Survey identifies strengths, problem areas for LGBTQ health in Iowa

A new report from a team of Iowa researchers summarizes the findings of a survey conducted last year about the health of lesbian, gay, bisexual, transgender, and queer (LGTBQ) individuals in Iowa.

The project was a collaborative of faculty and staff from the University of Iowa College of Public Health, One Iowa (an advocacy organization), the Iowa Cancer Consortium, and Des Moines University.

Paul Gilbert, lead researcher on the project and assistant professor of community and behavioral health at the University of Iowa, says that while there is national data that suggests important health disparities for LGBTQ populations, there has been scant attention to LGBTQ health in Midwestern states in general and very little available data on Iowa in particular.

“This project sought to develop detailed information that would inform future health services and research efforts,” Gilbert says.

According to Gilbert, the survey identified several strengths as well as some problem areas concerning the health of Iowa’s LGBTQ population. “On the positive side, we found that this population had high levels of health insurance coverage, general satisfaction with recent health care, low current smoking rates, and general feelings of safety and acceptance in the communities where respondents lived,” he says.

A portrait of Paul Gilbert, assistant professor of community and behavioral health at the University of Iowa College of Public Health.
Paul Gilbert

The survey also identified problem areas, such as unmet mental health needs, high levels of binge drinking, low perceived knowledge of LGBTQ health issues among health care providers, and ongoing experiences of discrimination.

“Some sub-groups, such as transgender people, had an excessive amount of health deficits,” Gilbert says. “They constitute a minority within a minority and should be a priority group for supportive services.”

The survey, which was anonymous, asked questions in six broad areas, including physical and mental health status, experiences using health care, substance use, social support and civic engagement, experiences of discrimination and victimization, and personal characteristics. A total of 567 individuals completed the online survey between June and November 2017.

While this study serves as an important starting point for researchers, the team has already begun the next phase of the project and is currently conducting focus group discussions to develop a deeper understanding of the health profiles and needs of LGBTQ Iowans.

The full report is available at https://www.public-health.uiowa.edu/wp-content/uploads/2018/10/LGBTQ-Health-in-Iowa-Summary.pdf

 

UI students contribute to research on Roma health disparities in Romania

Romania political map. Illustration.On the edge of the thriving city of Cluj, Romania, is the decidedly not thriving community of Pata Rât. Located at Cluj’s former city dump, it’s filled with ramshackle houses, little indoor plumbing, pollution, and dirt roads that quickly turn to mud.

The population is about 1,500 people and almost all of them are Roma, otherwise known by the pejorative term gypsies. They are scattered throughout Europe and are subject to discrimination wherever they live. Pata Rât is an example of this. Many of its residents, about 350 people, once lived in a residential neighborhood in Cluj until the government evicted them and forced them to move to a landfill.

Health Care Disparities

Far from jobs and schools in the city—the nearest bus stop is about a mile and a half away, on the other side of a rail yard—and forced to live in a literal dump of a neighborhood, the people of Pata Rât have suffered significant health issues as a result. This summer, a group of 13 University of Iowa students from across the campus traveled to Romania as part of the Minority Health and Health Disparities International Training Program (MHIRT), a research training internship program to encourage under-represented minorities to pursue health careers. Two of the students—Darian Thompson and Breanna Kramer—worked with the Roma population in Pata Rât, on projects led by mentors at the Cluj School of Public Health that quantifies what that impact has been and help improve the lives of the children who live there.

“They met with Roma and held focus groups to determine what the health care disparities are between the Roma and the general Romanian population,” says Rema Afifi, professor of community and behavioral health in the College of Public Health who coordinated the training grant. She notes that the Roma—who make up about 8 percent of Romania’s population—have much higher rates of poor health outcomes than the general population as a result of the social, economic, and environmental conditions that surround them.

The students spent ten weeks in Romania, guided and mentored by researchers at the Cluj School of Public Health at Babeș-Bolyai University who have been monitoring health issues among the Roma for many years. They performed field work gathering data, and computational work analyzing the data. What they found was a largely homogenous population of white, ethnic Romanians with little acceptance of minorities such as the Roma.

Discriminatory Attitudes

Darian Thompson, one of the students participating in the MHIRT research internship, points to surveys that show 56 percent of Romanians do not feel comfortable living near Roma and 38 percent would not agree to have a Roma as a friend. While Romania’s unemployment rate is 8 percent, among the Roma, it’s 34 percent, and most of those who are employed work in unskilled, low-wage jobs.

Thompson is an African-American and so he’s seen and felt racism in the United States. What he saw directed at the Roma in Romania less subtle and more abrasive than the discrimination directed against minorities in the U.S.

“I was surprised by how openly discriminatory the population was toward the Roma,” says Thompson, a junior pre-med major from Cedar Rapids. “I realized that while we still have a lot of issues to work out in the U.S., we’re still pretty accepting of minorities compared to people in other parts of the world.”

Thompson spent most of his ten weeks of the project analyzing data, comparing past statistics to newly gathered data while looking for changes and trends. Meanwhile, Breanna Kramer, a Master of Public Health student in the College of Public Health, was in the field, talking with the Pata Rât Roma about their health.

Helping Children Succeed

Kramer’s work was focused on measuring the effectiveness of a Cluj School of Public Health program that’s designed to help Roma children in Pata Rât succeed in school. Because of transportation difficulties and fear of discrimination, most Pata Rât parents keep their children in a local, segregated school in the community. But Kramer says the school is substandard and the language of instruction is their native Romani, instead of the Romanian they will need to learn to be successful.

The program helps the students by providing bus transportation to better quality schools, new clothing, access to showers, hot meals, and other assistance to better prepare them for learning. Kramer says that preliminary research suggests the program is working to fulfill family needs at a basic level.

“It’s taking that weight off their parents so the kids can go to school and get the education they need,” says Kramer, from Donnellson, Iowa. “But poverty and discrimination still exist, and for that to improve, large-scale institutional change needs to happen, which will take years.”

Afifi says funding for the training program came from the National Institute on Minority Health and Health Disparities, a federal agency designed to lead scientific research that improves minority health and reduces health disparities through promotion and support of the training of a diverse research workforce. All 13 of the UI students who participated were from minorities underrepresented in the health sciences.

Culturally Responsive Health Care in Iowa conference is June 8

Diverse, Multi-Ethnic Group Of PeopleThe College of Public Health is pleased to be a co-sponsor of the 2018 Culturally Responsive Health Care in Iowa Conference.

Date & Location:  Friday, June 8, 2018 |  7:15 AM – 4:30 PM  | College of Public Health Building, Iowa City, IA

Intended Audience: Physicians, Nurses, Social Workers, Physician Assistants, Pharmacists, Public Health Professionals, Dentists, Health Educators, Health Administrators, Health Science Students. All personnel who provide health care services to diverse populations.

Conference Goal: To educate Iowa’s health care providers about the importance of providing culturally responsive and competent care; to improve access to quality health care; and to reduce health disparities.

Continuing Education Credit will be provided.

Information and registration:

https://uiowa.cloud-cme.com/aph.aspx?P=5&EID=19628

Or go to:  https://medicine.uiowa.edu/cme/ and click on Upcoming Programs

Individuals with disabilities are encouraged to attend all University of Iowa sponsored events. If you are a person
with a disability who requires an accommodation in order to participate in this program, please contact the
Continuing Medical Education Division in advance at 319-335-8599.

Baquero discusses her work on health disparities

Barbara Baquero, CPH assistant professor of community and behavioral health, recently spoke to Public Health Minute about her work focusing on community-based health behavior interventions to reduce health inequalities related to obesity and cancer among Latinos in low-resource communities.

Wright studying role FQHCs play in reducing health care disparities

Emergency Signs at HospitalResearchers at the University of Iowa College of Public Health have been awarded a $1.54 million grant from the National Institute on Minority Health and Health Disparities to study the role federally qualified health centers (FQHCs) might play in reducing disparities in potentially preventable hospital-based care among dual-eligibles.

Approximately 10 million Americans are eligible for both Medicare and Medicaid. According to Brad Wright, assistant professor of health management and policy at the UI and principle investigator on the grant, these dual-eligibles are a disproportionately high-cost population with substantial and often unmet healthcare needs.

A portrait of Brad Wright of the University of Iowa College of Public Health.
Brad Wright

“Despite having two sources of insurance coverage, dual-eligibles are one of the most vulnerable populations in the country,” he says. “They often experience high rates of potentially preventable hospitalizations and emergency department visits resulting from disparities in access to primary care.”

Little is known about the relationship between primary care access and the broader continuum of potentially preventable hospital care, which includes not only emergency department visits and hospitalizations, but also observation stays, 30-day return ED visits, and 30-day all-cause readmissions.

“This grant allows us to further our understanding of how we might use FHQCs to improve access to primary care, reduce disparities along ethnic and racial lines, and reduce those costly and potentially preventable emergency department visits and hospitalizations,” Wright says.

 

Gilbert leading survey of LGBTQ health needs in Iowa

LGBT rainbow flag and health care providerThis year, Iowa becomes one of just a handful of states to conduct a health assessment of its lesbian, gay, bisexual, transgender, and queer (LGBTQ) residents. The University of Iowa College of Public Health, the Iowa Cancer Consortium, and One Iowa (a state-wide LGBTQ advocacy organization) have partnered to conduct a comprehensive survey to describe the health status and identify the health needs of LGBTQ Iowans.

“There’s a saying in public health that no data equals no problem,” says Paul Gilbert, CPH assistant professor of community and behavioral health and principal investigator. “We’re doing this survey to find out what LGBTQ Iowans need in order to be the healthiest they can be.”

The group began with an in-person survey earlier this summer at LGBTQ Pride events in Des Moines, Iowa City, Council Bluffs, and Cedar Rapids, and have just launched an online survey to ensure participation across the state. The group also plans to augment findings through several focus groups to be held later this year.

Lauren Pass, an MPH student in community and behavioral health, has helped develop and launch the LGBTQ health assessment. “Designing the survey, we wanted to account for the diversity within the community so we can represent all LGBTQ Iowans as best and accurately as possible,” she says.

LGBTQ Iowa residents can take the online survey at tinyurl.com/lgbtqhealthsurvey. For more information, contact Dr. Gilbert by phone (319-384-1478) or email (paul-gilbert@uiowa.edu).