Out in the North: Perspectives of Gay Men's Health Issues in Northern BC

“ I am not even sure my own doctor knows I am gay.” Gay Men’s Health in Northern BC Notes from the front Theresa Healy Healthy Community Development ruralgaydating.com /

Overview ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Mary L. Gray, Out in the Country: Youth, Media, and Queer Visibility in Rural America , contradicts the presumptions of a deadly "broke back mountain" rural gay reality and the image of quiet desperation and hidden sad lives. Yes, there may be some, often painful, negatives in gay lives outside the larger urban settings but the necessity of building and forming relationships across differences in smaller communities means lives are lived intersectionality and the resulting complexity and collision where sexuality is not the only thing you are.

Northern Health ,[object Object],[object Object],[object Object]

Where do we fit? Agnes Snow Janine Luggi Julie Kerr Theresa Healy PUBLIC HEALTH - CORE FUNCTIONS Injury Prevention Tobacco Reduction Community Nutrition

The ICEBERG: What lies beneath ,[object Object],Diet Exercise Tobacco Poverty Abuse Addictions Racism Colonization Mental Health Literacy Housing Isolation The tip of the iceberg, we can see and measure and direct people to change; individual focus Beneath the surface are the things that impact and influence lifestyle, choices and capacities of change we can see and measure and direct people to change; needs a collective focus. Higher levels are barriers to be addressed. The deeper we go, the more complex and difficult the issues Sexual orientation matters above and below the waterline Homophobia

Determinants of Gay men’s health ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Focus on men’s health ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

This is why I work at Northern Health ,[object Object],[object Object],[object Object],A full copy of “Where are the men? Chief Medical Health officer’s report on the health and wellbeing of men in Northern BC” can be downloaded from the Northern Health website under Your Health – Men’s Health. ( www.northernhealth.ca ).

EXPOSING THE DETERMINANTS Bacteria, Behaviour & Boyfriends ,[object Object],[object Object],[object Object],[object Object],[object Object]

Presentation based on work done for the Northern Health Report on the Health and Wellbeing of men in northern BC ,[object Object]

Can a population health lens help to improve the health, wellbeing and quality of life for Gay men? ,[object Object]

Population health is…. An approach that aims to: elevate the health of the entire population AND reduce inequities among population groups

But….What’s missing? ,[object Object],Graph from: POPULATION HEALTH POLICY: ISSUES AND OPTIONS , Fourth Report of the Subcommittee on Population Health of the Standing Senate Committee on Social Affairs, Science and Technology

Income and health status ,[object Object],[object Object],You know, I am not even sure my own doctor knows I am gay. I want the fear of telling him to go away. My preference would be to go to an openly gay doctor where I wouldn’t even have to think about this. But from what I hear, from many gay health care professionals, nurses, doctors, they are deeply closeted. The health care isn’t kind to its own. I would line up to see a gay doctor. I mean, I like my doctor. He’s smart, he takes good care of me. I have no reason to believe he would treat me any different if he knew I was gay but I don’t know. . I am doing these complicated mental calculations about whether it is safe to come out or not: he’s married, he has an East Indian heritage, all these complex adding up and subtracting that tells me whether to be out or not.

Social Support Networks ,[object Object],[object Object],There is a reason they say Vancouver is the healthiest city with the healthiest lifestyle in Western Canada. There is access to healthy produce, to healthy activities, accessible and affordable choices. There is a great diversity of social opportunities. I can be openly out and having coffee in public with my friend. I can find a great diversity of entertainment. We just don’t have that here. Focus group #3 University of the Fraser Valley, Pride Network

Education and literacy ,[object Object],[object Object],Sit in protest, Sept 2010 UNBC Centre grand opening Nov 2010 No room at the inn, 2009

High schools as a place of torture? ,[object Object],[object Object],[object Object],If the stories hurt to hear – IMAGINE living them

Employment and working conditions ,[object Object],[object Object],[object Object],Men’s work in the North is generally more risky: logging, forestry, trucking, mining. In some cases there is extreme isolation – out in a camp far from anywhere for weeks at a time. Being out in conditions like that is unthinkable. But you take the work. Focus group #3 Photo Source: http://sun.menloschool. org/~sportman/ethics/ project/topics/heimbuck/ There is a psychological and ongoing stress to being gay in the North. Like at my workplace. Who to, or how much to come out; who is likely to beat me up after work.

Social Environments: Is it really a man’s world? “ The other barriers [to men’s health] are in the media. And this is happening to all men. There is pressure, an image of what a man should be, to measure up to. And it is a pretty boy image, he shaves everything every few days, has a ripped six pack.” “ Girls get all the rituals of puberty; they get taught about their bodies; they get a supported passage into womanhood. Boys get nothing like that and, in fact, men are taught not to talk to other men about their bodies.” Focus Group #3, August 2010 Gay men finding a place to belong and find appreciation and respect – difficult in any setting; complicated even further in the North.

Physical environments Pride 2008 PG ,[object Object],[object Object],[object Object],[object Object],[object Object],Here even finding counseling is hard. The community is so small people will find out. And if it is that bad here it is ten times worse in Burns Lake. Focus Group #3

Personal health and coping skills ,[object Object],[object Object],My first experience with health care in PG, I went to the walk-in clinic because I didn’t have a family doc. I needed a letter completed on my health for a position I was applying for. I still remember his name, I will till the day I die. He completed the form and came to the question about applicable diseases. I told him I was a gay man. He wrote in, “This man is at risk for HIV/AIDS and needs to be tested.” I take care of my health probably better than most straight men. He essentially outted me in this letter and I could have lost the job through discrimination. I whited it out before I submitted the letter. I was proactive. There are more risky behaviours around anal sex among straight men than gay . Focus group #3 Visit: www.savagechickens.com

Healthy child development ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],“ I just want somewhere safe to do my homework.” Haida Gwaii youth

Biology and Endowment ,[object Object],[object Object],Neil Swidey, What Makes People Gay? Boston Globe, (Illustration / Chris Buzelli; Globe Staff Photo / David Kamerman) “ I knew when I was five I was different. But I learnt to shut up about it. And when I was in high school, I did all the things you are supposed to do, dating girls, but I knew.” Interviewee, aged 23 “ My lover was murdered in a hate crime. I left Britain and came here. I lived in the closet my whole life. When I came out 2 years ago, it was because I didn’t want to die and have the neighbours come in and say, “I never knew he was gay.” Interviewee, aged 67

Health services ,[object Object],[object Object],On the job site you will get a razzing if you go to emergency for anything less than broken bones. I don’t know how many times I should have gone to the hospital for stitches but I just change the band aids more often. My finger grew back. Sort of. Eventually. Focus group #3 I don’t know if there is a greater risk in not telling him; what if something comes up that my orientation would be relevant to; that it would matter to gay men’s health that it should come up. I am in a committed and monogamous relationship, I am not part of the gay culture where sex practices might be a health issue. But the equation is there. Less than 100% honest = less than 100% care. Completely honest might mean no care. Focus group #3 Image from report on barriers to social and economic development cena1212.wordpress.com/

Gender ,[object Object],[object Object],[object Object]

Culture ,[object Object],[object Object],Facebook: Allies of Kutztown University Visit www.savagechickens.com permission

FEAR – Real and everywhere reinforced ,[object Object],[object Object],Size of community = loss of privacy Loss of job, home, place in society Violence: verbal, physical, emotional, mental, intellectual

Pride in Prince George 15 years next year ,[object Object]

“Not by the body alone” ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Contact information Theresa Healy, Ph. D. Regional Manager Healthy Community Development Ph: 1-250-565-7390; cell: 1-250- 612-2457 email: [email_address]

What we bring – IMAGINE a healthy community: it is all about relationships I nvesting upstream and for the long haul Improve for this generation and the generations to come M ultiple, strength based, strategies Many tools many hands A ddressing the determinants of health All things are connected, nothing stands alone G rassroots engagement Give everyone a chance to participate I ntersectoral collaboration Include partners from all around the community N urturing healthy public policy Nurture the leaders - they can make changes last E vidence based decision making Ensure the stories are recorded and told

Out in the North: Perspectives of Gay Men's Health Issues in Northern BC

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Out in the North: Perspectives of Gay Men's Health Issues in Northern BC