Task Force Reports

Health Initiatives Task Force

New efforts are afoot to address LGBT health disparities.

By Edward J. Callahan, PhD, and Linda Travis, PhD

The 2013-2014 academic year has been an active and exciting one for the Health Initiatives Task Force. Recognition that LGBT populations experience serious health disparities (Institute of Medicine, 2011) has raised an ethical obligation for medicine to improve care for LGBT patients (Callahan, Hazarian, Yarborough, & Sanchez, in press). In response to recognition of these health disparities, the University of California, Davis Health System has become the first academic health center in the nation to include sexual orientation (SO) and gender identity (GI) demographics in its electronic health record (HER; Callahan, Henderson, Ton, & MacDonald, in press). Inclusion of these data in the medical record requires careful monitoring of access to the EHR for patients who self-disclose to assure there is no inappropriate access to these data. Critically, successful adoption of SO/GI demographics cracks the door for enhancing quality of care for LGBT patients through systematic prevention and intervention efforts. Opening that possibility will likely trigger other health systems to undertake similar efforts. Such efforts require considerable effort on the part of the institution to explore its policies and procedures to assure that LGBTIQ patients are treated fairly, and that LGBTIQ faculty, staff, learners and patients are not mistreated as well (Callahan, Henderson et al., in press; Snowdon, 2014).

During the past academic year, there have been concerted efforts in alignment with the Association of American Medical Colleges Group on Diversity and Inclusion to celebrate National Come Out for Your Health Week. At UC Davis Health System and other institutions, the celebration has expanded from earlier National Coming Out Day events to celebrate all ethnicities and minority groups, including differently abled groups, veterans and others often overlooked as diverse. This second consecutive celebration presses forward on the ideas of celebrating all diversity with outreach from LGBTI organizers to the other diverse groups in the institution.

Collaboration with AAMC resulted in the first national survey of second-year medical students to include demographic questions on sexual orientation. More medical students refused to report their ethnicity than refused to report their sexual orientation/gender identity. LGBT students reported higher levels of feelings of isolation, echoing the responses of students of color and first generation college students studying medicine (Sondheimer, Koenig, Caulfield, Roskovensky, & Callahan, 2014). Each medical school in North America will get feedback on the adjustment and engagement of its LGBT students at least every two years from this point forward. These data will be available to medical school applicants as they consider where to apply to study. At the same time, the first exploration of LGBT faculty in a medical school was conducted, showing that LGBT faculty were more engaged with their departments than their peers, but also demonstrating that they gave more consideration to leaving their faculty appointments (Gordon, 2013).

Finally, 2014 marked the 2 nd Annual LGBT Health Workforce Conference in New York City in May (Sanchez, Sanchez, Lunn, Yehia, & Callahan, 2014). Two hundred and fifty health care providers and students explored issues including whether it is safe to be out while applying for training or being in training, health needs for LGBT populations, special needs for trans patients, and work on the LGBT workforce pipeline. There is a lot happening and a need for more psychology presence as key providers of healthcare.

During this past year, Ed Callahan was elected western regional representative to the Steering Committee of the Group for Diversity and Inclusion of the Association for American Medical Colleges. Linda Travis was elected secretary of Div. 44 and to membership on the Board of Director of GLMA (formerly the Gay and Lesbian Medical Association), a group which also welcomes LGBT members.

References

Callahan, E.J., Sitkin, N.A., Ton, H., Eidson-Ton, W. Weckstein, J., Latimore, D., (In press). Introducing sexual orientation and gender identity into the Electronic Health Record: One Academic Health Center's experience. Academic Medicine .

Callahan, E.J., Hazarian, S., Yarborough, M., Sanchez, J.P. (In press). Medicine's ethical obligation to eliminate LGBT health disparities: The associated roles of electronic health records and institutional culture. Hastings Center Review .

Callahan, E.J., Henderson, C., Ton, H., & MacDonald, S. (In press). Utilizing the Electronic Health Record as a tool for reducing LBGTI health disparities. In J. Ehrenfeld and K. Eckstrand, LGBT Health .

Gordon, L. (2013, May). LGBT faculty satisfaction and engagement . Paper presented at AAMC Group on Diversity and Inclusion Meeting, Toronto, Ontario, Canada.

Institute of Medicine. (2011). The health of lesbian, gay, bisexual, and transgender people: Building a foundation for better understanding . Washington, DC: National Academies Press.

Sanchez, N.F., Sanchez, J.P., Lunn, M.R., Yehia, B.R., & Callahan, E.J. (2014). First annual LGBT health workforce conference: Empowering our health workforce to better serve LGBT communities. LGBT Health, 1 (1), 62-65.

Snowdon, S. (2013). Recommendations for enhancing the climate for LGBT students and employees in health professional schools . Retrieved June 16, 2014, from http://www.glma.org/_data/n_0001/resources/live/Recommendations%20for%20Enhancing%20LGBT%20Climate%20in%20Health%20Professional%20Schools.pdf

Sondheimer, H., Koenig, T.W., Caulfield, M., Roskovensky, L. , & Callahan, E.J. (April, 2014 ). The medical student surveys evolve: A first look at the new second year survey. American Association of Medical Colleges: GDI/GSA/OSR National Meeting, San Diego, CA.