Main Body
Cultural Humility and LGBTQ Communities in the Healthcare Environment
Julia Applegate
Introduction
Over 10 million people in the United States over the age of 18 identify as LGBTQ (Gates, 2017). Due to systematic inequities, disparities, and injustices, the LGBTQ community is disproportionately affected by physical and mental health illnesses, are less likely to have health insurance, and experience worse health outcomes compared to the general population. Despite being a population with pronounced healthcare needs, LGBTQ individuals face a lack of culturally humble and structurally competent providers, which further increases their obstacles to accessing and securing safe and high-quality health care.
Equitas Health is a health care delivery system with 17 offices in 11 cities serving 67,000 individuals on an annual basis across the state of Ohio. With nearly 400 employees, Equitas Health employs nurses, social workers, physicians, pharmacists, HIV prevention specialists, and a wide range of other staff devoted to taking care of the LGBTQ Community, People Living with HIV (PLWH) and anyone looking for a medical home. The organization also provides education and training for health and social service providers, and for community members, who identify as LGBTQ. These services are provided through the Equitas Health Institute for LGBTQ Health Equity. In the two years since the formation of the Institute, over 5,700 providers in settings as diverse as a children’s hospital, an adolescent inpatient psychiatric facility, a home health agency, countless college classes, and a veterinary clinic have been conducted in an effort to decrease the many health disparities experienced by LGBTQ community members.
This chapter explores in depth the tactics deployed by Equitas Health and the Institute for LGBTQ Health Equity to activate its mission of providing ‘Care to All’ in the most culturally humble and inclusive manner for serving LGBTQ communities.
A Case Study on Leadership Best Practices for Serving the LGBTQ Population
Health Disparities in the LGBTQ Community
Among the health disparities experienced by the LGBTQ community, LGBTQ people experience a disproportionate amount of suicide, homelessness, mental health challenges, breast and cervical cancer, HIV and other STIs, as well as obesity, tobacco, alcohol and other substance abuse. The transgender community is at even greater risk for many of these concerns than their lesbian, gay and bisexual counterparts. While some of these health disparities are a result of behavior, the vast majority of them are associated with social and structural inequities resulting from institutionalized homophobia, transphobia, stigma and discrimination levied against LGBTQ people. The health disparities experienced by LGBT people can be grouped into four basic categories; (Healthypeople.gov, 2010)
1. Infectious Disease
2. Chronic Disease
3. Behavioral Health
4. Quality of Life Issues
The LGBTQ community is less l