Health Disparities among Gay and Lesbian Populations - Research Paper Example

Health Disparities among Gay and Lesbian Populations Number Introduction and Brief Definition of Terms Homosexual is a general term denoting one who is sexually involved with someone else of the same sex. Gays are male homosexuals while lesbians refer to female homosexuals. Straight people are those associated sexually with partners of opposite sex. Heterosexuals refer to those who exhibit both homosexual and straight tendencies. This paper attempts to briefly highlight a variety of health disparities among gays and lesbians including neglect of these groups by advocates, researchers, practitioners, administrators, politicians and so on (absence of research devoted to this group, the higher economic, health and social risk profile in these groups, failure of existing aging policies to regard their needs and interests, failure of public agencies to address bias directed towards such groups, lack of cultural competency training among services personnel and so on). This essay also discusses but a few of the steps/ measures taken/ are being taken/ are proposed to address the concerns arising from the group. Research shows that in spite of the breath taking advances in medicine, this minority and historically disadvantaged communities such as gays and lesbians exhibit higher levels of illness, disability and premature death. One of the main objectives of the National Institute of Health is minimize and eradicate health disparities yet still, the unique health and aging requirements of lesbians and gays remain rarely addressed. Discussion Research on sexual orientation, as rightly identified by the CDC, is one of the most pronounced contributors to health disparities with gays and lesbians remaining some of the least understood groups in terms of health and aging needs. Health research remains glaringly absent in studies concerning gays and lesbians. On the other hand, understanding aging across such historically disadvantaged groups as gays and lesbians will further enhance our knowledge of the diverse experiences and needs of older adult population. With estimates showing more than 2 million American adults identify as homosexuals, the next few decades will see the number of older homosexuals will continue to soar (number expected to double in the period between 2000 and 2030) (Taylor et al., 2003). Homosexuals are therefore an at-risk population with major health disparities. Even while considering age differences, income, education and such other stratifications among homosexuals, the prevalence of many health problems is highest in gays and lesbians than in any other minority group (Taylor et al., 2003). 41% of homosexuals aged 50 and over have a disability with women more prone to such disabilities than men. In addition, gays and lesbians are observed to be more prone to health behaviors that elicit disease such as drug and substance abuse (heavy drinking and smoking). Older lesbians are more likely to engage in heavy drinking compared to their straight counterparts. In addition, diabetes is more prevalent in older gay men (perhaps a result of lifestyle) while gay men are more prone to contacting HIV/ Aids than straight men (Taylor et al., 2003). Research indicates no differences based on sexual orientation in terms of obtaining health insurance, engaging in physical exercise or having high blood pressure or high cholesterol. Older gay men are also said to have lower likelihoods of obesity and a higher chance of receiving a flu shot or an HIV test compared to straight men. Also, older lesbians are more likely to receive an HIV test than their straight counterparts and thereby receive prompt medication (healthy lifestyles) if need be. Differences between lesbians and heterosexual women also come to the fore with older lesbians, for instance, exhibiting higher chances of cardiovascular conditions, obesity and lower chance of having a mammogram compared to older heterosexuals. Further still, older gays and heterosexuals show higher poor physical health compared to their counterparts of the same age (Hudson, 2011). Also, almost all of the older homosexuals are less likely to be partnered or married which means less support as they age/ poor aging health conditions. They also have fewer children in the house and are more likely to live alone. Older adults who live in such solitude are at a higher risk of social isolation which may result in poor mental and physical health, cognitive impairment and premature morbidity and mortality (Hudson, 2011). However, despite all these, there exist signs of health and resilience among homosexuals. According to a recently conducted survey, most lesbians (approximately 91%) engage in weekly leisure and wellness activities and another 82% take part in physical exercises. More than a third, that is roughly 38%, attends spiritual/ religious activities almost monthly. The search also confirms the higher disability rates in homosexuals with half having a certain disability. A whopping 31% of homosexuals showed depression with elevated risks of mental distress observed in the population. More than half of the homosexuals, as per the report, experience loneliness with more than a quarter (27%) having lost a partner through death. Poor observed health among the older homosexuals has generally been a long time coming. Many of these older homosexuals grew up at a time when homosexuality and gender variance were seriously stigmatized and criminalized. It was not until the civil rights movements of the 1960s and the Stonewall Riots in 1969 that a plethora of homosexuals began openly revealing their orientations. However still, even in the contemporary world, many still mask their identities, with health delivery largely impacted hence and like most minority groups, gays and lesbians must constantly handle disclosure of their sexual orientations or gender identities with fear of discrimination and victimization/ adversity (Hudson, 2011). Historical and contemporary experiences of victimization create obstacles towards accessing and utilizing necessary health and social support services. 82% of homosexuals claim to have been discriminated against at least once in their lives and nearly 64% have been victimized at least three times. Up to two-thirds (68%) have been subject to verbal abuse and another 42% physically threatened by violence. Other common forms of bias aimed at homosexuals include harassment by police (27%), threats of ousting as homosexuals (23%), denial of job opportunities because of sexual orientation (22%) and property damage (20%). As a result of this reluctance to disclose sexual orientation, homosexuals encounter many obstacles in accessing quality healthcare services which can result in damaging consequences. Serious medical problems result if physicians fail to recognize patients’ sexual orientation or if patients fail to disclose such information. About 21% of homosexuals have not revealed their sexual leanings to the physicians which prevent discussions about sexual health, hormone therapy, risk of breast cancer, hepatitis and HIV risk or other potential risk factors. 13% of homosexuals have been denied or provided poor healthcare and almost one quarter (22%) are reported to have been locked out of healthcare services because of costs of treating patients with such orientations. 15% fear accessing healthcare outside the homosexual community while another 8% fear accessing healthcare inside the community. Some sex partners lack access to federal family leave benefits, equivalent Medicaid spend-downs, social security benefits, bereavement leave or automatic inheritance of jointly owned real estate and personal property (Hudson, 2011). Case Study A study investigating suicidality and sexual orientation was conducted in the Netherlands involving a total of 5,998 people ranging from 18-64 years. Homosexuality has been argued to be influential in suicidality and mental disorders and the study sought to prove/ discard this hypothesis. Grouping as either heterosexual or homosexual was done according to reported sexual behavior in the previous 12 months in a study that assessed the differences in lifetime symptoms of suicidality (death ideation, death wishes, suicide contemplation and deliberate self-harm) among different sexual orientations and various genders (De Graaf, Stanfort & ten Have, 2006). In conclusion, the study indicated a strong link between homosexuality and suicidal tendencies and mental disorders but fell short of proving whether homosexuality was related to suicidality independent of mental disorders. Of the sample interviewed, 2.8% of the men and 1.4% of the women were homosexuals. Homosexual men showed disparities in all four suicide symptoms compared to heterosexual men while homosexual women on the other hand, only differed from their heterosexual counterparts on suicide contemplation. The survey indicates that even in a homosexual friendly nation like the Netherlands, homosexual men were still at a much higher risk for suicidality than heterosexual men. In addition, younger homosexuals were not at lower risk of suicide than older ones when both compared with their heterosexual counterparts (De Graaf, Stanfort & ten Have, 2006). Current Strategies and Recommendations A comprehensive approach towards transforming existing public policies, aging services and research is critical in addressing these circumstances surrounding homosexuals. There are new regulations and policies which have been put into effect to look into the needs of homosexuals such as prohibition of discrimination based on sexual orientations in places such as hospitals. Protection against discrimination against homosexuals on all fronts is essential in ensuring economic security and safety of these groups and consequently, their health (Branstrom & van, 2013). It is also important that hate crimes based on sexual orientation, gender identity and age be fully prosecuted as has been the case in some areas. There is in addition the need for many more such acts which address the needs of gays and lesbians. In America, for instance, widespread advocacy has seen to the inception of the pioneer National Resource Center on LGBT aging that was funded through older Americans Act. An Innovative Service Centre aimed at the rights and welfare of the LGBT in New York is also opening. The Affordable Care Act, in addition, holds promise of extending coverage and easy access to health care by the LGBT community (Branstrom & van, 2013). Creating comprehensive health and aging services for homosexuals by fostering partnerships between aging and general services in the homosexual community as well as with federal, state and local mainstream providers of health and aging services is essential, along with cultural competency training which incorporates diversity in sexual orientation, age, gender, ethnicity, race, education, income, geographic location and ability. It is important to define the competencies necessary for effective healthcare practice which includes the needs of homosexuals as part of degree requirements in educational programs such as medicine, nursing, social work and other educational programs. In addition, early detection and identification of such groups enables exploration of strategies and interventions that promote healthy communities especially aimed at prevention and reduction of obesity, heavy drinking and smoking (Branstrom & van, 2013). The expansion of HIV prevention, education and treatment programs to induce older and generally homosexual adults will be an important measure. In addition, better data collection highlighting sexual orientation and gender identity will be crucial in determining risk of health disparities and high morbidity and mortality in the groups (McCabe et al. 2010). It is also important that the findings documented in such researches be fully implemented and not overlooked as is always the case. Further research is critical in exploring the decision-making processes guiding gays and lesbians, their caretakers and the relationships between health and key life events and the utilization of informal and formal supports. References Branstrom, R., & van. S. A. (2013). All inclusive Public Health--what about LGBT populations? The European Journal of Public Health, 23, 3, 353-354. De Graaf, Ron, Stanfort, Theo G. M & ten Have Margreet (2006). Suicidality and Sexual Orientation: Differences Between Men and Women in a General Population. Archive of sexual behavior, 35, 3, 235-262. Hudson R. (2011).Service and Advocacy for Gay Lesbian, Bisexual and Transgender Elderly: Integrating Lesbian, Gay, Bisexual, and Transgender, older Adults into Aging Policy and Practice. Public Policy and Aging Report, 21, 3, 1-38. McCabe, Sean Esteban, Bostwick, Wendy B., Hughes, Tonda L., West, Brady T., Boyd, Carol J. (2010). The Relationship Between Discrimination and Substance Use Disorders Among Lesbian, Gay, and Bisexual Adults in the united States. American Journal of Public Health, 100, 10, 1946-1947. Taylor, C. L. C., Boudreaux, E. D., Jeffries, S. K., Scarainci, I. C., & Brantley, P. J. (2003). Applying Exercise Stage of Change to a Low-Income Underserved Population. American Journal of Health Behavior, 27, 2, 99-107. Read More