Organizational and ecological efforts to address gender and sexual minority health disparities and inclusivity within the healthcare and mental healthcare delivery system

Abstract

According to the Health Equity Index (Human Rights, 2016), only three hospitals in Kansas were determined as leaders for health care equality. All three facilities are located closer to Kansas City and therefore inaccessible for many gender and sexual minorities residing in Wichita, KS. The recent index has motivated the LGBT Health Coalition to ensure that other facilities are determined as healthcare equality leaders; however, it's been difficult to create broader positive changes that ensure safe spaces for LGBT patients. In a collaborative effort with the Wichita LGBT Health Coalition, Human Rights Campaign, George Washington University, and Wichita State University, interviews were conducted with medical students and physician assistants (n=8) and medical administrators (n= 9) to identify what barriers exist for healthcare facilities to become health equality leaders. In addition, interviews were conducted with sexual minority women and gender minorities (n= 13) to gain insight into their experiences in healthcare within Wichita. The study used an inerative analysis; the research team has alternated between finding emerging themes of the data similarly to grounded theory (Glaser & Strauss, 1967), but in addition, using the etic of existing theories (Srivastava & Hopwood, 2009). In this case, the minority stress model (Meyer, 1995), the ecological model (Eliason, & Fogel, 2015) and the cultural competence model (Betancourt, Green, & Carrillo, 2002). Findings include lack of healthcare access that caters to gender and sexual minorities, how the community disseminates resources and advice related to health, and a lack of LGBT related support for medical administrators and health professional students. Although there have been strong efforts in creating a safety net for gender and sexual minorities, there is still mistrust especially towards faith-based healthcare services. Medical administrators expressed the need for improving services for this population but has not found support or data to justify investing in inclusive-related policies and practices. Recommendations for policies and initiatives for the City of Wichita will also be discussed.