Crowley, A PBH 602: Social Justice and Health Disparity Paper 12/07/22

Amanda Crowley

PBH 602: Principles and Philosophy of Health Education

Social Justice and Health Disparities Paper and Intervention Proposal

12/07/22

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Crowley, A PBH 602: Social Justice and Health Disparity Paper 12/07/22

In the United States, health and healthcare has been a debate regarding the status,

affordability, and perceptions of what quality health care should be. Unfortunately, some

American’s do not have the luxury of this discussion, as they often face issues with social justice

issues and health disparities within the health care system. In this example, social justice is

defined as the idea that all individuals have a right to high-quality health care regardless of

external factors. Often times factors such as levels of education, socioeconomic status, and

location can affect the type of care an individual has access to. Other times, discrimination and

minority populations often experience disparities in healthcare. These disparities can be defined

as a preventable circumstance in which a health status of an individual can affect their access to

resources, and lead to variations in mortality, life expectancy, burden of disease, mental health,

insurance coverage statuses, as well as a lack of access to healthcare in general (6 Examples of

Health Disparities and Potential Solutions, n.d.). A healthcare issue and a group in particular that

this happens to often, is those members of the LGBTQ community. Although there are many

health concerns that can be of focus within this group and the healthcare system, often times

mental health of this group is negatively impacted.

Overall, members of the LGBTQ community typically fall under certain stigmas in healthcare,

and usually display incidences of poor mental health, which can be connected to increased

difficulty in access to quality healthcare. In seventy-six countries throughout the world,

homosexual relations are still deemed a criminal act that can be punishable by fines, prison time,

or even execution in some cases. Other places, such as Ukraine, will force individuals who

identify as transgender to undergo extensive psychiatric evaluations prior to legally being able to

identify as transgender (Moagi, 2021). After a literature review, it has been stated that members

of the LGBTQ have higher rates of emotional distress than heterosexual individuals. This

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includes higher rates of adverse childhood experiences, depression, anxiety, suicidal ideation and

suicidal attempts. To put even further into perspective, those in the LGBTQ community are up to

fourteen times more likely to commit suicide, and depression rates are over five times higher

than heterosexuals (Moagi, 2021). Additionally, some other factors are major determinants of

this mental health issue. For example, members of this community often face stigma,

discrimination, and victimization, as well as social exclusion. Due to these determinants, health

access is often restricted from the LGBTQ population. These individuals may refrain from

routine or necessary office visits or treatment options to avoid stigmatization. In other cases, if

they attend their appointments, they may not be truthful to their practitioner in fear of judgment

or persecution for who they are. If they do not receive stigma from others, often times there is an

internalized stigma that negatively impacts an individual’s mental health; due to this, they would

benefit greatly from mental health intervention, but do not receive it out of fear. Adversely, if

individuals did reach out for help from practitioners, in particular in the mental health field, they

were often met with healthcare professionals who were not knowledgeable enough in everyday

issues that members of the LGBTQ community face.

There are a number of areas within this topic where action is needed most. In addition to sadness,

depression, and suicidal thoughts or actions, people of the LGBTQ face other obstacles that

negatively affect their mental health. Typically, once these individuals accept themselves, they

may face unsupportive friends and family members who may disown them, leaving them on the

streets without a home, causing instability in their socioeconomic status. LGBTQ adolescents

have a 120% higher risk of becoming homeless than heterosexual individuals (Meyer, 2007).

They can face trauma from being rejected by those who they thought loved them for who they

are, or become targets for prejudice. They can also fall into abusing substances due to their poor

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mental health (Morris, 2009).

Historically, there has been evidence of oppression within the LGBTQ community that

drastically can affect the mental health of individuals and cause them to fear themselves and

others. Historians have seen trends of homosexuality and transgender dating back to biblical

times in Israel, where such tendencies were persecuted. This trend extended throughout history,

with homosexuals often being discriminated against in the military and governmental positions

of power. Discrimination and prejudice have even gone so far to cost this individual their lives as

recent as 2016 where a gay nightclub in Orlando Florida was the site of a mass shooting to

persecute homosexuals (AMA Foundation Launches New Plan to Address LGBTQ Health

Disparities , 2020). With these historical trends, it not only takes a toll and adds additional fear

into those in the community, it negatively affects their mental health and can make it more

difficult for them to seek help, despite how much they may need it, due to the history of

injustices.

Due to these disparities regarding the mental health of individuals in the LGBTQ community,

several intervention strategies should be put in place to protect equality of healthcare. One main

goal that needs to be addressed in this proposal is the access of care that is accepting to this

population. These individuals need to be represented, respected, and understood, and need to

understand that their healthcare is just has important and valued as anyone else’s. The American

Medical Association Foundation will lead a Fellowship Commission of LGBTQ Health

consisting of thirteen to fifteen leaders, educational specialists, physicians and philanthropists

that will be carefully appointed by the AMA. Some key focuses of this fellowship are to ensure

that all healthcare practitioners within the commission are knowledgeable and competent

towards LGBTQ health. To do this, healthcare practitioners must be trained to decrease

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disparities through education of various means. They need to be educated on how to improve

their competence on health-related concerns of this community, and how to identify and address

these needs. Additionally, the perspective on healthcare and acceptance needs to be addressed

and made to be more accepting without fear of judgement. These strategies and educational

opportunities will be available to practitioners currently in the field, but also will be offered to

those beginning medical school to ensure they are prepared and educated to the highest extent

before working with any individual to provide the highest level of healthcare equity as possible.

There is another intervention strategy that is proposed to be utilized called “Transforming

Primary Care of LGBT People”. This is a year long initiative that focuses on improving the

healthcare of individuals who fall in this category through education and practices centered

around this specific care. It essential trains physicians to provide proper and equal healthcare

among all individuals, and screen for certain conditions specific to risk behaviors such as HIV,

STDs, and cancers. The commission is responsible for training all new hires in decision making,

preventative health screenings, culturally affirming practices, policies, and how to improve

overall care (NIH Transforming).

Historically, it has been shown that although it is assumed that everyone has equal opportunities

to receive proper healthcare, that often is not the case with individuals who identify with the

LGBTQ population. They are often discriminated against, victims of prejudice, and have health

specific needs that are overlooked. A major need to be addressed is the mental health of

individuals in this community. Members of the LGBTQ are often struggling with anxiety,

depression, and suicidal thoughts that stem from various means, however, are not properly

addressed due to disparities in the healthcare system. These individuals either feel

misrepresented, or fear they will be judged by their physicians; therefore, they do not receive

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what could be life saving treatments. In order to help improve these disparities, there are

programs in place to educate healthcare workers to better serve this population, thus increasing

the compliance, health, and wellbeing of those in the LGBTQ community.

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Bibliography
6 Examples of Health Disparities and Potential Solutions. (n.d.). Retrieved from USCPrice:
https://healthadministrationdegree.usc.edu/blog/examples-of-health-disparities/

AMA Foundation Launches New Plan to Address LGBTQ Health Disparities . (2020). AMA.

Furness, B. W. (2020). Transforming Primary Care for Lesbian, Gay, Bisexual, and Trasgender People: A
Collaborative Quality Improvement Initiative. National Library of Medicine, 292-302.

Important Risk Factors of LGBTQI Mental Health. (n.d.). Retrieved from National Alliance of Mental
Illness : https://www.nami.org/Your-Journey/Identity-and-Cultural-Dimensions/LGBTQI

Meyer, I. H. (2007). Prejudice, Social Stress, and Mental Health in Lesbian, Gay, and Bisexual
Populations. National Library of Medicine, 674-697.

Moagi, M. M. (2021). Mental Health Challenges of Lesbian, Gay, Bisexual, and Transgender People .
National Library of Medicine .

Morris, B. J. (2009). Histroy of Lesbian, Gay, Bisexual and Transgender Social Movements . American
Psychological Association .