Improving LGBT Health: The 2012 Department of Health & Human Services (HHS) Annual LGBT Report

This Alert highlights elements of the 2012 annual report of the Coordinating Committee of HHS on improving the health and well being of the Lesbian Gay Bisexual and Transgender (LGBT) community.[1]   This Alert also highlights work identified by HHS in its 2011 annual report, as that work anchors the agency's goals for 2012. 

Background

In 2010, the Obama Administration advised HHS to develop strategies centered on improving the health and well being of lesbian, gay, bisexual and transgender (LGBT) Americans.[2]  In response, Secretary Kathleen Sebelius created a department-wide committee to address specific health and wellness issues relevant to LGBT individuals.  The 2011 and 2012 reports are part of an overall effort to advance equality and expand opportunity for LGBT individuals.[3]

The HHS objectives focus on the importance of including LGBT individuals in the process of addressing the healthcare challenges faced by their community.  Similarly, the initiatives highlighted in the committee report provide opportunities to reduce health disparities among LGBT people, offer greater access to resources, and concentrate efforts in areas most relevant to the needs of LGBT Americans.

2011 Accomplishments

HHS identified seven core areas to address regarding improvements to the health and quality of life for LGBT individuals: research, LGBT children & families, cultural competency, anti-violence efforts, the Affordable Care Act (ACA), funding opportunities, and outreach.[4]  As a result, attention has been directed to:

• Including LGBT health data in national health surveys and reports;
• Encouraging the Administration on Children & Families (ACF) within HHS to focus on the protection and support of LGBT children and youth in the foster care system;
• Strengthening the Center for Medicare & Medicaid Services' (CMS) stance on assuring the rights of same sex partners to participate in medical decision-making;
• Establishing federal protection of spousal assets to same sex couples;
• Making funds available through agencies such as Health Resources & Services Administration (HRSA) and the Substance Abuse & Mental Health Services Administration (SAMHSA)for cultural competence trainings and publications to the healthcare community;[5]
• Increasing LGBT visibility within violence awareness campaigns such as domestic violence, bullying, and suicide prevention through specific inclusion of LGBT populations;
• Highlighting provisions under the Affordable Care Act (ACA)[6] that will extend healthcare coverage to LGBT individuals;
• Creating funding opportunities to benefit LGBT communities and organizations;
• Expanding outreach efforts to the LGBT community through information sharing, stakeholder feedback, and creating public engagement efforts.

Of critical importance for LGBT advocates is the CMS position on medical decision-making, allowing LGBT couples greater flexibility to make care decisions for their loved ones.  Similarly, it is important that LGBT patients and their families are more recognized in health care service delivery environments and approaches, including the development of a culturally competent service standard to be followed by healthcare professionals and organizations. 

The committee's focus on community engagement is also an important achievement. In 2011, HHS engaged LGBT communities and stakeholders in listening sessions and convened the first ever White House conference on LGBT health in Philadelphia, PA. 

The 2012 Agenda

In 2012, HHS continues its focus on the objectives and goals established for 2011.  New items for 2012 include:

• Extending biomedical research on LGBT health;
• Funding that specifically prioritizes interventions for HIV/AIDS care among transgender women of color;
• Establishing initiatives in national women's health to combat obesity in bisexual and lesbian women;
• Awarding Community Transformation Grants (CTG) to organizations that target LGBT individuals in order to reduce chronic diseases in vulnerable communities;[7]
• Including sexual orientation in the discussion on intimate partner violence (IPV) and releasing the National Intimate Partner and Sexual Violence Survey;[8]
• Creating campaigns to address tobacco use in young persons ages 13-24, including LGBT youth;
• Facilitating the development of tools and training materials through SAMHSA/HRSA that will assist behavioral health and primary care practitioners in culturally competent service delivery to LGBT individuals;
• Including in ACF activities the consideration of sexual orientation and gender identity in runaway homeless youth program funding;[9] and
• Working toward release of a joint CMS/Administration on Community Living (ACL) training video conveying best practices for serving LGBT older adults in a variety of settings.

The expanded efforts of HHS increase opportunities for LGBT persons to participate in health care decision-making, focus attention on expanding the scope of health care options available to LGBT persons, and target chronic diseases among the LGBT community. All these efforts help reduce health care disparities for the LGBT community.[10] In addition, funding opportunities under the Affordable Care Act (ACA),[11] such as Community Transformation Grants, allow organizations to evaluate disease prevention and health promotion programs in LGBT communities.  Work flowing from these funding opportunities will provide new information that can be used to ensure the effectiveness of future disease prevention and reduction efforts.

Conclusion

LGBT Americans require diverse efforts to address varying levels of health care need across the population.[12]  The current response of HHS provides a useful account of its objectives and associated outcomes.  It is hoped that HHS will continue its efforts toward improving the health of LGBT individuals.  If successful, these efforts should expand the administration's capacity to provide culturally competent and effective health care services to the nation's LGBT population.