BY KAYLEE DUFF
(Photos courtesy of Jerry Mallicoat)
This health alliance in southwestern Ohio is paving the way for more comprehensive and culturally competent healthcare targeted towards the LGBTQ+ community.
In April 2018, Public Health Dayton & Montgomery County (PHDMC) started the LGBTQ Health Initiatives Program in response to the staggering health disparities in the community. Their motivations were the LGBTQ community’s tortured healthcare history, the minority stress model approach that explains minority health disparities, such as higher risks of some cancers and diabetes in lesbians, higher risks of HIV and other STDs in gay men and queer folks of color, and higher rates of smoking, substance abuse/addiction and suicide. The overall goal is to help improve the health of LGBTQ people across their lifespan — whether it’s LGBTQ parents with a newborn or an older adult needing home care.
Today, the LGBTQ Health Initiatives effort is led by Jerry Mallicoat and a coalition of six action teams known as the LGBTQ Health Alliance. Jerry has been involved with the LGBTQ+ community around the area for several years, and relied on his experience with major healthcare organizations and a network of community activists and colleagues to select the people and organizations serving with the Health Alliance.
“We wanted people who could influence their organizations and who also have personal credibility and influence as individuals in the community,” Jerry explained. “We also wanted to ensure that we took a multicultural and intersectional approach to building the Alliance as well.”
This included identifying LGBTQ+ people and organizations (like local LGBTQ+ service organizations and nightclubs), allies and people from other communities (such as representation from the Muslim community). According to Jerry, the group is “truly an impressive cross-section of people and organizations.”
Each action team has a specific focus, and is tasked with engaging the community to address issues. The LGBTQ Health Initiatives Alliance currently is made up of six teams:
- Cultural competence
- Transgender issues
- Mental health, substance abuse and violence
- Outreach and awareness
The action items were determined through a prioritization survey taken by Alliance members towards the beginning stages of the initiative. Members ranked items in order of importance, and were given the opportunity to make suggestions and offer additional information. They were then sorted into teams based on their ranked priorities. Two items (LGBTQ equity in childhood adoption processes and prevalence of tobacco use) were deferred; PHDMC is working on customizing existing smoking cessation programs and finding local partners to address adoption issues in the near future.
Some of the action teams already have big plans in the works — and the other teams aren’t far behind.
The action team working with aging is currently planning an LGBT aging conference, called LGBT Horizons of Aging Summit on Feb. 11 and 12, 2019. “Older people in general get marginalized and that is more prevalent with older LGBTQ people, who face higher risk of isolation due to discrimination and stigma and because many lack the traditional support networks of family and children,” the Aging Team said.
The conference is aiming to educate senior service providers, the healthcare community, and older LGBTQ adults on such issues, and will involve several local organizations. “We want older LGBTQ adults to be able to live safe and affirmed lives as they age, using the resilience and crisis competence they developed gained by fighting for equality and surviving throughout their younger years,” they explained. The Aging Team is also forming groups to explore affordable LGBTQ-inclusive senior housing and to help field a survey to assess the needs of local older LGBTQ+ adults.
Another action team is addressing the needs of LGBTQ+ youth, working with local gay-straight student alliance groups to determine priorities. The Youth Action Team is working with an Alliance member from Dayton Public Schools to plan an LGBTQ+ youth discussion panel at the upcoming Ohio School Nurse Association Conference in Dayton in March 2019.
“Across all channels of learning and communication, one important theme emerges: there is a dearth of culturally competent care in our community.” This is the reason that one action team is addressing cultural competence when it comes to LGBTQ-targeted healthcare. The Cultural Competence Action Team has already started developing LGBTQ+ cultural competence training and community outreach. “This is a major undertaking that, once implemented, will change the landscape of care for LGBTQ people in our area,” they said.
The other three groups — focusing on Transgender Issues; Mental Health, Substance Abuse and Violence; and Outreach/Awareness — are still working on developing their approaches to addressing their areas of need. “There is serious misunderstanding among the general public — and even in the LGBTQ community — about transgender identity,” said the Transgender Issues Team. “Healthcare issues tend to be more complex for transgender people and they experience extreme discrimination and lack of knowledge among healthcare providers.” For this reason, they are relying heavily on the personal experiences of trans people, in order to determine what next steps to take.
The Mental Health Team is working to address disparities pertaining to mental health issues, such as depression, caused by the negative stigma surrounding and abundant discrimination against the LGBTQ+ community. They are focusing on prevention and addressing unhealthy coping mechanisms, such as substance abuse or smoking, as well issues such as suicide, abuse and violence, as well as self-harm.
Although each team is working together towards one main goal — better healthcare for the local LGBTQ+ population — the Outreach/Awareness Team will promote team efforts in order to get the word out about services, events and culturally competent care. “There is still education needed to help dispel stereotypes and myths about LGBT people, and to help make LGBT people aware of the health services available to them,” they explain. “If LGBT people know that service and healthcare providers are LGBT culturally competent and affirming, then people will more likely seek out the services and health care that they need versus being fearful or avoiding care.”
Looking forward, the Health Alliance expects to have a lasting beneficial effect on the local community. “We expect that the teams will help create a safety net of care/support for LGBTQ people who may be struggling to receive the culturally competent care and services they need or who may have financial challenges in accessing care,” Jerry said. They want to be able to connect community members to qualified services and healthcare professionals that can provide effective care.
The Health Alliance is one of the first in the state (Columbus started a similar collaborative effort a few years ago), and expectations are high. “Everyone is really excited to be involved and anxious to accomplish things, but at the same time, we are treading on new ground and still feeling our way a bit,” Jerry admitted. “But there is such wonderful expertise and passion among our Alliance members that it is really motivating and fulfilling — sometimes overwhelming to the point of happy tears.”
He continued: “Communities are sustainable only through collaboration. There is tremendous truth in the adage ‘it takes a village’ and that certainly is true when it comes to good health. When people build something together and take ownership, then there is the opportunity for lasting effect and impact.”
The PHDMC LGBTQ Health Initiatives are a shining example of the good that is born from diverse and intersectional parties coming together for the benefit of the community. In a perfect world, all healthcare around the world would be equitable and comprehensive, but until then, the community is grateful for efforts such as this groundbreaking
Visit the PHDMC LGBTQ Health Initiatives website at www.phdmc.org/client-services/lgbtq-care for more information and resources.
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