Institute of Medicine Makes Recommendations About LGBT Health Disparities

A study panel convened by the Institute of Medicine (IOM), an “an independent, nonprofit organization that works outside of government to provide unbiased and authoritative advice to decision makers and the public,” has added its voice to the growing chorus of leaders publicly calling for more attention to LGBT health disparities.

Asked to identify key health targets for the nation in the next decade, the panel noted that it was “disappointed” that it could not select any objectives in the areas of social determinants of health, health-related quality of life and well being, and LGBT health “because no objectives had been listed [in these areas] by Healthy People 2020.”  The panel listed some LGBT health disparities and then went on to say and recommend the following:

“The committee reviewed the 24 objectives it selected for inclusion in the Healthy People 2020 Leading Health Indicators and noted that, while these objectives are relevant to all, there are particular disparities in many of the underlying indicators that are related to LGBT populations.  As discussed earlier in this report, educational achievement is related to improved health which may be of particular importance in LGBT populations, many of whom face high rates of special and complex health problems (e.g., HIV/AIDS) and difficulties in dealing with the health care system generally.  Therefore, the committee offers the following modifications of the selected objectives for use in tracking LGBT health.  For ease of comparison with the original Healthy People 2020 objective, the number of the objective has been modified by placing an L immediately after the number to indicate its use with LGBT populations:

  • AH 5L:  Increase the educational achievements of LGBT adolescents and young adults.
  • AHS 1L:  Increase the proportion of LGBT persons with health insurance.
  • AHS 5L:  Increase the proportion of lesbians and transgender persons with a usual primary care provider.
  • HIV 17L:  Increase the proportion of condom use among gay or bisexual males aged 15 and above who are sexually active with other men or women.
  • MHMD 4L.1:  Reduce the proportion of gay, bisexual or questioning males and females aged 12 to 17 years who experience major depressive episodes (MDEs).
  • MHMD 4L.2:  Reduce the proportion of LGBT persons aged 18 years and older who experience major depressive episodes (MDEs).
  • NWS 10L:  Reduce the proportion of lesbian and bisexual female adolescents who are considered obese.
  • SA 13L:  Reduce the proportion of LGBT persons’ past-month use of illicit drugs.
  • SA 14L:  Reduce the proportion of lesbian, gay males, and bisexual persons engaging in binge drinking of alcoholic beverages.
  • TU IL:  Reduce tobacco use by lesbian, gay men, and transgender adults.

“The committee believes that by including objectives that address issues of disparities in health for the LGBT populations, there will be a focus for implementing actions to lessen disparities and improve the health of LGBT populations.

“A major difficulty in examining LGBT health relates to the availability of data for analysis.  According to the Healthy People website, ‘Sexual orientation and gender identity questions are not asked on most national or state surveys, making it difficult to estimate the number of LGBT individuals and their health needs.’  Therefore, the committee believes that HHS should focus on improving and developing datasets that will facilitate analysis of disparities in LGBT health, thereby leading to action that can improve the quality of life and well-being of LGBT populations.”

After providing your email address, name, and (broadly defined) profession, you can download a prepublication draft of the report, “Leading Health Indicators for Healthy People 2020: Letter Report,” at http://www.nap.edu/catalog.php?record_id=13088

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