IOM LGBT Health Report

 

Institute of Medicine issues historic report on LGBT health issues

Dr. Bradford and Dr. Makadon from The Fenway Institute served on 17 member committee that assembled report

The Committee on Lesbian, Gay, Bisexual, and Transgender (LGBT) Health Issues and Research Gaps and Opportunities at the Institute of Medicine (IOM) of The National Academies advanced the future of LGBT health research today with the release of The Health of Lesbian, Gay, Bisexual, and Transgender People: Building a Foundation for Better Understanding.  This historic report will guide the National Institutes of Health (NIH) as they design and fund research projects aimed at documenting and addressing LGBT health disparities. 

It is likely that other federal agencies and the United States Congress will also take notice of the Committee’s findings and consider ways to identify strategies to improve both the education of health care professionals as well as improving access to preventive and health care services. Consistent with the goals of the affordable care act, this report also will provide tools to begin to do work on improving the health of LGBT populations.   

Recent findings on the differences in heart disease among women and men and among blacks and whites show that characteristics such as gender and ethnicity matter when it comes to health research. The IOM report acknowledges that LGBT people have unique health experiences and needs, but that as a nation we lack a good understanding of what these experiences and needs are.  It also recommends steps to ensure that clinical researchers identify and address these needs.  Judith B. Bradford, PhD, and Harvey J. Makadon, MD, of The Fenway Institute both sit on the 17 member IOM Committee that issued the report. 

Recommendations included in the report:

  • Researchers must engage LGBT people in health studies and collect data on these populations to identify and better understand health conditions that affect them.
  • Federally-funded surveys should proactively collect data on sexual orientation and gender identity, just as they routinely gather information on race and ethnicity.
  • Information on patients’ sexual orientation and gender identity should be collected in electronic health records, provided that privacy concerns can be adequately addressed.
  • The National Institutes of Health should support the development of standardized measures of sexual orientation and gender identity for use in federal surveys and other means of data collection.
  • The NIH should provide training opportunities in conducting research with LGBT populations and encourage grant applicants to address how their studies would include or exclude sexual and gender minorities.

The Committee on LGBT Health Issues and Research Gaps and Opportunities was formed a year ago in response to a request from the U.S. Department of Health and Human Services for guidance on researching LGBT health issues.  The committee conducted an extensive review on the health status of lesbian, gay, bisexual, and transgender populations in preparation for issuing their recommendations.  The committee worked to identify research gaps and opportunities related to LGBT health and to outline a research agenda that will assist NIH in enhancing its research efforts in this area.  The committee also examined research training needs aimed at fostering the advancement of knowledge about LGBT health to identify impediments that hinder such advancement. 

In doing this work, the committee noted that:

  • Research has not been conducted evenly across sexual and gender minority populations, with more research focusing on gay men and lesbians than on bisexual and transgender people.
  • Research has not adequately examined subpopulations, particularly racial and ethnic groups.
  • Most research has been conducted among adults, with a modest number of studies on adolescents and less attention on LGBT elders.

From the available research, the committee found that:

  • LGBT youth have an elevated risk for attempted suicide and depression, and sexual minority youth may have higher rates of substance use than heterosexual youth.
  • One of the barriers to accessing quality health care for LGBT adults is a lack of providers who are knowledgeable about LGBT health needs as well as a fear of discrimination in health care settings.
  • LGBT elders are more likely to rely on friends and others as caregivers than biological family members, at least in part because they are less likely to have children.

The Committee’s report is the latest in a series of milestones in federal recognition of LGBT people as a population with specific health needs.  Some highlights include:

  • In December 2010, the federal government released Healthy People 2020, the blueprint for national public health prevention and policy goals for the next decade, had historic inclusion of LGBT populations. 
  • In July 2010, the White House issued a National AIDS Strategy with a specific focus on reducing HIV infections in gay and bisexual men and transgender people.
  • In April 2010, President Obama issued an executive order on hospital visitation rights for same sex couples. 

“It was a great privilege to participate in the IOM process.  At The Center for Population Research in LGBT Health at The Fenway Institute, we are constantly trying to centralize and improve data on the health of LGBT US residents so that there is a better understanding of the health needs of our community,” said Judith B. Bradford, PhD, Director of the Center for Population Research in LGBT Health and Co-Chair of The Fenway Institute.  “The IOM report assembles existing research and makes recommendations for next step priorities.  This provides a framework for identifying and reducing health disparities among sexual and gender minorities and directly supports the health of our community.  It is truly historic.”

“It is incredibly gratifying to be part of the team that helped assemble this historic Institute of Medicine report,” said Harvey J. Makadon, MD, Director of Education and Training at The Fenway Institute.  “This effort is clearly an important first step to creating an agenda that will advance the health of LGBT individuals. Aside from a research agenda, we must recognize the importance of educating health professionals about LGBT issues and creating welcoming environments for care.  Studies show a reluctance to care for LGBT individuals and education about LGBT health issues in medical schools and schools for other health professionals is minimal.” 

Judith B. Bradford, PhD is Director of the Center for Population Research in Lesbian, Gay, Bisexual and Transgender Health at The Fenway Institute, funded by the Eunice Kennedy Shriver National Institute for Child Health and Human Development.  She is also Co-Chair of The Fenway Institute.  Harvey J. Makadon, MD is Director of Education and Training at The Fenway Institute and is lead editor of The Fenway Guide to LGBT Health, published by the American College of Physicians in 2007.  He is also a Clinical Professor of Medicine at Harvard Medical School.  A complete list of IOM Committee members is available online.

The National Academies was chartered in 1863 under President Abraham Lincoln as the National Academy of Sciences.  It has since expanded and is now known collectively as The National Academies, which perform an unparalleled public service by bringing together committees of experts in all areas of scientific and technological endeavor to serve as advisors to the nation on science, engineering and medicine. These experts serve pro bono to address critical national issues and give advice to the federal government and the public.  Four organizations comprise the Academies: the National Academy of Sciences, the National Academy of Engineering, the Institute of Medicine and the National Research Council.

The Institute of Medicine is an independent, nonprofit organization that works outside of government to provide unbiased and authoritative advice to decision makers and the public.  Established in 1970, the Institute of Medicine is the health arm of the National Academies.

For nearly forty years, Fenway Health has been working to make life healthier for the people in our neighborhood, the LGBT community, people living with HIV/AIDS and the broader population.  The Fenway Institute at Fenway Health is an interdisciplinary center for research, training, education and policy development focusing on national and international health issues.

 

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