People who identify as LGBTQ+ often have unique health care needs. However, this community is experiencing health inequities that make it more difficult for them to get the individualized care they need, worsening their health outcomes.
“The greatest disparities are seen in areas such as behavioral and mental health, physical health, and in overall access to care,” said Dr. William Lopez, a national medical director at Evernorth Health Services. “This community is at higher risk for certain health conditions and is more likely to experience access issues that stem from stigma, discrimination, and institutional bias in the health care system. Other causes for these disparities include restrictive health benefits, a lack of clinical research and expertise on LGBTQ+ health-related issues, and social determinants of health.”
Compared with the majority of Americans, LGBTQ+ individuals have a harder time finding providers who understand them, make them feel seen, and make them feel heard. This lack of understanding, coupled with fear of discrimination and being less likely to have health insurance coverage, often leads to delayed care.
Let’s take a look at some of the areas where we are seeing greatest disparities and explore what we as a health care industry can do to remove these barriers to care.
LGBTQ+ people are at greater risk for mental health challenges and certain health conditions
Stigma and discrimination put LGBTQ+ people at greater risk of developing suicidal thoughts, mood disorders, anxiety, eating disorders, alcohol and substance misuse, and tobacco use. Research also shows that people who identify as LGBTQ+ are more likely to develop certain health conditions. For example, lesbian and bisexual women are at greater risk for breast and certain gynecological cancers but less likely to be screened than their heterosexual counterparts. Additionally, according to the American Heart Association Meeting Report, LGBTQ+ adults have a higher risk of heart disease and cardiac issues than heterosexuals. These increased risks are due in part to institutional bias in the health care system, which leads to challenges in accessing quality, culturally competent care.
Next steps for health plans
Health plans can help close gaps in care by implementing strategies to improve access to health care for LGBTQ+ individuals – particularly for preventive care. Strategies may include expanding in-network access to LGBTQ+ friendly health providers, providing training and educational resources to in-network clinicians, and offering greater access to education and resources for LGBTQ+ patients and their caregivers about how to navigate the health care system. Designing inclusive benefits is also key, as is partnering with nonprofit organizations, such as OUT Maine, and The Trevor Project, to name a few, to reduce health disparities for this group of individuals.
“It’s going to take a village,” said Dr. Luis Torres, Evernorth behavioral health equity medical director and former CEO Action for Racial Equity Fellow. “Health equity can only be achieved when every person, regardless of their gender identity or sexual orientation, has the same ability to reach their highest health potential. We must work together as a health care ecosystem to ensure that we are doing all we can. Education, training, resources, and support for patients, their employers, and health care providers is key.”
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