LGBT Health Disparities: Opportunities for Engagement June 16, 2015

Tobacco Cessation Tuesdays Webinar

Juan Carlos Vega, MLS Policy Manager, LGBT HealthLink

Danya Institute

We will will cover cover… We 

LGBT Language 101

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LGBT Health Disparities LGBT Smoking Prevalence

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Why do we smoke more?

LGBT Cancer Disparities Strategies to Reach Out to LGBT Communities Promising Practices and Other Resources for Inclusion of LGBT Communities in Your Programs

Language 101 Excerpted from: A providers Introduction to Substance Abuse Treatment for LGBT Individuals, training curriculum.

Defining Our Terms Sexual   

Orientation

lesbian gay bisexual

Gender 

Identity

transgender

We are on a Continuum

Descriptors & Categories SEX (category)  Male (descriptor)  Female SEXUAL ORIENTATION 

Lesbian

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Gay

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Bisexual

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Heterosexual

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Queer

GENDER/GENDER ROLE  Male  Female  Masculine  Feminine GENDER IDENTITY  Transgender  Transsexual  Male  Female  Queer or Genderqueer

LGBT Health Disparities

LGBT Health Concerns

Tobacco Alcohol Drugs Mental Health

HIV Cancer

Current State Nondiscrimination Laws Courtesy of the National Gay and Lesbian Task Force, as of May 21, 2014

Blue = States banning discrimination based on sexual orientation and gender identity Pink=Laws banning discrimination based on sexual orientation

How many people are affected? 

There are an estimated minimum of 9 million LGBT persons in the U.S.

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This is roughly equivalent to the population of the state of New Jersey

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The Census does not count LGBT people, but does count same sex couples, if we use these couples as a proxy for all LGBTs, we then know LGBT people are found in all

Congressional districts in the U.S.

Mental Health

Alcohol/Drugs It is estimated that between 20-30% of LGBT people abuse substances, compared to about 9% of the general population.

Approximately 25% of LGBT people abuse alcohol, compared to 5-10% of the general population

LGBT Smoking Prevalence (a.k.a. Why are we here?)

LGBT Tobacco Disparity National Adult Tobacco Survey data found that LGBT people smoke at rates 50% higher than the general population

Why LGBT people smoke more

#1: Stigma

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Discrimination is all too common for some LGBT people.

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Homophobia and transphobia contributes to higher levels of substance abuse as a coping strategy.

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These challenges can be compounded for LGBT of color.

#2: Youth coming out LGBT youth most often come out in their late childhood through teen years. The stressors of coming out occur just when the youth is at greatest risk for smoking uptake.

#3: Where are LGBT people? 

Historically, a primary social outlet for LGBT folks are bars and clubs, where drinking and smoking are prevalent and used as tools for socializing and meeting people.

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Even as we have more options for gathering with LGBT people, like at community centers, smoking for us is still a socially transmitted disease.

#4: Tobacco companies love to target us. 

Big Tobacco has successfully targeted our communities

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They are good at twisting our civil rights messages to look like pro-tobacco messages

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How do they target LGBT Communities? •

Pride and event sponsorship

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Bar promotions and giveaways

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Customized ads in LGBT magazines

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Underwriting events at community organizations

Industry targeting campaign

"Project SCUM" focused on the gay community in the Castro and homeless people in the Tenderloin, both neighborhoods of San Francisco. The documents recount how one tobacco company tried to capitalize on what it called "consumer subcultures" to boost sales of its cigarettes among San Francisco's gay and homeless people in the 90s. American Legacy Foundation

Industry targeting ads

1995 Parliament promotion Details, Cosmopolitan, Mademoiselle, Penthouse… and Out Magazine

Industry targeting ads

1990’s Virginia Slims Campaign

PhilipMorris brand, L&M, published in European magazines, 2001

Industry targeting ads

Industry Sponsorship

#6: Smoking is not a primary issue

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In a recent survey, 7 out of 10 LGBT men and 4 out of 5 LGBT women thought smoking was no bigger problem for LGBTs than everyone else

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In another survey, half of the LGBT smokers felt the LGBT community should not publicly counter the tobacco industry

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Our leaders rarely see it as a priority: UCSF researchers found that only 17% of 75 LGBT community leaders listed tobacco as a top three LGBT health issue.

LGBT Cancer disparities across the continuum risk

screening

survivorship

Increased Risks Tobacco Alcohol

Obesity Nulliparity

HPV HIV

Decreased Screening

Mammograms Cervical pap smears Anal pap smears Colonoscopies

Incidence/Prevalence

Survivorship

Resources and strategies for inclusion of LGBT communities in your health programs, work plans, and coalitions

Reach out & connect locally

Community Centers are an excellent first connection… • • •

Existing and established community relationships Wellness, substance-abuse programs, resources, and referrals Any community centers in your state?

www.lgbtcenters.org

Do you collect LGBT data on your program? (i.e. sexual orientation and gender identity)

Polling question

Opportunities for Engagement      

Do you co-brand with LGBT trusted groups? Do you promote through LGBT media channels? Do you include LGBT goals in your action plans? Do you run LGBT breakouts on all evaluation reports? Do you have LGBT people included in your community advisory body? Are you collecting LGBT resources for referrals?

Other Strategies 

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Understand access to barriers Enhance and create welcoming environment at your organization Is it safe for LGBT employees?  Do

LGBT employees feel safe coming out?  Do LGBT employees feel safe including LGBT focus in their work?  Do you have a mechanism for using your LGBT employees as in-house experts on this subpopulation?

LGBT Pride Events

LGBT Pride Events

LGBT Pride Events

LGBT Quitline Campaign

CDC Campaign – LGBT focus

CDC Tips Campaign – LGBT focus

Cancer Resources

Contact LGBT HealthLink We link people and LGBT wellness information. We promote adoption of best practices in health departments and community organizations to reduce cancer and tobacco disparities. We build community wellness through: 

Training

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Education

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Policy change

Current LGBT health news & awareness highlight LGBT cancer and tobacco issues

Innovative media use CDC Spreads Tips From Former Smokers Campaign to Reach LGBT Communities PRESS RELEASE April 7, 2015 For Immediate Release Contact: Dr. Scout (954) 765-6024 [email protected]

Blog stories

Share your story! Checkout what other state programs are doing to reach out to LGBT communities!

HealthLink Resources  Motivational

 Needs

assessment model

 Sample  LGBT

quitguide pamphlet

non discrimination policies

welcoming posters

 Coming

soon: Cancer action plan

 Coming

soon: Best practices for cancer

Order educational materials

www.lgbthealthlink.org

Link with Us Web: http://www.lgbthealthlink.org/ Blog: http://blog.lgbthealthlink.org/ Facebook: LGBT HealthLink Twitter: @LGBTHealthLink

E-mail: [email protected] Phone: (954) 765-6024 Contact: Juan Carlos Vega, Policy Manager