411 on Including LGBT Communities in CTG Proposals

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411 on Including LGBT Communities in CTG Proposals
Scout, Ph.D. Director, Network for LGBT Health
Equity at The Fenway Institute
Debra Morris, MPH CHES Director of Technical
Assistance Tobacco Technical Assistance Consortium
Gustavo Torrez, Manager - Network for LGBT Health
Equity at The Fenway Institute
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• Network for LGBT Health Equity
• The Network for LGBT Health Equity is
  community-driven network of advocates and
  professionals enhancing LGBT health by countering
  tobacco use, and enhancing diet and exercise. We
  are one of six CDC-funded tobacco disparity
  networks and a project of The Fenway Institute in
  Boston. We advance these issues primarily by
  linking people and information to advocate for
  policy change. We actively monitor national and
  state health policymakers and urge community
  action when there is an opportunity to enhance
  LGBT wellness.
• We would like to thank our cosponsor for this
  webinar

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• This webinar is the 2nd in a series
• The first webinar was for LGBT community
  experts/advocates, training them on how to
  identify and offer assistance to their local CTG
  applicants.
• We would like to thank our community
  collaborators for the LGBT engagement

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Agenda

• Why integrating LGBT partners strengthens your
  proposal
• Data sources for local LGBT health information
• How to identify local LGBT partners
• Examples of successful LGBT policy advocacy
  campaigns
• Models for inclusion in CTG proposals and/or
  action planning
• Comments from Tobacco Technical Assistance
  Consortium staff

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Goals of This Webinar

• Educate CTG applicants on the policies urging
  LGBT inclusion
• Provide the information so you can successfully
  integrate LGBT people into your CTG proposal and
  activities
• Provide linkages to local LGBT organizations
• Build the number of LGBT focused/inclusive CTG
  programs nationwide

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Why integrating LGBT partners strengthens your
proposal
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LGBT Cultural Competency in 1 Slide

• LGBT people have notable health disparities, for
  example we smoke at rates 35-almost 200 higher
  than the general population.
• Due to a legacy of discrimination, LGBT people
  often do not trust that mainstream health
  interventions are welcoming to them.
• You need to demonstrate a project is welcoming to
  LGBT people, otherwise you will perpetuate old or
  build new disparities.

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LGBT Wellness Disparities in 1 Slide

• Smoking rates much higher
• Major access to care barriers aggravate all
  health issues
• Some concerns of overeating ( undereating)
• Lack of data defines much of knowledge not
  enough to comment on diet/exercise widely
• Remember We need to include LGBT people in all
  health work, so we dont accidentally create new
  disparities by only changing behavior among
  others.

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CTG Request for Applications

• There is much stronger focus on including
  disparity populations routinely, sexual
  orientation specifically mentioned as a possible
  one.
• It didnt take as much leadership as desired
  (see http//lgbthealthequity.wordpress.com/2011/
  05/13/the-long-awaited-community-transform-grants-
  thumbs-down/) but other policy docs do show
  notable leadership on including LGBT folk.

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New Changes in Federal Commitment to LGBT
Disparities

• A series of policy documents in the last year
  capture the newly enhanced commitment to LGBT
  inclusion in health activities.

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Healthy People 2020

• Overarching goal Achieve health equity,
  eliminate disparities.
• Disparities/inequity to be assessed by
  Race/ethnicity, Gender, Socioeconomic status,
  Disability status, Lesbian, gay, bisexual, and
  transgender status, Geography
• New LGBT Topic Area

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IOM Report

• Historic review of LGBT health disparities
• Calls for data collection, cultural competency,
  additional research.
• Read more Is This The Biggest 48 Hrs Ever for
  LGBT Health? Why the IOM report is a healthy
  change for LGBTs Op-Ed on IOM Report on
  LGBT Health

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HHS Tobacco Action Plan

• Available evidence also reports very high
  smoking rates among lesbian, gay, bisexual and
  transgender populations however these
  populations remain underrepresented in current
  surveillance systems used to monitor tobacco
  use.
• Read more here HHS Tobacco Strategic Plan
  Launch Eyewitness Account LGBT
  Inclusion Details

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National Prevention Strategy

• Pillar 4. Eliminate Health Disparities
  Eliminate disparities in traditionally
  underserved populations to improve the quality of
  life for all Americans. Some groups are
  disproportionately affected by health risks
  including major disorders such as heart disease,
  obesity, diabetes, HIV/AIDS, or viral hepatitis
  high rates of infant mortality and high rates of
  violence. Disparities often occur under
  conditions of social, economic, and environmental
  disadvantage. All Americans should have access to
  opportunities for healthy living and be supported
  in their efforts to make choices that promote
  long, healthy, and productive lives, regardless
  of race or ethnicity religion socioeconomic
  status gender age mental health cognitive,
  sensory, or physical disability sexual
  orientation or gender identity geographic
  location or other characteristics.

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HHS ACA LGBT Factsheet

• In addition, the Affordable Care Act is funding
  preventive efforts for communities, including
  millions of dollars to use evidence-based
  interventions to address tobacco control, obesity
  prevention, HIV-related health disparities, and
  better nutrition and physical activity. The
  Department of Health and Human Services intends
  to work with community centers serving the LGBT
  community to ensure the deployment of proven
  prevention strategies.
• Read more here New Government Factsheet on LGBTs
  Health Care Reform

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Summary

• Including the LGBT population in your CTG
  application work is not only scientifically
  indicated, it reflects the latest policy
  directives from HHS.

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Data sources for local LGBT health information
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LGBT local needs assessments
Michigan Breaking the Habit Southeastern
Michigan LGBT Tobacco Use Report (2006)   New
Mexico New Mexico LGBT Tobacco Community Survey
(2006) Adding Sexual Orientation Questions to
Statewide Public Health Surveillance New
Mexico's Experience (2010)   Arizona Smoking
Prevalence and Cessation among Lesbian, Gay,
Bisexual, and Transgender Residents in Arizona
(2008) Tobacco Use and Interventions among
Arizona Lesbian, Gay, Bisexual, and Transgender
People   New York A Blueprint for Meeting LGBT
health and Human Services Needs in NYS
(2010)   Minnesota Creating an Effective Tobacco
Plan for Minnesota's Gay, Lesbian, Bisexual, and
Transgender Communities (2005)   Idaho Idaho
Tobacco Prevention and Control Program
(2004)   North Carolina North Carolina Report-
Tobacco Disparities in the LGBT Community
(2004)   Ohio Ohio LGBT Report Voices of the
Lesbian, Gay, Bisexual, Transgender on Tobacco
Use, Tobacco Control, and the Effects of
Tobacco   Colorado Tobacco Control Needs in
Colorado For more, check out our website for
further assessments lgbttobacco.org
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States that have included LGB on BRFSS
Sexual orientation included (22 and DC)
Sexual orientation not included (19)
Sexual orientation included in specific counties
(2)
Leigh Evans, MPH, The Fenway Institute, 2011
Information not available (7)
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LGBT national data sources

• Full probability
• NHIS same sex household data
• Pooled YRBS data (caveats)
• National Survey of Family Growth
• (NATS?)
• Tobacco use among sexual minorities in the USA,
  1987 to May 2007 a systematic review Tobacco
  Control August 2009. Joseph Lee, Gabriel Griffin,
  Cathy Melvin
• Community based sample
• National transgender survey (tobacco info in full
  report only, not exec summary)

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How to identify local LGBT partners
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Our secret formula

• Do we have members in your state?
• Is there one or more community centers in your
  state?
• If youre a large city, you could also have one
  of the 12 health centers.
• Are there members of the National Coalition for
  LGBT Health in your state?
• Is there an equality federation in your state

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But lets make it easy

• We will send each of you an email with the names
  of one more key LGBT leaders/organizations in
  your state

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Examples of successful LGBT policy advocacy
campaigns
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Examples 01

• DC - CIA passage in Washington DC
• CA legislators refusing tobacco money
• CA assisting getting tobacco out of pharmacies
• WA No tobacco funds pledge for pride

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On the horizon

• MO created an LGBT tobacco/wellness action
  plan, now moving to implementation phase
• IL, DC CPPW subcontracts in action
• GA planning LGBT wellness campaign heavily
  focused on policy changes

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Our Tools/Assistance

• LGBT organizational wellness policy toolkit
• Online LGBT organizational environmental scan
• Online resource library needs assessments,
  sample reports, etc.
• We can do LGBT cultural competency trainings
  help you find local experts provide technical
  assistance to them.

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Models for inclusion in CTG proposals and/or
action planning
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How you can include us big picture

• Subcontract to local LGBT organization(s).
• Fund a project that pushes for policy changes in
  LGBT organizations.
• Fund local organization to assist general
  coalitions working on policy change (e.g. clean
  air measures)
• Require other subcontractors to demonstrate LGBT
  inclusion in their work.
• Add smart LGBT measures to health surveys to
  evaluate LGBT disparity changes.

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Where to mention LGBT in proposal

1. Needs section (10 pts) write 1-2 paras
   describing LGBT community health disparities
2. Leadership Team Coalitions (20 pts) a. Commit
   to include LGBT leadership in the leadership team
   or coalition. B. Secure letter(s) of support
   from LGBT groups
3. Community Transformation Implementation Plan
   (20 pts) include or plan to include LGBT
   targeted activities in the implementation plan
4. Performance Monitoring Evaluation (10 pts)
   Commit to adding LGBT measure in eval measures.
   (we have resources to assist)

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Comments from Tobacco Technical Assistance
Consortium staff
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Questions
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• THANK YOU!
• We look forward to working with you to
  collaboratively address LGBT wellness
  disparities.
• Please take 2 minutes to complete an evaluation
  on this call http//www.zoomerang.com/Survey/WEB2
  2CJFN25YF9/
• Additional questions?
• Feel free to contact us whenever needed

Debra Morris Tobacco Technical Assistance
Consortium debra.morris_at_emory.edu
Network for LGBT Health Equity lgbthealthequity_at_gm
ail.com The Fenway Institute Fenway Health 1340
Boylston Street Boston, MA 02215 voice
401-263-5092 fax [phone] Our Blog