E-Cigarettes: Friend or Foe for the LGBT Communities?


E-Cigs

 As published on Huffington Post’s new LGBT Wellness blog, see original at: http://www.huffingtonpost.com/scout-phd/e-cigarettes-friend-or-foe_b_5024583.html

Working in tobacco control sometimes elicits interesting reactions from people. Some try to hide their smoking. While I certainly appreciate not being near the smoke itself, I’ve got great empathy for smokers. In fact, since most smokers have already tried to quit, they’re much more likely to be fellow fighters against tobacco than non-smokers. Sometimes they ask me how to best quit and I’m happy to tell them (hint, call 1-800-QUITNOW). These days everyone’s asking me something new: What about e-cigarettes? The shortest answer is “they could be helpful for a few, but we all worry about our youth.”

First, if you’re not familiar with e-cigs, they are battery-powered imitators of old-school cigarettes, designed to deliver nicotine, flavor and other chemicals through vapor inhaled by the user. Most of them have a swag little electronic light at the tip to make it seem more like an old-school cig. Some now have other names like e-hookah to avoid any cigarette associations. The claim is here’s a no-combustion device to get your nicotine fix, great for cessation and great to smoke in places where cigarettes are banned.

There is one study supporting the effects of e-cigs in helping people quit smoking but now another study is out contravening it. Considering how toxic cigarette smoke is, we all applaud anything that helps reduce the amount of cigarette smoke in the air. But if you’re trying to use e-cigs as a cessation device it’s a bit dicey right now because they’re unregulated, so the amount of nicotine you get in each dose varies, and sometimes does not match the advertising. It’s commonly known that it only takes about two weeks to kick the nicotine addiction of smoking, but anyone who’s quit will tell you, it’s the social habit of smoking that draws you back again and again. I’m not sure how putting a cigarette replacement in your mouth helps you kick that social habit — sounds to me like it’s just perpetuating it. Plus there is a new study showing other toxic chemicals in the vapor. To top it off, there’s no real science on the long-term effects of inhaling nicotine vapor. So while I’m willing to bet it’s better than inhaling tobacco smoke, that’s like saying I bet it’s better than inhaling truck exhaust. Nicotine is so toxic, poison control centers just issued an alert about high numbers of calls on accidental exposure. Just touching the liquid is enough to cause vomiting and ingesting as little as a teaspoon of some of the liquid nicotine concentrations can be fatal. I hope people set a higher bar for their own cessation journey.

The real problem is, as anyone who’s visited a vaporium can see, it’s not a cessation game. Vaporiums and e-cigs are all about enticing, and particularly enticing young people. Wander into your local vaporium belly up to the “bar” and you’ll be shocked to see how many vaporiums look like the lovechild of a hip coffee shop and a candy store. I’m not sure exactly which adult Marlboro user would switch to cotton candy flavored nicotine cartridges, or banana nut bread, or cherry limeade. Sounds to me more like flavors I’d find at a little league game. To make it worse, these products are easily available online and many states aren’t yet doing anything to restrict access to minors. Data show LGBT youth continue to smoke at rates much higher than their non-LGBT counterparts and the number of youth experimenting with e-cigs is rising rapidly… the very last thing we need is to have some fancy new gadgetry on the market enticing LGBT youth to start using a highly addictive drug to deal with the stress of stigma against us all.

We pass on smoking down through the LGBT generations socially. I’ve always called it an STD for us, a socially transmitted disease. So I also worry about adult e-cig use. Every time you “light up” you’re perpetuating the huge LGBT cigarette culture, all of us laughing and having fun and hanging out, with cigarettes in our mouths.

We already have cessation aids that deliver you nicotine in controlled regulated doses, you can find those on every drugstore shelf. Nicely, there’s not one gummy bear or watermelon flavored nicotine patch, spray or gum. So while e-cigs might help a few in quitting, I say the big picture on e-cigs for the LGBT communities is we need to think of our youth and “beware of the wolf in sheep’s clothing.”

_____

self-portrait-scout

 

 

 Dr. Scout, Director

 The Network for LGBT Health Equity

 

 

Follow Scout, Ph.D. on Twitter: www.twitter.com/scoutout

Honestly, Signing up for Obamacare Was Hard but Worth It

get_covered_bandage_hero

 It’s a bit embarrassing to admit how difficult it was to sign up for health insurance on the new exchanges. As a public health professional who’s trying hard to spread the word that people need to #GetCovered, I was trying to studiously ignore how every time I called there was some problem in signing up. Ultimately, it seemed to be related to my name change. Maybe it was more complicated because I only have a single name? I just hope every trans person doesn’t have to go through some of the hoops I did in proving they are U.S. citizens, because I know it delayed my enrollment by months.

One of the myths about these health insurance exchanges is they are only for the uninsured among us, or only for low-income folk. Actually the exchanges offer a chance of better health insurance for many of us. For example, I was already enrolled in health insurance, but to my dismay it didn’t cover any testosterone, which left me skipping some months then finally shelling out $400/month through clenched teeth. Plus, my health insurance didn’t include dental coverage, so I carefully unclenched those teeth again.

To be honest, I had to call the Rhode Island health insurance exchange probably eight times. First there was the complication of not living in the same state as my partner. While some private insurance plans would cover us both, the exchanges wouldn’t. Then they asked me to send in my drivers license and social security card to prove I was a citizen. So I scanned and uploaded them to the site then I waited for some notice it was ok to proceed… and crickets. It’s easy to put off enrolling like it’s easy to put off writing a will. Nothing bad is going on now, right? With three teenagers and a busy job, I had lots of other things competing for my attention. But once a month, as I shelled out that $400 for hormones, I kept remembering that maybe that insurance exchange could do this better?

So I called back and filled out more of the application with the friendly person on the line. But now they needed to know how much my kids’ health insurance premiums were. Really? I am not the parent who pays them, so why did it matter? It stopped me again, until that $400 payment came again and I was motivated to track down the info and called back. This time, they needed even more information about my name change. I was definitely trying hard not to curse the insurance exchanges at this point. Remember, the party line is #GetCovered. Repeat until you believe it. Or better yet, go back and watch the hilarious SNL skit on the early website problems. I’ve watched it so many times now I can do a fair impersonation of their Sebelius impersonator.

Ultimately, it was the coming deadline which moved me off my duff again. If people don’t get enrolled by March 31st, it’s see ya later until next year’s open enrollment period. So, I found my birth certificate, my legal name change document and uploaded them to the site. And voila — they finally admitted I was a U.S. citizen. I could choose a plan!

But wait, the runaround stop didn’t stop there. I wasn’t going to sign up for another plan that didn’t include hormones. Plus, I needed to make sure my trans-friendly doc was in their plan. That took four more confusing calls, this time to Blue Cross. But everything was included. And I was going to get sweet dental coverage for the whole family too, including 50 percent of my kids’ braces costs. I signed up like lightning.

I can’t lie; it was a total hassle for me to sign up and it could be for you too, but trust me it’s worth the hassle. I was cursing the insurance exchanges before but now I say bring on the new coverage as fast as it can come. Remember, we’ve only got until March 31st to sign up so spread the word. Visit Out2Enroll for more information and find more social media friendly images on the CenterLink Network for LGBT Health Equity blog here.

——

Dr. Scout, Director

The Network for LGBT Health Equity

As published on Huffington Post’s new LGBT Wellness blog, see original at: http://www.huffingtonpost.com/scout-phd/obamacare-enroll-health-insurance-exchange_b_4961096.html?utm_hp_ref=lgbt-wellness

 
Follow Scout, Ph.D. on Twitter: www.twitter.com/scoutout

HHS Secretary Sebelius Meets With LGBT Leaders

self-portrait-scout
 
 
Dr. Scout, Ph.D.
Director of CenterLink’s Network for LGBT Health Equity
 
 
 
 
As published on Huffington Post’s new LGBT Wellness blog, see original at: http://www.huffingtonpost.com/scout-phd/hhs-secretary-sebelius-me_b_4899306.html?utm_hp_ref=lgbt-wellness
 
Earlier I asked you what you wanted me to say in the annual meeting with HHS Secretary Sebelius, now I’m back to report out on the meeting itself. This annual meeting with Secretary Sebelius is the chance for LGBT leadership to understand what’s top on HHS’s priority list and for them to hear what’s top on ours.

Our work for this meeting started beforehand as the National Gay and Lesbian Task Force folk stepped in to organize a call between the different community participants. My first impression was while the number of attendees grows each year this year it took a larger jump. There were reps from most every major LGBT group in the country and many HIV groups now too, like GMHC. This alone is a nice comment on change, because when I started going to these meetings years ago, many of these groups wouldn’t have had anyone expert enough on health to attend. I love the increased emphasis on health among our community organizations.

When we got to the meeting itself my first impression was the exact same — there were a lot more feds in the room than ever before. This meeting literally started years ago as about 12 people, now there were 40 community reps around the table, and nearly as many feds ringed around the sidelines. National Institutes of Health alone had three reps in the room, including the man trying to hire more LGBT staff and their main LGBT liaison. Gautam Raghavan, the White House LGBT liaison, was also there to bring our top issues back to White House strategists. This meeting is always packed with feedback from us, much of it aimed at specific HHS agencies, so I really appreciated seeing the agency staff there in person.

Then it was time for Sebelius debut, while this is our meeting with her, she’s only there for the first 15 minutes to give us top line info. What were her top line LGBT foci in the last year? 1. Access to health care and 2. Equal rights under the law, especially related to the Windsor/DOMA ruling. HHS had already taken action on several equal rights fronts pre-Windsor including: creating a National Resource Center on Aging; passing non-discrimination rulings for hospital and nursing home visitation; and passing non-discrimination rules for employment and HHS contractors. Now that DOMA ruling came out they bumped up the work on this, asking every agency to review their policies to ensure LGBT family inclusion. For example, HHS has now broadly adopted the “Celebration Policy” that IRS put out. This policy makes it standard for HHS to recognize legally married LGBT couples, even if they live in a state where the state doesn’t (yet) recognize them.

We know that LGBT people have a long history of access to health care barriers and that one in three low income LGBT people is uninsured. That’s why taking advantage of this historic open enrollment period for insurance exchanges is so critical for us. Secretary Sebelius pushed us to please do everything possible to help encourage people to enroll before the March 31st deadline. I agree, it’s why CenterLink’s Network for LGBT Health Equity has just put out more social-media ready ads for people to share. Please share them and visit Out2Enroll for more ideas.

Before the secretary left our designee, the ever-quick Harper Jean Tobin, was able to highlight a few of our consensus of top issues from our call. Our top ask was for a clear prohibition on overt discrimination in health care. Then we wanted LGBT cultural competence trainings for all providers; more clarity on acceptable practices in the insurance marketplace (there’s some HIV and trans exclusion hijinks going down in some states); quick action once the Medicare transgender ruling comes down; better measures for and more data collection on trans people; more research on many topics; and smart attention to legacy planning as we inch nearer an administration change.

Then it came time for the Chairs of the HHS LGBT Issues Coordinating Committee to hear our individual priorities. The meeting ran long as we all got our 90 seconds to chime in. This list really covered most everything anyone could think of, it’s a testament again to the depth of our joint work on health that there’s activity on so many fronts.

What were my top priorities for the administration in the coming year?

First, tobacco. We’ve developed a great depth of HIV work in part because the feds prioritize it, as they should. Considering tobacco is our top health burden by far, we need the feds to use that model to do more to prioritize LGBT tobacco. The fact that since 1988 NIH has only funded nine studies on LGBT tobacco use and only a handful more on cancer is a shame and the first area to fix.

Second, data. The feds may be pleased with more trans data collection on state surveys, but they’re spreading a measure that is only tuned to LGB across the federal surveys — including replacing a trans inclusive question on the smoking survey with this new LGB question. So we need them to start spreading trans data collection across federal surveys too, not just the states’ surveys.

Third, legacy planning. It’s a sad truth that our health integration is dependent on politics, but until science rules the day, we have to brace ourselves for internal discrimination after an administration change. One of the most powerful things HHS can do to help preserve progress is to finally declare LGBT people a legally designated health disparity population. There’s ample evidence to support the move and once it’s done you’ll see LGBT listed alongside other disparity populations on funding announcements across HHS, regardless of who’s in the Executive branch.

That’s the report! It was a vibrant meeting, I look forward to seeing how HHS turns LGBT health priorities into an action plan for the coming year.

Follow Scout, Ph.D. on Twitter: www.twitter.com/scoutout

Network Pitches HuffPost to Launch Wellness Page & They Do!!!

Director of CenterLink’s Network for LGBT Health Equity

I assure you, we have plenty of ideas which are horrible, but some of them are good, and a few might even be great. Last Fall, as the head of the Cancer Network (Liz) and I were talking over how to spread more LGBT wellness messages we tossed around a bunch of ideas. Our running favorite for the longest time was to start a new blog, one that had less policy (like this one) and more of a focus on wellness things individuals could do. (Because really, this blog spends a lot of time talking public health wonk talk, and we hear there are some people who couldn’t care less about that. <– crazy tho that may seem) We even came up with a name: Rainbow Chard. (Come on, crack at least a small chuckle, ok?)Screenshot 2014-02-24 12.30.55

But why have an ok idea if a great idea is waiting in the wings? All my media friends keep saying, “don’t start a new blog, write for someone else”. So that got me thinking, and long and we thought, what if we could get the largest LGBT media outlet to start a page focused on LGBT wellness? We immediately sent off an email and asked the intrepid Noah Michelson, the editor of Huffington Post’s super popular Gay Voices page if he’d meet with us and within a day we were sitting in the Huffington Post fancy offices (I’m not sure Noah has an office, I think we met under a stairwell) telling him how no one was talking about how the whole wellness revolution was affecting queers, and we had this vision of a new Gay Voices page which could be an anchor for wellness writ large. Social support, getting over barriers to healthcare, exercising more, eating better, staying tobacco free, taking care of our mental health, everything we do to make ourselves healthier every day — Gay Voices could have one page showcasing all of this.
Little did we know we arrived at just the perfect time. Noah told us all about how Arianna Huffington had been talking with a mutual friend, Hilary Rosen, about what else, what else went into a life well lived beyond the usual suspects, money and power. Hilary hit the nail on the head, “So you’re looking for the third metric?” And if you notice, there’s been a whole upsurgence of #thirdmetric focused reporting across the whole Huffington Post website ever since. Well… our idea was a perfect fit with this concept. To our surprise, and happiness, Noah was on board right away. Let’s do this!
Let’s also give a little context. As Noah told us that day, Huffington Post Gay Voices gets 80k people visit it every day to see what’s new. That’s huge, 80k people a day going to the site to find out whassup. That’s not even counting the number of people reading stories which are pushed out.
So after a swath of planning time, we could not be more proud to report that Huffington Post has now launched their new Gay Voices Wellness section. Now their reporters and bloggers can tag stories to go straight to this page, or you can visit it to get all your LGBT wellness inspiration. Liz and I have promised to blog like mad for the page, and we’re trying to get other HuffPost bloggers turned on to post more health stories as well. So make it your goto for health and be sure to send kudos to Huffington Post as well! Check the page out directly here: http://www.huffingtonpost.com/news/lgbt-wellness/.

Sia Inspires Me to Be a Healthier Trans Person

An Evening With Women Benefiting The L.A. Gay & Lesbian Center - Red Carpet

There’s something oddly intimate about a person’s exercise playlist. If you’re like me and hear the same songs every day for 30 minutes to an hour of sweating, the playlist takes on its own life. Memories of pushing, sweating, and endorphins get laid on top of each track like delicious frosting. But these are popular singers, so you may like the music, but you rarely have a personal connection to the performers.

So imagine my surprise when I realized that several of my treasured workout songs are sung by a woman I first met at a meeting to plan a trans visibility action. At first I was disbelieving. I knew that their names are the same, but I told myself that the Sia who sings “Titanium” and the Sia I first met on that grassy hillside must be different people. My daughter finally convinced me that they are one and the same.

My most pronounced reaction was incredulity: She supports us! I already respected her for taking a leadership role in such a beautiful and strong visibility action, but now, knowing the pressures of the heady professional world she travels in only increased my respect tenfold.

Every day, as I ran, swam, or cycled further, it was like I had a friend encouraging me every time a song of hers came on. But when I thought further about the situation, I realized that the other side of the story was the really sad part: My incredulity at Sia being willing to stand up and support trans people showed how much I had internalized the norm that most celebrities would not stand up for my rights. They would not be moved nearly to tears thinking about the daily threats of violence that some trans people endure, or the staggering lack of safety that so many trans youth face as they try to survive. For every Lady Gaga, for every Sia, there are hundreds of celebrities who could use their potential to influence public opinion in our favor, yet they stay quiet. As we always teach in our cultural competency trainings, considering our history of discrimination, until you prove you’re a friend, we have no way of knowing you’re not an enemy.

Sia’s far from an enemy. She’s unabashedly one of us, publicly proclaiming her bisexuality. “I’ve always dated boys and girls and anything in between,” she’s said. “I don’t care what gender you are, it’s about people.” I know that a few other singers have said similar things, but I also know of many, many more who have worked very hard to hide any LGBT tendencies. Actions send messages, and the negative ones are still much more frequent than the positive ones.

Now I follow Sia stories with particular interest. I was fascinated to read of her effortsto keep her pictures out of the media, in what was a cogent analysis of the false promise of widespread fame. I also heard with concern how her own health issues led her to consider retiring from singing forever.

Every day, as I push myself to become stronger, as I chase the wonderful endorphins that help calm and center me for a world whose winds too often blow cold for trans people, I have a visit from a friend as Sia’s songs come on. Sia has inspired me to become a healthier trans person. I’d love to be able to return the favor in person, but until then I can only hope that Sia is taking good care of herself too.

Follow Scout, Ph.D. on Twitter: www.twitter.com/scoutout

Missouri Case Study 3: The Hospital That Wants To Stay In the Closet

Tracey PROMOTracy McCreery
Manager of Public Policy, PROMO
The Closeted Hospital Lobby

The Closeted Hospital Lobby

A targeted hospital, when we researched online, was discovered to have what appeared to be a perfect score on the Human Rights Campaign (HRC) Healthcare Equality Index (HEI). How exciting, right? Now I just needed to find someone inside to complete the survey. I didn’t know anyone on the management team, but from my days in the legislature I’d met and worked with the hospital’s lobbyist. He had some checking to do and what he reported to me was a bit shocking but maybe not really surprising, this is Missouri after all. This hospital did not want anyone to know about their policies and so were not going to complete the survey.  No explanation was given so I can only speculate. Are they worried about anti-LGBT protesters outside their hospital? Obviously, executives at the highest level think it is important to have policies that are friendly to both LGBT patients and employees. But until those policies are promoted to patients they won’t really create any change. Our job in the next year will be to convince them that the public supports workplace fairness and an LGBT patient’s right to health care free from discrimination.

People need to know this information, so why am I being mysterious?  Because I prefer the carrot (versus the stick) approach.  I will be working with this hospital to encourage them to complete the 2014 HRC HEI.  I’m hopeful they will do it willingly this year.  Why?  Because if they don’t, HRC is going to include this hospital in the HEI 2014 anyway.  HRC staff will evaluate them vis-a-vis the Core Four criteria for LGBT patient-centered care even if they choose not to actively participate.

Missouri Case Study 2: The Nurse Who Changed A Whole Hospital System

Icon_2011 Headshot
Sherrill Wayland
ED, SAGE of Metro St. Louis
Cochran VA

John Cochran VA Medical Center

In 2011, when “Don’t Ask, Don’t Tell’ was repealed, the Veterans Health Administration (VA) looked at ways to optimize healthcare for LGBT veterans. The VA medical centers were encouraged to participate in the HEI.  In the past, SAGE has consulted with local Veterans receiving care at the VA and helped them navigate the system. We reached out to VA and invited them to be a part of our LGBT Health Access Roundtable.

Sometimes all it takes is one person to champion a cause.  The nurse in charge of the VA LGBT Diversity Council learned of the trainings being conducted by SAGE and invited us to join the VA LGBT Diversity Council.  This Council interacts with all levels of the VA to help ensure that the local VA is meeting all requirements set forth at the federal level to ensure LGBT health access.

A critical change was recognizing that LGBT patients may have concerns related to fair treatment and access. The VA created an LGBT liaison who is available to help LGBT patients navigate the system and request a new doctor if they are not comfortable with the care being received. Over the past year, the work at the VA in St. Louis has grown to include a robust offering of LGBT Health Cultural Competency Trainings provided by VA employees and SAGE. We are currently in the process of developing a schedule of trainings for SAGE to present on a monthly basis.

SAGE recognized the VA with the first SAGE excellence in community care award at our 5th Anniversary celebration.  SAGE presented them with a plaque and asked all Veterans in the audience to step forward so the VA could see those impacted by LGBT care.

2014 is shaping up to be another good year for the VA.  They’re making plans to attend their 2nd Pride Festival, continuing to identify things they can do  to be more LGBT inclusive, and are offering ongoing LGBT health trainings.

Missouri Case Study 1: The Almost-There Hospital

Barnes-Jewish Hospital in St. Louis

Barnes-Jewish Hospital in St. Louis

Tracey PROMOTracy McCreery

Manager of Public Policy, PROMO

Barnes-Jewish Hospital (BJH) was the single Missouri entity that filled out the Human Rights Campaign (HRC) Healthcare Equality Index (HEI) the year before. But according to the HEI, they only had two protections out of 7, yet when we looked online, we could find evidence of 5 protections out of 7. But before we go further, let me explain the seven different HEI components for 2012 (they added one more in 2013).

Healthcare Equality Index from Human Rights Campaign

1a. Patient Bill of Rights and/or nondiscrimination policy includes “sexual orientation”?

1b. Ditto “gender identity”?

1c. [added in 2013] Nondiscrimination is conveyed to patients in at least two accessible ways?

2a  Explicitly inclusive visitation for same-sex couples?

2b. Ditto same-sex parents?

3a. Equal employment opportunity policy includes “sexual orientation”?

3b. Ditto “gender identity”?

4.   Provide cultural competency training?

Luckily BJH has an office on diversity, inclusion and equity- so since the new HEI survey was open, we started calling this office to see who could fill it out, and hopefully add the additional protections we found online in the mix too. The process took longer than we’d thought. We found a liaison in the office who could fill out the HEI survey, but HRC reported that they’d filled out the same responses as the year before (thanks Shane!). It took several meetings and a series of calls, and even then, the HEI deadline almost passed and they still hadn’t entered their updates. To make things even more complicated, we were looking up protections assured by their parent company, BJC HealthCare, which had a great LGBT nondiscrimination policy which initially appeared to apply to all subsidiaries… but after meeting with Barnes-Jewish Hospital — they said it did not apply. (And to make things even more complicated, now the page with the parent corporation protections has been taken down. ← were we imagining it?)

Eventually our persistence paid off and BJH filled out the survey reporting five of the now eight categories as yes. They might have been a different five than we first thought, but the point was now one hospital system in the St. Louis region was firmly establishing itself as a leader among the pack for LGBT protections!

But at the same time PROMO was working with BJH, a private hospital, SAGE was working diligently with the largest public healthcare system in the area, Cochran VA Medical Center. Read more about that journey in our next case study.

Hello from PROMO & SAGE Metro St. Louis’ LGBT Health Policy Change Project

Tracey PROMOTracy McCreery
Manager of Public Policy, PROMO

Hi, my name is Tracy, and yes, like Scout said in his intro post, I’ve been leading an LGBT health policy change project in Missouri for the last year. It’s really been a fascinating journey, and as I get ready to end my tenure on this project (and move onto running for public office again!) I’d like to talk about some of the strategies we’ve used and the lessons we’ve learned. As you can guess, there have been a few surprises en route!

Rather than reinventing the wheel, we looked at the criteria the Human Rights Campaign (HRC) used for their Healthcare Equality Index (HEI)- a good benchmark to use for measuring policies. The HEI’s “Core Four” criteria for LGBT patient-centered care are 1. patient non-discrimination 2. equal visitation 3. employment non-discrimination and 4. training in LGBT patient-centered care.  One of the bonuses of using the HRC tool is that it has allowed for collaboration with local HRC folks. So few institutions respond, we realized one of the things we had to work on was getting more to fill out the survey. We focused on the biggest employers in the state, because the HEI looks at policies not just with consumers but with employees too.

We found a list of the 50 biggest private employers in the state, then prioritized seven of the biggest hospital systems to focus on initially. Then we started our legwork, trying to see what we could discover about their protective policies by searching online. We knew this, only one had even filled out the HEI the year before. But to our surprise, we found many more with protective policies. But frankly some of those policies existed but were not well publicized at all. You’d think if we just searched for LGBT on their website it would all come up, but that wasn’t always the case.

This led to a discussion about what were the necessary components to effective policy change. Ultimately, we all agreed — policy changes without adequate promotion aren’t real policy change at all. If a patient isn’t easily provided with the information that they have protections against discrimination, then are they really protected?

After doing this research we realized our change needed to focus on both policy adoption, and policy promotion. It seemed like getting agencies to promote policies they already had would be easy, so we tried to focus there first.

One of the challenges is finding the right person to contact at each institution who would even know the information to answer the HEI. You have to call and call and be transferred all over, it can be really challenging. The hospital that had a department focused on diversity and inclusion was the easiest, but no one else had a department like that. Overall we never found a single rule to help identify who the key person who might be in charge of adopting or promoting policies, we just called the front desk and started asking around.

Stay tuned, next post I’ll talk about our first hospital system.

Lessons from a Big State LGBT Health Policy Change Project

Director of CenterLink’s Network for LGBT Health Equity

Who’s got some of the best funded and staffed health policy change work in the country? Stop thinking coasts, because the answer will surprise you… Missouri. For a little over a year now the Missouri Foundation for Health has been funding locals to use their civil rights skills to change health policies to better serve the long overlooked LGBT population.

MO Group Photo

SAGE’s Sherrill Wayland and PROMO’s Tracy McCreery with Scout & Gustavo

For the last year we’ve had the pleasure of being the technical assistance provider to this Missouri-based collaboration aimed at changing health policies in the state to support LGBT health. Now we know health policy change is the most durable way to invest resources, because it lasts long after the funding is gone. We also know that the focus on policy change has really been amped up in recent years. Beyond that we know one more thing: there are very few resources to find out how to do policy change for LGBT wellness. Many of us are incorporating policy change into our goals, but it’s a newer field for the arena, we have fewer precedents to guide us. That’s why we are pleased to introduce a tiny series of blogs from the great folk in Missouri – telling us some of the lessons they’ve learned in the last year of LGBT health policy change work there.

Without further ado, please welcome Tracy McCreery, from the Missouri equality advocacy organization, PROMO. Tracy and the head of their partner group, Sherrill Wayland from SAGE Metro St. Louis, are the two person team who’s trying to change LGBT health in Missouri, one policy at a time.