# Presentation: 263325

## Health Disparities:  Progress, Challenges and OpportunitiesLesbian Health

- 19th National Conference on Chronic Disease Prevention and Control
- March 1, 2005

- Atlanta Lesbian Cancer Initiative

## Overview

- Last ten years show some progress in lesbian health research
- Evidence shows lesbians may be at higher risk than heterosexual women for many chronic diseases
- Homophobia is a health risk
- Grassroots efforts are leadingthe way

- Atlanta Lesbian Cancer Initiative

## Progress has been made in recognizing lesbians as a target population

- 1985 – National Lesbian Health Care Survey
- 1994 – National Institute of Health (NIH) includes lesbians and bi-women in Women’s Health Initiative Study
- 1997 – Institute of Medicine (IOM) Committee on Lesbian Health Research Priorities convened
- 1997 – CDC’s National Breast and Cervical Cancer Prevention  Program (BCCP) includes lesbians as priority population
- 2000 – Gay and Lesbian Medical Assn., with HHS funding, publishes Healthy People 2010 Companion Document for LGBT Health
- 2000 – U.S. Census first begins to track same-sex couples

- Atlanta Lesbian Cancer Initiative

**Notes:**
600,000 same gender couples, 49% were female.  Every county in the US except 11.

## 
Childbearing
Routine screening
Insurance
Unhealthy behaviors
Access to care

- Childbearing
- Routine screening
- Insurance
- Unhealthy behaviors
- Access to care

- Factors affecting lesbian health

- 1985-1995 pooled survey data for lesbians1994 NHI Survey and 1984-1994 Nat’l Health and Nutrition Examination Survey III,
-  Cochran and Mays, Am J Pub Health, 2001

- Atlanta Lesbian Cancer Initiative

**Notes:**
Lesbians more likely to be childless or delay childbirth until after 30.  Childbirth and breastfeeding before thirty reduce risk of breast cancer. 
Lesbians less likely to receive routine gynecological services (birth control, prenatal care), therefore less likely to be screened.
Lesbians more affected by women’s lower earning power, do not have benefit of spousal health insurance coverage
Are more likely to have a higher BMI, drink alcohol or use tobacco regularly.
Lesbians access healthcare less frequently than straight women because of past experience or anticipation of discrimination.  Urban lesbians have it better.

## Lesbians report negative experience of healthcare

- “A soon as I said I was a lesbian, the nurses started giving me disgusted looks.”
- “You’d get poorer care if they knew you were a lesbian.”
- “It’s like putting your life in the hands of someone who really hates you.”

- Stevens, P.E. and S. Morgan (2001). J Pediatric Health Care 15(1): 24-34

- Atlanta Lesbian Cancer Initiative

## Homophobia is a health hazard

- Being gay or lesbian is not inherently hazardous to health
- Homophobia – external and internalized – must be recognized as a legitimate health hazard

- Atlanta Lesbian Cancer Initiative

## Opportunities and Next Steps 

- Education efforts are increasing
- Community-based efforts continue to grow
- There is increased support from some on the national level
- We need to know more

- Atlanta Lesbian Cancer Initiative

**Notes:**
Education, both of women in the community and healthcare providers.
24 member organizations in the National Lesbian and Feminist Health Coalition.  All are involved in provider training, community education efforts.
Nationally, on-going support of CDC’s Breast and Cervical Cancer Early Detection Program, American Cancer Society and Susan G. Koman  Breast Cancer Foundation and Ovarian Cancer Alliance.
Research needs – inclusion of sexual orientation questions in general women’s studies, long-term studies that explore the full range of sexual orientation and it’s impact on health,  consider full racial, ethnic and social–economic diversity in lesbian community

## Questions or Comments?

- Linda Ellis, MEd, MDiv
- Executive Director
- Atlanta Lesbian Cancer Initiative
- www.alci.org

- Atlanta Lesbian Cancer Initiative