooms that correspond with their gender, compel teachers to “out” students, and censor in-school discussions of LGBTQ+ people and history.

The slate of laws targeting LGBTQ people reflects a growing culture of violence. In 2022, anti-LGBTQ+ violence and extremism – including demonstrations, acts of political violence and murder, and the distribution of offline propaganda – surged around the United States. Anti-LGBTQ+ extremism harms LGBTQ+ people, who are up to 4x as likely to experience violent attacks as non-LGBT+ people.

Public health practice and science recognizes that the social conditions we experience effect mental and physical health.  Trauma lives in the body in the form of chronic inflammation and pain. Trauma drives coping and health behaviors. It’s not surprising that LGBTQ+ people fare worse on leading health indicators. At a population-level, tobacco use, vaping, and binge drinking are higher among LGBTQ+ people. We also experience high rates of hypertension and heart disease; diabetes; asthma and COPD; and lung, cervical, anal, breast, and colorectal cancers. We lose too many to homicide and suicide.

As public health workers, funders, and scientists, we can protect and support LGBTQ+ communities. We can:

  • stand against legislation that puts the lives and health of LGBTQ+ people at risk.
  • develop services, organizations, and communities that welcome and are accessible to LGBTQ+ people.
  • include LGBTQ+ health case studies and share LGBTQ+ focused research in our curriculum and continuing education programs.
  • fund community-engaged research and initiatives to strengthen and support LGBTQ+ communities.
  • add sexual orientation and gender identity questions to surveys so our health and wellness is accounted for.
  • support local LGBTQ+ businesses.
  • speak up and show up with our LGBTQ+ neighbors, coworkers, family, and friends.

The phrase "We are proud everyday" sits above a rainbow wave and the tag @PSLGBTQFinal thoughts

LGBTQ+ people and communities are resilient. We are strong. We are hopeful. We endure. We matter.

All LGBTQ+ people deserve to feel safe, joyful, and connected.

We need public health to stand with us, to advocate with us, and to help us build toward justice for all people.

| Joanne

Lesbian, Bisexual, and Queer (LBQ+) women and non-binary people assigned female at birth (NB people AFAB) are more likely than their heterosexual peers to smoke. and use e-cigarettes. One explanation is that for over 20 years, the tobacco industry has targeted LGBTQ+ populations through culturally-targeted advertising and marketing. It is possible that culturally-targeted marketing could be leveraged for anti-tobacco public health messaging.

Our study, published in the Journal of Health Communications, found that culturally-targeted anti-tobacco messaging more effectively reached LBQ+ women and NB people AFAB who held more positive feelings about their sexual identity. To read more, https://go.osu.edu/22DLHC

#lgbtqhealth #lgbtqhealthresearch #queerhealth #smokingcessation #womenshealth #tobaccoresearch #thisispublichealth

P{oster describing study results reported above.

 

What makes an LGBTQ+ inclusive campus?

| Joanne

Today, I am celebrating because I work at an institution that is positively contributing to the health, wellbeing, and education of LGBTQ+ people.  The Ohio State University was selected as one of 40 institutions nationwide for the Campus Pride “Best of the Best” index for LGBTQ+ students. The university received a 5-star rating on an index that rates institutional commitment to LGBTQ-inclusive policies, programs and practices. According to Campus Pride, campuses are scored from 0 to 100 on the Campus Pride Index, which assesses the presence of LGBTQ-inclusive policies, programs, and practices. Forty institutions scored 93 percent or higher and received a 5/5 ranking and place on the “Best of the Best” list. This rating is especially noteworthy given that OSU is a public university situated in a more socio-politically conservative state.

Image from https://www.campuspride.org/

What makes an LGBTQ+ inclusive campus? The LGBTQ+ Campus Pride Index was developed by Campus Pride with a team of national LGBTQ researchers. The tool includes 50+ self-assessment questions, which (according to the CPI website) correspond to 8 LGBTQ-friendly factors:

  1. LGBTQ Policy Inclusion
  2. LGBTQ Support & Institutional Commitment
  3. LGBTQ Academic Life
  4. LGBTQ Student Life
  5. LGBTQ Housing
  6. LGBTQ Campus Safety
  7. LGBTQ Counseling & Health
  8. LGBTQ Recruitment and Retention Efforts

Individual questions are weighted to emphasize specific components, which are determined to be more additive to an LGBTQ+ inclusive, welcoming, and respectful campus. All 8 LGBTQ-friendly factors are equally weighted in the overall score.

What’s missing? While I’m celebrating today, as a public health scientist focused on LGBTQ+ health, I’m also aware the Campus Pride Index is not without gaps. In all transparency, I have never seen the full CPI instrument, so it’s challenging to evaluate its strengths and limitations. However, there are broad areas for potential bias we should all be aware of.

To start, the CPI relies on an opt-in method; campuses self-elect to participate, leading to selection bias. The item is also a self-report survey, which is filled out by campus administration, which increases the risk for self-report bias due to social desirability, or the tendency for people (or institutions) to generally present themselves in a favorable fashion. The CPI only rates the presence of positive/supportive policies and programs. Now, I’m all for being strengths-based (we need a little joy in the world!), but it’s important that we also understand how these strengths-based, LGBTQ+ programs and policies are enacted in real life. Unfortunately, the CPI does not include student, faculty, or other staff experiences, perspectives, or attitudes. This is problematic because the presence of policies does not necessarily reflect people’s lived experiences of those policies. Take these examples:

  • A university may have a policy that supports inclusive housing for transgender and gender diverse students; however, the process of accessing those services may or may not be challenging for students depending on how the information is disseminated and who is running the program. For a while I worked at an institution that had an LGBTQ-supportive dorm housing program, which was known to LGBTQ+ and allied faculty, but not well advertised on campus
  • A college may have paid staff responsible for LGBTQ support services; however, there is often not enough staff to meet demand. I have worked with multiple students (across college and university institutions in three states) and all have experienced challenges accessing LGBTQ+ supportive counseling services through campus health. Sure, all of these institutions had LGBTQ+ supportive paid staff, but most were under-staffed and with waitlists. When LGBTQ+ students were referred to counselors not trained specifically in LGBTQ+ needs, they were often met with microaggressions or, worse, outright hostility.

Finally, none of the CPI ranking indices take into account the experiences of multiple minoritized LGBTQ+ students, including BIPOC LGBTQ+ students, LGBTQ+ students with disabilities, neurodivergent LGBTQ+ students, and first gen LGBTQ+ students. These groups’ experiences of campus climate, policies and programs are unique, as these students experience intersectional discrimination and oppression because they hold multiple minoritized identities. Their lack of specific inclusion in the CPI measures is a HUGE gap in this instrument and needs addressed in future iterations.

Let me say it again… the presence of an LGBTQ+ policy or program does not necessarily reflect ALL LGBTQ+ people’s lived experiences of those policies. That is, the presence of an LGBTQ+ supportive policy does not automatically confer LGBTQ+ people’s safety and wellbeing on campus. BUT, policies and programs are critical foundations for increasing LGBTQ+ people’s safety and wellbeing at our university.  

So… are we still celebrating? Yes, we’re still celebrating! There are few measures of campus climate for LGBTQ+ people; even fewer through which we can compare institutions nationwide. The Ohio State University is doing an excellent job putting in place foundational policies and programs to support LGBTQ+ people on campus. OSU is also doing the work of conducting their own campus climate assessments (see the 2019 Campus Sexual Violence Survey and the 2020 LGBTQ+ campus climate survey, led by the Undergraduate Student Government) to accompany national rankings, like the CPI. My hope is that as we learn about our strengths and limitations as an academic community, that we continue to ACT to improve our policies, programs, and their implementation to benefit diverse groups of LGBTQ+ students, staff, and faculty.

Looking for info on LGBTQ+ programs at OSU? Visit the LGBTQ+ at Ohio State Website.

Town Hall Talk on Flavored Tobacco in LGBTQ+ Communities

| Joanne

Cross-posted from: Town Hall Talk: Flavored Tobacco Use in LGBTQ Communities (osu.edu)

Hi all!

I was recently invited to join in a Town Hall Talk on Flavored Tobacco Use among LGBTQ communities hosted by the LGBT Cancer Network and Equitas Health Institute. My colleagues Gabe Glissmeyer (LGBT Tobacco Network), Julia Applegate (Equitas Health Institute), and Michael Pistrui (Ohio University) talk from professional and personal experiences on the issue. Check us out below:

To learn more about tobacco use among LGBT communities check out the LGBT Cancer Network’s fact sheet: National LGBT Cancer Network LGBT Tobacco Fact Sheet (cancer-network.org)

If you want to learn more about the FDA’s proposed regulation on flavored tobacco, visit: FDA Proposes Rules Prohibiting Menthol Cigarettes and Flavored Cigars to Prevent Youth Initiation, Significantly Reduce Tobacco-Related Disease and Death | FDA

 

Commentary on proposed HB616

| Joanne

Cross posted from On Academic Life and Living

See Dr. Patterson featured on WTVN 10

Ohio’s House Bill 616  states that no public school, community school or private school that accepts vouchers shall “teach, use, or provide any curriculum or instructional materials on sexual orientation or gender identity” in kindergarten through third grade. And older kids can’t be taught “any curriculum or instructional materials on sexual orientation or gender identity in any manner that is not age-appropriate or developmentally appropriate for students in accordance with state standards.”

Proposed HB616 is an LGBTQ+ health equity and public health concern.

The proposed legislation’s language, particularly the phrases “classroom instruction” and “age-appropriate,” could be interpreted so broadly that it creates unsafe spaces for teachers who may be more likely avoid the subjects entirely or fear repercussion from any private citizen that disagrees with them. By silencing teachers, legislation like HB616 codifies oppression. This is unacceptable. Developmentally appropriate K-5 education includes teaching about people and families of diverse identities and structures – that includes LGBTQ+ families and people.

HB616 isn’t happening in a vacuum.

This year, state lawmakers have proposed more than 280 bills that would limit LGBTQ people’s rights. About half target transgender people specifically. In 2018, less than 50 of these bills were introduced.

The slate of legislation includes measures like HB616 that restrict LGBTQ issues in school curriculum along with legislation that would 

    • permit religious exemptions to discriminate against LGBTQ people
    • limit transgender people’s ability to play sports and use bathrooms that correspond with their gender identity
    • ban access to gender-affirming health care.

Yet support for public LGBTQ rights and policies prohibiting LGBTQ discrimination is at an all time high. Nearly 8 in 10 Americans support laws that protect LGBTQ people from discrimination. Legislation like HB616 does not represent majority public opinion. BUT, it is dangerous, because it creates a hostile climate– especially for LGBTQ young people.

HB616 threatens to widen health inequities experienced by LGBTQ youth.

Approximately 11% of young people in grades 9-12 years old identify as LGBTQ. The CDC’s recent Adolescent Behaviors and Experiences Survey (ABES) found that LGBTQ students are experiencing disproportionately high levels of poor mental health and suicide-related behaviors.

  • 2 out of 3 LGBQ high school students experienced poor mental health during the pandemic (vs 1 in 3 heterosexual student), including feeling persistently sad or hopeless.
  • LGBQ students were more likely to vape and smoke cigarettes than their cishet peers (22% vs 14% reported any current tobacco use).
  • LGBQ students also reported higher current alcohol use (26 vs 19%) and binge drinking (9 vs 8%), marijuana use ( 18 v 12% ), and prescription opioid misuse (7 vs 4%).
  • In 2021, almost 1 in 2 LGBQ high school students seriously considered attempting suicide.
  • 1 in 4 LGB and 1 in 6 students who identified their sexual orientation as other or questioning reported ATTEMPTING suicide  (vs 5% heterosexual peers)

ABES doesn’t reported on transgender and gender diverse students, but from YRBS data, we know that T/gender diverse students are more likely to experience violence victimization, ATOD, and suicidal ideation and attempts than cishet students.

Higher rates of poor mental health, risk behaviors, and suicidality are not a failing for  LGBTQ students. We are failing them. 

Creating safe schools protects LGBTQ students. 

Connectedness refers to a sense of being cared for, supported, and belonging, and can be centered on feeling connected to school and peers. In 2021, Fewer LGB students felt close to people at school (ABES).

This is problematic because, compared to students who were not connected to peers, students who felt close to people at school had lower rates of poor mental health during the pandemic (28.4% versus 45.2); less persistent sadness or hopelessness (35.4% versus 52.9%), and were less likely to seriously consider or attempt suicide (14.0% vs 25.6%) (5.8% vs 11.9%).

School connectedness is also protective across the lifecourse. Youth who feel connected at school are 66% less likely to experience poor mental health and health risk behaviors, including ATOD use and violence in adulthood.

If we know that school connectedness protects students’ health, then we have to create environments where all students can feel connected. For LGBTQ students, this means creating LGBTQ supportive school environments through:

    • Gay-Straight/Genders and Sexuality Alliances
    • Developing safer spaces to learn, work, and play
    • Inclusive curricula

Teaching inclusive curriculum is especially important. LGBTQ+ youth are not often taught about LGBTQ+ history, culture, and people. In 2019, a study by GLSEN found that only half of LGBTQ students could find LGBTQ+ relevant content at the school library or access LGBTQ+ content from school computers.

School environments which are inclusive of LGBTQ+ history + culture are safer learning environments for LGBTQ+ youth. According to the same study,

  • LGBTQ+ students whose schools had inclusive curricula reported hearing fewer slurs and experienced lower levels of victimization
  • They report feeling safer and more accepted in their community (GLSEN, 2019).

Teaching inclusive curriculum also resulted in better educational outcomes.

  • Students at schools with inclusive education missed fewer days of school and had a higher GPA ( vs students whose schools did not cover LGBTQ+ (GLSEN, 2019)
  • Data from the Trevor Project suggests that LGBTQ youth who learn about LGBTQ issues in school are less likely to attempt suicide.

Inclusive curriculum is about more than teaching culture and history… it’s about creating spaces where all youth – including LGBTQ youth and children with LGBTQ parents feel seen, affirmed, and safe, HB616 threatens to eliminate that safety for LGBTQ students in Ohio.

What can you do?

Call or write your legislators. Tell them you disagree with HB616.

Let your local PTO and School Board know that you disagree with HB616.

Talk to your children about why teaching about LGBTQ people and culture is important.

Show community support by joining in a PRIDE event this year.

Donate to a local LGBTQ organization, especially those that serve youth and young adults in our greater Columbus community.

Get to know local LGBTQ healthcare organizations.

 

Study reveals disparities in quality of life and health behaviors among lesbian and bisexual women surviving cancer

| Joanne

In a US national study of women surviving cancer, researchers at The Ohio State University James Comprehensive Cancer Center and University of Kentucky Markey Cancer Center found that lesbians and bisexual women cancer survivors reported poorer quality of life and increased health risk behaviors than heterosexual women.

These factors may contribute to excess chronic disease morbidity and mortality among lesbian and bisexual women, and widen existing disparities.

Findings underscore the importance of investing in cancer prevention and survivorship research that intentionally engages LGBT populations.

Hutchcraft ML, Teferra AA, Montemorano L, Patterson JG. LGBT Health. 2021; 8(1).

Read more: https://www.liebertpub.com/doi/full/10.1089/LGBT.2020.0185 

Food security study featured by BMC Public Health

| Joanne

Our recently published study, Sexual orientation disparities in food insecurity and food assistance use in U.S. adult women: National Health and Nutrition Examination Survey, 2005–2014, was featured today in the BMC Series blog.

Documenting food security disparities among sexual minority women women in the United States, we found that:

  • 1 in 4 sexual minority women experienced food insecurity in the past 12-months
  • Sexual minority women were 34-52% more likely to be food insecure
  • Alarmingly, sexual minority women were 50-84% more likely to experience at least one period during the past 12-months where eating patterns were disrupted and food intake was reduced due to lack of money or other resources (severe food insecurity)
  • Lesbians and heterosexual women reporting past same-sex behavior were more likely to rely on emergency food assistance (e.g., food pantries) to supplement food intake.
  • Sexual minority and heterosexual women were equally as likely to use federal food assistance programs (e.g., Supplemental Nutrition Assistance Program; SNAP)

Food insecurity is associated with nutritional deficiencies and increased risk for cancer, diabetes, and cardiovascular diseases. Addressing food insecurity in the population may require:

  • increasing overall economic stability (e.g., reducing job discrimination, increasing compensation)
  • increasing SNAP use among sexual minority women
  • improving access to nutritious food via local and LGBTQ-accessible emergency food assistance (e.g., food pantries and soup kitchens)

Read the blog post at the BMC Series Blog and our original article at BMC Public Health.

 

Citation: Patterson JG, Russomanno J, Jabson Tree JM. Sexual orientation disparities in food insecurity and food assistance use in U.S. adult women: National Health and Nutrition Examination Survey, 2005–2014. BMC Public Health 2020: 20, 1155. https://doi.org/10.1186/s12889-020-09261-9


Hunger: a lesbian and bisexual women's health crisis

Welcome!

| Joanne

Welcome to Practice & Science for LGBTQ Health Equity! Our mission is to highlight interdisciplinary and translational research and practice dedicated to dedicated to eliminating health and cancer-related inequities in lesbian, gay, bisexual, transgender, and queer (LGBTQ) communities. We aim to achieve our mission by connecting research with practice in order to (1) engage LGBT community members as experts, (2) identify multilevel determinants of health inequities in LGBTQ populations, (3) develop community-based, innovative, culturally congruent, evidence-based approaches to addressing disparities, and (4) reach scientific, practice, policy, and general audiences.

Who. What. Why.

PS: LGBTQ Health Equity represents the efforts of scientists and practitioners conducting LGBTQ health and cancer-related research and community-based practice at The Ohio State University. The program was created by Joanne G. Patterson, PhD, MPH, MSW – a T32 Cancer Prevention and Control Postdoctoral Research Fellow at The Ohio State University Comprehensive Cancer Center (CCC) – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute. 

As member of The Ohio State University,  Dr. Patterson aims to connect LGBTQ health equity researchers and practitioners at The Ohio State University with the intent to  highlight innovative research-in-progress and community-based practice to improve LGBTQ health equity.

Interested in collaborating? Sharing your research? Learning more? Contact us at PS: LGBTQ Health Equity.