Developing Better Information
HHS has taken several steps to enhance the collection of health data on LGBT populations. Gathering data on LGBT individuals will help researchers, policy makers, health care providers, and advocates identify and address health disparities affecting the LGBT population. The following are examples of initiatives implemented across the department to ensure that there is better data specific to the needs of the LGBT community:
National Institute of Health (NIH) Research
NIH continues to work toward broadening the field of health research relating to the sexual and gender minority (SGM) communities. The NIH established the Office of Sexual and Gender Minority Research Office (SGMRO) in September 2015. The goals of the office are to:
- Increase SGM-related research in the extramural and intramural portfolios
- Promote the development and implementation of appropriate measures and methods to facilitate SGM-related research
- Increase expertise in SGM health research within and across existing NIH review panels and study sections, as needed
- Encourage SGM-related cultural competency training opportunities for both NIH-funded extramural and intramural trainees and researchers
- Monitor and evaluate progress in advancing SGM health research at NIH
The NIH also released the NIH 2016-2020 Strategic Plan to Advance Research on the Health and Well-being of Sexual and Gender Minorities. The SGMRO will work across the NIH Institutes, Centers and Offices to implement the plan. In addition to the strategic plan, NIH has released several Funding Opportunity Announcements to increase SGM-related research.
Survey Question on Sexual Orientation and Gender Identity
The Centers for Disease Control and Prevention (CDC) included a question on sexual orientation in HHS’s flagship National Health Interview Survey. Based on a year of data collection, CDC issued its first report entitled “Sexual Orientation and Health among U.S. Adults: National Health Interview Survey, 2013.” The data were published as a National Health Statistics Report. CDC also released a public use data file for other researchers to analyze. The full report can be found at http://www.cdc.gov/nchs/data/nhsr/nhsr077.pdf
In addition, HHS developed survey questions on gender identity and sexual orientation, and conducted cognitive testing on the questions, which were implemented as an optional module for states on CDC’s 2014 Behavioral Risk Factor Surveillance System. The adoption of this module helps develop scientific survey data on the health status and health care experience of lesbian, gay, bisexual and transgender populations. HHS provided technical and financial assistance to the thirty-one states that have either adopted the module or are using a variation on the questions, and will do so again this coming year.
Other agencies within HHS have also undertaken efforts to gather additional data on sexual orientation and gender identity:
- The Substance Abuse and Mental Health Services Administration (SAMHSA) completed a pilot test of the sexual orientation questions for inclusion in the 2015 National Survey on Drug Use and Health.
- Health Resources and Services Administration (HRSA) included a question on gender identity in the 2013 and 2014 National Health Service Corps Patient Satisfaction Survey and the 2014 NURSE Corps Participant Satisfaction Survey.
Health Resources and Services Administration (HRSA) Report on Women’s Health
HRSA released Women’s Health USA, the 12th edition of an annual data book identifying priorities, trends and disparities in women’s health. This report features data on the health of lesbian and bisexual women. The report found that lesbian and bisexual women are at increased risk for adverse health outcomes, including overweight and obesity, poor mental health, substance abuse, violence, and barriers to optimal health care resulting from social and economic inequities. The full report is available at http://www.mchb.hrsa.gov/whusa13/
Healthy People 2020
Every ten years, HHS develops national, science-based objectives for promoting health and preventing disease for the following decade. In 2010, for the first time, a formal workgroup was established to examine scientific literature on LGBT health. As a result, Healthy People 2020 proposed the first-ever objective regarding LGBT health data collection. The objective has two sub-measures – one for LGB health data collection and the other for health data collection in transgender communities.
Healthy People 2020 held a webinar on transgender health which is archived on the website at http://www.healthypeople.gov/2020/connect/webinarsArchive.aspx
Agency for Healthcare Research and Quality (AHRQ)
AHRQ released the 2013 National Healthcare Disparities Report, which focuses on disparities in health care delivery as it relates to racial factors and socioeconomic factors in priority populations. The report includes a focus on health care for LGBT populations. The report can be viewed online at http://www.ahrq.gov/research/findings/nhqrdr/nhdr13/2013nhdr.pdf. Information specific to the LGBT population can be found in Chapter 11 of the report titled “Priority Populations.”
In addition, AHRQ funded a nearly $500,000 grant to review key issues in shared decision making. Shared decision making within this context is focused on the cultural competence of clinicians to provide health care services that are specific and responsive to the unique needs of certain populations when engaging them in healthcare decisions. Through cultural competence of clinicians, they are able to more effectively engage in bi-directional conversations with their patients to guide evidence-based, patient-centered decisions. This review will include interventions related to cultural competency that are targeted to reduce health disparities in minority populations and LGBT individuals.
The National Intimate Partner and Sexual Violence Survey
CDC has released findings on Victimization by Sexual Orientation in a report and accompanying fact sheets. This report highlights the national prevalence of intimate partner violence, sexual violence, and stalking among lesbian, gay, and bisexual women and men in the United States. For the first time, this report presents comparisons of victimization by sexual orientation for women and men.
CDC has worked to increase the visibility of the report and its findings by sharing information with LGBT service organizations, practitioners, policymakers, and the LGBT community in general. The report, fact sheets and other materials are available on CDC’s website at http://www.cdc.gov/violenceprevention/nisvs/.