The Impact Of Social Cohesion and Distress On The Health Of Race/Ethnic, and Lesbian, Gay, And Bisexual People

Abstract

Social stress theory posits that minority status (race/ethnic and LGB) can impact both coping resources and health outcomes. The study examines the role social cohesion plays in the health of race/ethnic and lesbian, gay, and bisexual (LGB) populations using data from the 2013-2015 National Health Interview Survey.

The NHIS is a multistage, area probability sample design and is a nationally representative health survey of US noninstitutionalized, civilian population conducted by the National Center for Health Statistics. The total number of cases in all three waves was 104928. Analysis was done using R (v 3.3.3) and Rstudio (v 1.0) for windows. In order to properly analyze NHIS’s sampling design the analysis utilized the Survey package developed by Thomas Lumley for use with surveys with complex sampling designs.

Race/ethnic and sexual minorities reported less social cohesion than white and heterosexual participants, and social cohesion was negatively related to measures of distress, and smoking more than a pack of cigarettes a day.

These findings support the theory in that minority groups have reduced people’s social resources (in this case social cohesion).  Lower levels of social cohesion indicates having not as many social connections and relationships with people their neighborhood.  The experience of being a race/ethnic or sexual minority means isolated from other social relationships, which could impact their access to coping resources like social support. This creates a situation very different from that experienced by White heterosexual men and women.

PDF of my poster:  LGBTQ Health Conference 2017 Lombardi

I wrote “Enhancing Transgender Health Care” around 2000 when I was finishing a post-doc at UCLA.  It was the time when I was just beginning my academic/research career there were very few people doing trans related work let alone being trans identified as well.  The public health field was beginning to take Trans health issues seriously; The American Journal of Public Health also published an important needs assessment of trans women and HIV and the the American Public Health Association published a policy statement in 1999 supporting greater support for trans research and clinical care.

Since then there has been slow improvement in regards to trans health issues thanks to the growing number of trans health activists, academics, and clinicians and allies.  There has been movement in the inclusion of trans measures in national health surveillance (it has been included in HIV surveillance for awhile) and health plans are beginning to include trans health care.  That is not to say that everything is going well.  While things have been improving for some, many trans people (especially trans women of color) still experience an excessive amount of discrimination and violence.

The change in administration may also mean reduced support (if not reversal) of many of the trans supportive activities that has happened in the past eight years (Thanks Obama!).  The growing trend of legislation preventing trans people access to public accommodations based on their gender (“bathroom bills”) is also troubling.

So, while I’m happy to see an older paper of mine get new life, it is a reminder to me of what more needs to be done and in defending what has already been accomplished.

http://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2016.303598

http://www.liebertpub.com/overview/transgender-health/634/

Transgender Health is one of the newer Journals publishing original research on transgender health issues.  Robert Garofalo is its Editor-in-Chief and has been involved in transgender health research as well as providing health care to transgender people for many years.  We talk about the journal and about trans health research in general.  The journal is looking for data driven manuscripts, short reports, and perspectives.

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This is an interview I did Alana Jochum, Executive Director of Equality Ohio last month.

We talked about a legislative actions that have been and will be occurring this summer, notably Equality Ohio’s Summer of Action.   Since the interview Cleveland City Council approved and the Mayor signed the legislation that changes the city’s anti-discrimination policy to protect people on the basis of their gender identity and expression in public accommodations.

More information on what Equality Ohio has been doing can be found on their website.

Information on their summer of action can be found here, and on Facebook

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Research concerning the health issues of lesbian, gay, bisexual, transgender, and intersex (LGBTI) individuals has been very limited and more work is needed to better understand the health needs of LGBTI populations. This was the finding of an Institute of Medicine (IOM) 2011 report written at the request of the National Institutes of Health (NIH). Since then, academics, researchers, and government officials have been working to improve the state of LGBTI health research.

(Link: http://www.iom.edu/Reports/2011/The-Health-of-Lesbian-Gay-Bisexual-and-Transgender-People.aspx)

With this in mind, representatives from Baldwin Wallace University, Cleveland State University, and MetroHealth Medical Center have organized a conference to provide people (students, researchers, and community members) an opportunity to learn more about LGBTI health research. Speakers from across the United States will discuss their work. The conference will be able to provide students, researchers, and community members with opportunities to learn more about LGBTI health research, to network with existing researchers, and learn of opportunities for training in LGBTI health research.

The conference will be held August 7-9, 2014 at Baldwin Wallace University (Center for Innovation & Growth (CIG), 340 Front Street, Berea, OH 44017). The conference is free and open to students, researchers, academics, and community members.

Registration:

https://www.eventbrite.com/e/conference-on-current-issues-in-lesbian-gay-bisexual-transgender-and-intersex-lgbti-health-research-registration-11575064329

Contact:

Emilia Lombardi, PhD

elombard@bw.edu