COVID-19 changed everything. Almost one year later, we are still amid a global pandemic, but with the new vaccines, we have the hope of an end in sight. The United States has lost more than 460,000 people to COVID-19, with clear disparities among marginalized communities.
Prior to COVID-19, discussions about health inequity were held largely among public health and health equity leaders, who have long advocated for change. If there is a silver lining, it is that the pandemic caused our health care system to begin grappling with the inequities that have existed in health and social justice for hundreds of years. There is a concerted effort to reduce health disparities, especially with the Biden administration’s inclusion of leaders who understand community health and health equity. New commitments to advance health equity are also being made within local and state governments, public health agencies, health insurers, biopharmaceutical companies, health care technology companies, hospitals and health systems.
A recent study from the US Centers for Disease Control and Prevention (CDC) indicates that people who are part of the LGBTQ community may be more susceptible to contracting COVID-19 and may experience more severe forms of the illness. The CDC’s national health-related telephonic survey, known as the Behavioral Risk Factor Surveillance System, revealed data from the 2017–2019 study showing that the LGBTQ community, regardless of race or ethnicity, reports preexisting health conditions that would make them more susceptible to COVID-19 complications due to asthma, high blood pressure, heart disease and other severe chronic conditions.
The LGBTQ community suffers from greater health disparities in comparison to straight people, and this is no surprise given the amount of discrimination and sexual stigma that occur when LGBTQ people interact with the health care system. Sadly, this isn’t the first time this community has experienced a virus that led to mass casualties. HIV/AIDs was the pandemic for this population in the 1980s and 1990s. There still exists a much higher rate of diagnoses among Black LGBTQ people, constituting 26% of new HIV diagnoses and 37% of new cases among gay and bisexual men.
Despite self-reported behavioral risk data, there are still major gaps in data because sexual orientation and gender identity information isn’t systematically captured in COVID-19 data nor in many other clinical conditions. As a result, the true extent of our disparities is likely underreported, and specific actions to reduce health inequity are obstructed by the lack of data.
Our health care system was not built to be culturally nuanced for marginalized groups, including those with disabilities, people of color, those who speak English as a second language, the LGBTQI population and women. The result is a growing gap in health disparities leading to poor outcomes, negative experiences and increased cost to the health care system.
So, what do we need to do moving forward? As the federal government begins to consider changes in policy related to health equity, the collective voice of the LGBTQI community must be heard. We must influence health care leaders and policy makers to make the elimination of health disparities a priority for ALL communities. COVID-19 has exposed health inequities at a national level, and now is the time for LGBTQI Americans, partnered with other marginalized and intersecting communities, to demand that a more just and equitable public health and health care system be constructed. This also means we must advocate for policy and legislative changes that improve employment, education, housing and other social determinants of health impacting racial, ethnic and
cultural minorities.
Beyond what we ask of our government and the health care system, we should also learn about the various health disparities within our community. According to a study conducted by Lambda Legal (2010), LGBTQ people are less likely to have health insurance and are more likely to be refused health care services and be harassed by health care providers. When it comes to specific conditions, Lesbian and bisexual women have higher rates of breast cancer and gay and bisexual men are more likely to have HIV/AIDS (CDC, 2020). The history of prejudice and discrimination in America underlies many of the social, environmental and political determinants of health within which many vulnerable communities suffer today.
Because of COVID-19 health disparities, we have a unique and timely opportunity to invoke change. Now is the time for us all to take an active role in advocating for equity in health.
Just Health Collective guides organizations in creating cultures of belonging, enabling a fair and just opportunity for everyone to achieve optimal health. For more information, please email info@justhealthcollective.com or visit justhealthcollective.com.