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Colwill Sept 2013

OPAH Presentation for Collwill on Sept 25 2013

Jane McElroy

on 3 March 2015

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Transcript of Colwill Sept 2013

Health Disparities in the SGM Community
Jane A. McElroy, PhD
Family & Community Medicine Department
University of Missouri - Columbia
Colwill Seminar
September 25, 2013
Tobacco-related attitudes, beliefs, and behaviors
n = 2,904
Preferred cessation locations
n = 600
(no funding)
Discuss the
study and findings
of the Out,
Proud, and Healthy project.
Review the
programmatic outcomes
currently in practice across Missouri.
Define terminology
describe concepts
associated with SGM (sexual and gender
minority) populations.
What's a researcher to do?
Social Media
Behaviors and Responses
Imagine that you wanted to quit smoking, what would you do?
Quit Smoking Options - Current Smokers
Perceived Effectiveness of
Methods to Quit Smoking
45% Quit
cold turkey
on my own
Ask partner
for support
22% Use
to help quit
19% Talk to
my doctor
about a plan
Pride 2010
Relation between Perceived Effective Treatment and Reported Behavior
Pride 2010
Pride 2010
SGM >24 yrs old
Smoking and College Educated
Risky Alcohol Drinking
Depressive Symptoms
Pride 2011
SGM college educated
2.5 times more likely
to smoke.
(in the last 6 months)
Pride 2011
SGM risky drinking
that of Missouri population.
Male/MtF: avg. 14+/week or 4+/day
Female/FtM: avg 7+/week or 3+/day
Pride 2011
Kansas City
St. Louis
2010 - 2012
2008, 2010 - 2012
2008 - 2012
Black Pride: 2008, 2011 - 2012
2008, 2010 - 2012
Study Design & Methodology
Use of social media, strategies for quitting
n = 3,199
Health issues and access to care
n = 4,038
Perceived stress and resilience
n = 4,584
(youth responses: n=405 with 222 SGM youth)
2008 - 2009
2010 - 2011
2011 - 2013
Surveys Collected at Pride Festivals
Mean adult age: 31 years
range 18 - 85 years
White (67%)
Black (18%)
Hispanic (6%)
for those > 24 years
High school or less (13%)
4 yr college degree or more (40%)
SGM Status
Sexual Identity
Gender Identity
as Transgender
SGM Health Disparities in the US
In 2008,

we started
gathering data

SGM individuals have higher and more frequent use of social media.
Age is the most significant determinant of social media use with younger people using more and
more diverse social media outlets.
(Harris Interactive, 2010)
(Pride 2011)
E-mail is most preferred health communication overall.
Preferred Method of
Contact for All Users
Health Information Sources
Social media non-users
prefer healthcare professionals for health information
social media users
prefer internet.
Pride 2011
Pride 2011
Advisory Board
Bill Snook
Jeanette Mott Oxford
Carol Cox
David Schlomer
Ken Haller
Stephanie Perkins
Struby Struble
Department of Health, Kansas City
Former MO State Representative,
Executive Director
MO Association for Social Welfare, St. Louis
Truman State University, Kirksville
Language Service Coordinator,
University of Missouri Health Care - Columbia
Good Samaritan Project, Kansas City
Cardinal Glennon Children's Hospital, St. Louis
PROMO, Springfield
Coordinator, LGBTQ Resource Center, University of Missouri - Columbia
I’m my best me when ….” data driven interventions for sexual and gender minority population to address health disparities
Phase I
Phase II
Phase III
Web Data
2008, 2011-2012
Phase I
Phase II
Phase III
88.6% Having my
actively support me
Avoiding situations
that allow smoking
76.5% Using
(e.g. nicotine patches)
Avoiding places
that allow smoking
72.4% Being provided with
money incentive
68.9% Attending a
peer support group
Perceived Effective
Reported Behavior
Having my partner actively support me
Using medication (e.g. nicotine patches)
Avoiding places that allow smoking
Attending a peer support group
would ask partner to support them
would use medication
would talk to their doctor
would avoid places that
allow smoking
would attend a peer
support group
Kevin Everett, PhD
Susan Pereira, MD
Dean Andersen, MEd
Jenna Jordan, MPH
Megan Lee, BA
Grace Vega
10% Use
5% Join a
quit smoking group
Race distribution
over-represents minorities in Missouri
(County Level Survey)
(National Health Interview Survey)
Medical/Surgical Treatment
by age groups
Missouri SGM people are
2 times more likely NOT to get
medical or surgical treatment.
"During the last 12 months, was there any time you needed medical or surgical treatment but did not get it?"
Diabetes Diagnosis
"Have you seen a doctor in the
previous 6 months?"
No health insurance = 11%, 7%
Health insurance = 73%, 82%
Pride 2011
Pride 2011
Health Insurance +
Medicine and Medical Care
SGM Missourians with health insurance are
more likely to NOT
take medicine or get medical care than heterosexual counterparts.
Program Manager for Health and Social Marketing
Deputy Director
Associate Professor and Pediatrician
Executive Director
Professor of Health Science
* No difference by race
* Significant difference by race for NOT taking medicine: Black SGM = 41%; White SGM = 30%
Pride 2011
Phase III Out Proud and Healthy Project
SGM, Heterosexual
Co-Principal Investigator
Abused or Rejected by Family Rejection
Fired or Refused Housing

Refused Medical Care

Delays in Receiving Care
Dx with Anal Cancer (SGM Male)

Dx with Eating Disorders (SGM Male)

Have Mental Health Issues
Committed/Attempted Suicide

Harmful Alcohol Consumer
Overweight or Obese (SGM Female)

Provide evidence-based smoking cessation treatment; trained coaches in the 5 A's of Smoking cessation counseling:
Ask, Advise, Assess, Assist, & Arrange

Eliminate cost barrier to treatment by providing free nicotine patches and gum.

Cessation treatment
at 3 SGM locations
GLMA 'Safe' Provider's List (from 5 to 109 in Missouri)
Video contest focusing on LGBT tobacco use.

Facebook & Website
More likely to be....
Vital Voice Ads 2012 and 2013
age 18-64 year olds
What about Medical Care?
Counseling in Columbia

Mary Cruise, LMT
Deborah Danner, LCSW
Kurt DeBord, PhD
Heather Eastman-Mueller, PhD
Christine Even, PhD
Joanne Fulton, LCSW
Lynn Maloney
Jessica Semler, PhD
David Tager, PhD
Deborah Wright, PhD
Physicians in Columbia

Morgan Elmore, DO
Ashley Millham, MD
Susan Pereira, MD
Mira Aubuchon, MD
Stephanie Bagby-Stone, MD
Blake Corcoran, MD
Sara Crowder, MD
Abigail Emerson, MD
Susan Even, MD
Jessica Nittler, MD
Morgan Schiermeier, MD
Danny Schust, MD
Paul Tatum, MD
William Trumbower, MD
Comparing Perceived Stress Scores
by SGM and General Population
Knight Foundation Challenge
Harness Data and Information for the Health of the Community
Award, $1000-$1,000,000
Judging begins Oct 11th
SGM Avatar
General Population Avatar
Chad Michael's perspective on health
Aug 2013
I'm my best me when ......
Let's start........
Full transcript