Description
- Abstract:
- Access to Health Care by Sexual Minorities: A Population-Based Assessment Abstract: Introduction: Sexual minorities face health care disparities and delay seeking care as compared to heterosexuals. Identifying a primary care provider has a positive impact on health outcomes for all patients. It was the objective to perform an assessment of health care access as reported by sexual minorities in the United States, hypothesizing that being a sexual minority inversely relates to regular health care access. Methods: This study utilized data from the Behavioral Risk Factor Surveillance System (BRFSS) 2015, a telephone survey of United States residents, 18 years and older, assessing their health and use of preventive services. Responses from 21 states asking questions pertaining to sexual orientation were included (N = 163,803). Respondents self-identified as lesbian or gay, bisexual, other or responded that they didn’t know or weren’t sure to a question about sexual identity were considered sexual minorities. Primary outcome was identification of at least one primary care provider. Secondary outcomes included having health insurance, and routine care, and a flu shot in the past year. Covariates for adjusted model were age, race, sex, marital status. Weighted data was analyzed using STATA 14.1. Results: Among all respondents, 6838 were defined as sexual minorities. When comparing to heterosexuals (N=156,965), 72% of sexual minority respondents identified having at least one primary care provider (81% of heterosexuals) and 21.2 % of sexual minorities reported being uninsured (10.6% of heterosexuals). In adjusted model, sexual minorities were found to have .79 odds (95% CI .70, .90) of identifying at least one primary care provider compared to heterosexuals. No difference was found between the sexual minorities and heterosexuals for regular checkups in the last year [OR .91 (95% CI .80, 1.02)]. Sexual minorities were found to have 1.14 odds (95% CI 1.02, 1.26) of having a flu shot within the last year but had only .60 odds (95% CI .52, .70) of being insured. Conclusion: Sexual minorities are less likely to report having a primary care provider or being insured but were more likely to have received a flu shot in the past year compared to heterosexuals. Enhanced access to care, as seen by public health efforts to increase annual flu shot prevalence, may help decrease health related disparities for sexual minorities. Are Adolescent Patients Screened for their Sexual Health and Gender Identity in the Emergency Department?: The PEDSS (Pediatric Emergency Department Sexual Health Screening) Study Abstract: Introduction: Currently, universal screening of adolescent patients for sexual orientation and gender identity is recommended in all medical encounters. This is in part due to the health risks associated with sexual activity, but also the health risks associated with being a member of a sexual minority or being a member of a non-traditional gender identity. The actual rate of screening adolescents for gender identity and sexual orientation in the emergency department remains unknown, especially in a pediatric emergency department. The goal of this study was to assess the current state of screening of adolescent patients in the pediatric emergency department. Methods: An electronic survey was administered at Hasbro Children’s Hospital Emergency Department in Providence, RI via tablet on RedCap. A survey tool pilot of 10 patients was performed for evaluation of the survey tool. The survey was self-administered by 100 patients aged 14-17. The survey asked questions regarding patient experience being asked questions of the sexual orientation and gender identity. Demographic data was also collected. Analysis was done using statistical software package STATA version 14 (StataCorp LP, College Station, TX). Results: Of the 100 patients survey, 7% were asked their sexual orientation and 5% were asked their gender identity. The majority of patients identified as cisgendered (86%) and were heterosexual (81%). There was no difference between sexual minorities and heterosexuals or gender identity minorities and traditionally gendered individuals being asked their sexual orientation or gender identity. Discussion: This study identified that adolescents were not asked about their sexual orientation or gender identity during their emergency department visits. The reason for this remains to be elucidated. Adolescents also reported not wanting to be asked their sexual orientation or gender identity during their emergency department visits. In order to assess the barriers to screening, providers are currently being surveyed regarding their clinical practice regarding screening for sexual orientation and gender identity in the emergency department.
- Notes:
- Thesis (M. P. H.)--Brown University, 2019
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Citation
Lecuyer, Matthew Edward,
"Access to Health Care by Sexual Minorities: A Population-Based Assessment Are Adolescent Patients Screened for their Sexual Health and Gender Identity in the Emergency Department?: The PEDSS (Pediatric Emergency Department Sexual Health Screening) Study"
(2019).
Public Health Theses and Dissertations.
Brown Digital Repository. Brown University Library.
https://doi.org/10.26300/ngb7-rf54
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Public Health Theses and Dissertations
Theses and Dissertations for the Public Health department....