How Hate Hurts LGBTQ+ Hearts
Written by Justin Arguel
Edited by Cindy Ho
May 2, 2021
Edited by Cindy Ho
May 2, 2021
Despite accounting for nearly 11 million adults in the United States population, the LGBTQ+ community is significantly underrepresented in cardiovascular health research (Newport, 2018). Additionally, there is very little content in existing health professions education that specifically caters to LGBTQ+ health, contributing to as many as 56% of sexual minority and 70% of gender minority patients to experience discrimination in healthcare settings (Lambda, 2010; Streed and Davis, 2018). As more health organizations become more aware of such harmful outcomes, they beg for answers to a very important question: how can we as health professionals better provide LGBTQ+ individuals with informed and equitable healthcare?
The American Heart Association (AHA) recently released a scientific statement that specifically addresses health disparities amongst the LGBTQ+ community, explicitly positioning stress as the primary factor of LGBTQ+ health disparities (Brooks, 1981; Meyer, 2003). Their statement emphasizes how pre-existing societal and interpersonal stressors, such as financial hardship, childhood abuse, or having to navigate through one’s sexual or gender identity in a discriminatory environment, can compound upon one another and negatively affect heart health (Balsam et al., 2005). Systemic stressors also include higher poverty rates and even government policies failing to enact antidiscrimination laws (until the very recent June 2020 Supreme Court decision preventing sexual discrimination in the workplace) (Badgett et al., 2019). In addition to these stressors, LGBTQ+ adults are much more likely to use tobacco products and exhibit heavy alcohol use, altogether resulting in an elevated risk for cardiovascular disease than in their heterosexual and cisgender counterparts (Azagba et al., 2019; Caceres et al., 2017; Caceres et al., 2018; Caceres et al., 2019a; Hoffman et al., 2018; Lloyd-Jones et al., 2010).
However, cardiovascular health research amongst the LGBTQ+ community is limited. Current data is mainly derived from white cisgender members of higher socioeconomic status, disregarding important factors like race, education, and financial background. Additionally, research is often biased towards LGBTQ+ individuals who are more comfortable revealing their sexual or gender identity (SOGI), as other individuals may fear that disclosing this personal information could result in biased, inadequate patient care. As a result, the AHA not only encourages members of the research community to include SOGI data in future cardiovascular health studies, but they also encourage that the research teams mirror the diversity of the communities they are researching (Caceres et al., 2020; Caceres et al., 2019b; Katz-Wise et al., 2014).
The AHA’s final recommendation emphasizes the importance of LGBTQ+ health education amongst health professionals. Many members of the LGBTQ+ community have experienced discrimination and some have even been denied patient care by physicians (“When Health Care”, 2010). A 2018 survey found that about 80% of students from 10 different medical schools felt that they were incompetent at providing quality care for transgender patients. Through an increase of LGBTQ+ educational content, it is our hope that by understanding and recognizing these socioeconomic and psychological stressors, health professionals will be able to minimize discrimination in healthcare settings, as well as increase patient trust. While there is still much to be done to address and resolve health disparities amongst the LGBTQ+ community, implementing these recommendations can drastically help improve the health and happiness of LGBTQ+ hearts.
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