The discrimination faced by the LGBT community has been well documented. Now, a study that pulls together data from a variety of sources indicates that some of the obstacles faced by LGBT individuals — at least when it comes to their health — may be falling away.
The report, "Health and Access to Care and Coverage for Lesbian, Gay, Bisexual and Transgender Individuals in the U.S." comes from the Kaiser Family Foundation. Researchers sorted through and evaluated data produced by myriad sources, from the U.S. Census Bureau to research done by various state agencies, the Institute of Medicine, National Center for Transgender Equality, Centers for Disease Control and Prevention, and many more.
Kaiser weighed the value added by the Patient Protection and Affordable Care Act and the Supreme Court's DOMA ruling to LGBT attempts to achieve equitable status within the health insurance and provider communities. Overall, Kaiser found, while LGBT individuals still tend to have more physical and mental health challenges than the heterosexual community, their needs are finally being recognized and, on some level, met.
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"A number of health challenges disproportionately affect LGBT communities, particularly the HIV/AIDS epidemic, stigma and violence, substance abuse, negative experiences in the health care system, and lack of insurance coverage," Kaiser said in a summary of findings. "In addition to health outcomes, access to care has been a concern and intersects with many broader issues, including relationship recognition, legal identity recognition policies for transgender individuals, training and cultural competency of health professionals, as well as overarching societal and cultural issues, particularly a long history of stigma and discrimination.
"Recent policy and legal changes will serve to mitigate some of these challenges. In particular, the years ahead will see both the full implementation of the ACA as well as the full effects of overturning elements of DOMA. This convergence of policy and legal breakthroughs holds promise for broader access to health services, coverage, and benefits for LGBT communities."
Kaiser credited PPACA and the rejection of DOMA with "reshaping the health care and coverage landscape for lesbian, gay, bisexual, and transgender individuals and their families."
The multi-faceted report crunched numbers of LGBT health challenges and trends as well as reviewing the health care access and insurance landscapes.
For instance, it said that the 9 million self-reported LGB people in the U.S. "report more asthma diagnoses, headaches, allergies, osteoarthritis, and gastro-intestinal problems than heterosexual individuals. … Lesbian and bisexual women report poorer overall physical health and higher rates of asthma, urinary tract infections, and Hepatitis B and C than heterosexual women. Lesbian and bisexual women also report heightened risk for and diagnosis of some cancers and higher rates of cardiovascular disease diagnosis.
"Similarly, gay and bisexual men report more cancer diagnoses and lower survival rates, higher rates of cardiovascular disease and risk factors, as well as higher total numbers of acute and chronic health conditions such as headaches and urinary incontinence than heterosexual men. …
"Obesity rates are higher among lesbian and bisexual women compared to heterosexual women, but are lowest among gay men. Among both women and men, smoking rates are highest among bisexual groups, followed by lesbian and gay persons, and lowest among heterosexual people. A meta-analysis of several studies found that overall, LGBT people smoke cigarettes at 1.5 to 2.5 times the rate of heterosexual and non-transgender people."
Kaiser then reported data from various sources that underscored the lower level of insurance coverage reported by those who identify as LGBT, the difficulties they reported in accessing proper coverage (ranging from not being able to make doctor's appointments to being denied coverage for LGBT-specific health issues), and their greater tendency to postpone medical procedures due to an inability to pay.
"Research has also found that women in same-sex couples are less likely than heterosexual married women to have received timely medical care for both primary and specialty services. Among men in couples, gay men are three times as likely as their heterosexual counterparts to report delays in obtaining needed prescription medicines," Kaiser said.
But the future appears brighter for this population, Kaiser said, starting with the simple fact that the PPACA "will extend coverage to millions of uninsured persons through the expansion of Medicaid in some states, as well as the creation of new federally subsidized health insurance marketplaces."
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Dan Cook
Dan Cook is a journalist and communications consultant based in Portland, OR. During his journalism career he has been a reporter and editor for a variety of media companies, including American Lawyer Media, BusinessWeek, Newhouse Newspapers, Knight-Ridder, Time Inc., and Reuters. He specializes in health care and insurance related coverage for BenefitsPRO.
