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1. DATA SCAN: THE HEALTH OF THE
LESBIAN, GAY, BISEXUAL, AND
TRANSGENDER COMMUNITIES IN
COLORADO
Indira Gujral, PhD
Colorado Department of Public Health and Environment
Data Partner: ONE Colorado
September 8, 2011
2. Table of Contents
Elevating LGBT health in the United States
Overview of Survey Sampling
Health of LGBQ Youth: data from the 2009 Boulder
County Youth Risk Behavior Survey
Health of LGB Adults: data from the Colorado Behavioral
Risk Factor Surveillance System (2006 – 2009)
HIV or AIDS: state surveillance
Filling In the Gaps: Data from A Conversation with
Coloradans (One Colorado Education Fund’s Needs
Assessment)
Contacts and Resources
4. Elevating LGBT Health in the U.S.
In 2011, the U.S. Department of Health and
Human Services recommended 14 actions to
improve the health and well-being of the LGBT
communities.
5 Examples of Recommended Actions:
Healthy People 2020
The Affordable Care Act
Anti-Bullying Efforts
Improvements in Foster and Adoptive Care
Runaway and Homeless Youth Services
5. Elevating LGBT Health in the U.S.
U.S. Department of Health and Human Services
Recommended 6 Future Actions (2011).
Example of 2 Future Recommended Actions:
LGBT Cultural Competency Curricula
Increase the number of federally funded surveys
collecting data on Sexual Orientation and Gender
Identity (starts 2013)
7. Goals and Objectives
The goal of this data scan is to provide a
baseline of LGBT health in Colorado
To accomplish this goal, we have 2 Objectives
1. Provide data from two population-based surveys
assessing youth and adults
2009 Boulder County Youth Risk Behavior Survey
Behavioral Risk Factor Surveillance System
2. Provide data from convenience-sample survey of
adults
One Colorado Educational Fund’s Needs Assessment
9. Overview: Population-based Sampling
Population-based sampling is a probability
sampling method which selects a subset of
individuals from within a population to yield some
knowledge about the whole population.
Strengths of Population-based Sampling
Cost: cheaper to sample group than whole population
Time: data collection is faster
Extrapolation: can generalize results to whole population
Boulder County YRBS (generalize results about Boulder Youth)
Colorado BRFSS (generalize results about Colorado adults)
Weakness of Population-based Sampling
Accuracy: for small populations, need to aggregate years
Story: does not tell a full story
10. Overview: Convenience Sampling
Convenience sampling is a type of non-probability
sampling in which the sample is drawn from a
population because the sample is readily available
and convenient.
Strengths of Convenience Sampling
Cost: cheaper than probability sampling
Time: data collection is very fast
Small and difficult to reach populations
One Colorado Education Fund’s Needs Assessment (LGBT
community)
Provides insight for new questions to be asked on population-based
surveys
Weaknesses of Convenience Sampling
Extrapolation: can NOT generalize results to whole population
11. THE HEALTH OF LGBQ YOUTH IN
BOULDER COUNTY, COLORADO
Youth Risk Behavior Survey
Boulder County Health Public Health
November, 2009
12. Methods: 2009 Boulder County YRBS
2009 Boulder County Youth Risk Behavior Survey
US Youth Risk Behaviors Survey
Purpose is to monitor health risk behaviors (not assets)
Data collected from randomly sampled schools and
classrooms across the United States every other year
Does NOT collect sexual orientation
Boulder County YRBS does collect sexual
orientation (county adds the question)
13. Methods: 2009 Boulder County YRBS
Boulder County YRBS
Administered in 18 high schools
9 high schools in Boulder County School District
9 high schools in St. Vrain Valley School District
108 questions (including sexual orientation)
2,491 high school students
Sexual Orientation Status
Lesbian, Gay, Bisexual and Questioning (LGBQ)
Excludes Gender Identity
14. Results: 2009 Boulder County YRBS
Results by Topic Area
Demographics
Family and Community Service
Injury
Safety and Harassment
School Safety
Sexual Assault and Dating Violence
Depression
Suicide
Tobacco, Alcohol, and Marijuana
Weight Issues
Behaviors Influencing Weight
Physical Activity
15. Results: Demographics
Sexual Orientation
9.3
LGBQ
Heterosexual
90.7
Source: 2009, Boulder County Youth Risk Behavior Survey; Boulder County Health Department.
16. Results: Family and Community
100%
90% * 86%
80% 78% 77%
*
70% 64%
60%
50% *
43% LBGQ
40% 38%
Heterosexual
30%
20%
10%
0%
Parents have 4 or more meals with Engaged in
behavior standards family per week Community Service
*Statistically Significant Difference between LGBQ and Heterosexual (p<0.05)
Source: 2009, Boulder County Youth Risk Behavior Survey; Boulder County Health Department.
17. Results: Injury
100.0%
90.0%
80.0% 75.2%
68.8%
67.1%
70.0%
60.0%
50.0% LGBQ
40.0% * Heterosexual
31.6%
30.0% 24.6%
22.4%
Colorado
20.0% *
10.0% 7.7% 7.6%
5.0%
0.0%
Never/rarely wear Never/rarely wear Rode with Driver
bicycle helmet seat belt who drank alcohol
*Statistically Significant Difference between LGBQ and Heterosexual (p<0.05)
Source: 2009, Boulder County Youth Risk Behavior Survey; Boulder County Health Department.
18. Results: Safety and Harassment
100.0%
90.8%
90.0% *
78.4%
80.0%
70.0%
60.0%
50.0%
* LGBQ
40.0% *
29.8%
26.8% Heterosexual
30.0%
20.0% 12.9%
10.0% 3.9%
0.0%
Felt Safe in Electronically Bullied Harassed because
Neighborhood someone thought you
were LGB
*Statistically Significant Difference between LGBQ and Heterosexual (p<0.05)
Source: 2009, Boulder County Youth Risk Behavior Survey; Boulder County Health Department.
19. Results: School Safety
100.0%
90.0%
80.0%
70.0%
60.0%
50.0% LGBQ
40.0% Heterosexual
*
30.0% Colorado
* * 20.8%
20.0% 14.9% 14.1%16.7%
13.4%
10.0% 4.0% 5.1% 5.9% 8.0%
0.0%
Did not go to school Threatened or Carried a weapon
because felt unsafe injured on school
property
*Statistically Significant Difference between LGBQ and Heterosexual (p<0.05)
Source: 2009, Boulder County Youth Risk Behavior Survey; Boulder County Health Department.
20. Results: Dating and Sexual Assault
100.0%
90.0%
80.0%
70.0%
60.0%
50.0% LGBQ
Heterosexual
40.0%
* Colorado
30.0%
* 20.8% *
20.0% 13.8%
9.1% 10.7%
10.0% 6.4% 7.7%
4.4% 2.4% 4.6%
0.0%
Hurt by Forced to have sexual First sex < age 13
girlfriend/boyfriend intercourse
*Statistically Significant Difference between LGBQ and Heterosexual (p<0.05)
Source: 2009, Boulder County Youth Risk Behavior Survey; Boulder County Health Department.
21. Results: Depression
100.0%
90.0%
81.6%
80.0% *
72.9%
70.0%
60.0% *
52.2% 51.6%
50.0% LGBQ
Heterosexual
40.0% *
29.3% Colorado
30.0% 25.4%
22.3%
20.0%
10.0%
0.0%
Felt sad/hopeless Has someone to talk Gets help when sad
*Statistically Significant Difference between LGBQ and Heterosexual (p<0.05)
Source: 2009, Boulder County Youth Risk Behavior Survey; Boulder County Health Department.
22. Results: Suicide
100.0%
90.0%
80.0%
70.0%
60.0%
50.0% LGBQ
* * Heterosexual
40.0% 35.3%
28.9% Colorado
30.0% *
20.3%
20.0% 13.7%
11.1% 9.2%11.0%
10.0% 7.6%
4.2%
0.0%
Seriously considered Planned suicide Attempted suicide
*Statistically Significant Difference between LGBQ and Heterosexual (p<0.05)
Source: 2009, Boulder County Youth Risk Behavior Survey; Boulder County Health Department.
23. Results: Tobacco, Alcohol, Marijuana
100.0%
90.0%
80.0%
70.0%
60.0% *
52.3%
50.0% LGBQ
* 41.8%
39.0% 40.8% Heterosexual
40.0%
Colorado
30.0% 24.3%24.9% *
20.3%
20.0%
10.0% 7.6%
4.2%
0.0%
Current tobacco use Current alcohol use Current marijuana
use
*Statistically Significant Difference between LGBQ and Heterosexual (p<0.05)
Source: 2009, Boulder County Youth Risk Behavior Survey; Boulder County Health Department.
24. Results: Weight Issues
100.0%
90.0%
80.0% 73.9%
70.0% *
58.9%
60.0% *
50.0% 47.7% LGBQ
37.8%38.6% Heterosexual
40.0%
Colorado
30.0%
20.0% *
11.8%
10.0% 5.1% 7.1%
0.0%
Obese Trying to lose Vigorous physical
activity
*Statistically Significant Difference between LGBQ and Heterosexual (p<0.05)
Source: 2009, Boulder County Youth Risk Behavior Survey; Boulder County Health Department.
26. THE HEALTH OF LGB ADULTS IN
COLORADO
Behavioral Risk Factor Surveillance System
Colorado Department of Public Health and Environment
2006 – 2009
27. Background
According to the Williams Institute at
UCLA School of Law, it is estimated that
more than 186,000 LGBT individuals
live in Colorado, including 12,000
transgender people.
28. Background: LGBT Health
Colorado Behavioral Risk Factor Surveillance System (2006 – 2009)
Very few federal and state health surveillance
surveys include measures of respondents’ sexual
orientation
Research from non-population-based surveys
provides evidence of health disparities among
lesbian, gay, bisexual, and transgender (LGBT)
populations
Healthy People 2020, the US Department of Health
and Human Services, the Institute of Medicine, and
others call for increased efforts to study and to
improve LGBT health
29. Background: Sexual Orientation and
the BRFSS
Colorado Behavioral Risk Factor Surveillance System (2006 – 2009)
Few states have added sexual orientation to the
Behavioral Risk Factor Surveillance Survey (BRFSS)
Recently published results from Massachusetts and
Washington provide evidence of LGBT health
disparities
Conron et al., AJPH, October 2010
Dilley et al., AJPH, March 2010
Colorado added sexual orientation to its BRFSS in
2006
30. Methods: Colorado’s BRFSS Question
Colorado Behavioral Risk Factor Surveillance System (2006 – 2009)
“Research has shown that some sexual minority
community members have important health risk
factors. We are collecting information about sexual
orientation to learn whether this is true in Colorado.
Do You consider yourself to be: Heterosexual, that is, straight;
Homosexual, that is, gay or lesbian; Bisexual, or something
else?
Survey Does NOT measure Gender Identity
31. Results: Demographics of BRFSS Respondents
0.9% 0.1% 1.3%
Sexual Orientation
Homosexual
Heterosexual
Bisexual
Other
97.7%
Source: 2006 – 2009, Colorado Behavioral Risk Factor Surveillance System; Health Statistics Section, Colorado Department of
Public Health & Environment.
32. Demographics of Respondents: Age
100.0%
90.0%
79.3%
80.0%
70.0% 63.2%
60.0%
52.8%
Homosexual
50.0%
Bisexual
40.0% 37.4%
Heterosexual
30.0% 24.3%
20.0% 16.4%
12.5%
9.8%
10.0% 4.4%
0.0%
18-34 35-49 50+
Source: 2006 – 2009, Colorado Behavioral Risk Factor Surveillance System; Health Statistics Section, Colorado Department of
Public Health & Environment.
33. Demographics of Respondents: Urban/Rural
100.0%
90.0%
80.0%
70.0% 65.1%63.2%
60.0%
51.5% Homosexual
50.0%
Bisexual
40.0% Heterosexual
30.2%
30.0% 24.6%22.8%
18.3%
20.0% 13.7%
10.4%
10.0%
0.0%
Denver Metro Other Urban Rural
Source: 2006 – 2009, Colorado Behavioral Risk Factor Surveillance System; Health Statistics Section, Colorado Department of
Public Health & Environment.
34. Demographics of Respondents: Race/Ethnicity
100.0%
90.0%
80.0% 76.0% 75.0%
70.2%
70.0%
60.0%
Homosexual
50.0%
Bisexual
40.0% Heterosexual
30.0%
19.5%17.8%
20.0% 13.6%
10.0% 5.0% 4.0%
3.3% 2.5% 3.4% 3.4% 3.7%
1.2% 1.4%
0.0%
White Black Hispanic Other Multiracial
Source: 2006 – 2009, Colorado Behavioral Risk Factor Surveillance System; Health Statistics Section, Colorado Department of
Public Health & Environment.
35. Demographics of Respondents: Educational Attainment
100.0%
90.0%
80.0% 74.3%
70.0% 67.2%
59.3%
60.0%
50.0% Homosexual
40.0% Bisexual
29.1% Heterosexual
30.0% 24.0%
21.7%
20.0%
11.6%
8.7%
10.0% 4.0%
0.0%
Did not complete High School Some College
High School Graduate
Source: 2006 – 2009, Colorado Behavioral Risk Factor Surveillance System; Health Statistics Section, Colorado Department of
Public Health & Environment.
36. Demographics of Respondents: Poverty
100.0%
90.0%
80.0% 73.1% 74.1%
70.0%
60.0% 54.6%
Homosexual
50.0% 45.4%
Bisexual
40.0% Heterosexual
30.0% 26.9% 25.9%
20.0%
10.0%
0.0%
Below 200% FPL Above 200% FPL
Source: 2006 – 2009, Colorado Behavioral Risk Factor Surveillance System; Health Statistics Section, Colorado Department of
Public Health & Environment.
37. Demographics of Respondents: Marital Status
100.0%
90.0%
80.0%
70.0% 65.3%
60.0%
47.7% Homosexual
50.0% 46.2%
40.0% Bisexual
34.4%
29.2% Heterosexual
30.0%
20.0% 14.6% 16.0%
13.4%
8.6% 10.8% 9.7%
10.0% 4.2%
0.0%
Married Formerly Never Married Unmarried
Married Couple
Source: 2006 – 2009, Colorado Behavioral Risk Factor Surveillance System; Health Statistics Section, Colorado Department of
Public Health & Environment.
38. Demographics of Respondents: Children in Household
100.0%
90.0%
82.9%
80.0%
70.0%
60.0% 54.1%
52.1% Homosexual
50.0% 47.9% 45.9%
Bisexual
40.0% Heterosexual
30.0%
20.0% 17.1%
10.0%
0.0%
Yes No
Source: 2006 – 2009, Colorado Behavioral Risk Factor Surveillance System; Health Statistics Section, Colorado Department of
Public Health & Environment.
39. Results: Demographic Summary
Variable Significant Not Significant
Age X
Rural Residency X
Race/Ethnicity X
Education X
Poverty X
Marital Status X
Children in Household X
*Statistically Significant Difference between LGBQ and Heterosexual (p<0.05)
Source: 2006 – 2009, Colorado Behavioral Risk Factor Surveillance System; Health Statistics Section, Colorado Department
of Public Health & Environment.
40. What is the prevalence of health
conditions and behaviors among
Colorado’s LGB population?
41. Results: General Health
12.0%
Fair or Poor General Health 14.4%
9.6%
17.8% Heterosexual
Some Physical Disability 30.1% * Bisexual
20.9% Homosexual
50.10%
Don't Always Get Needed Emotional
71.40%
Support
57.20%
*Statistically Significant Difference compared to Heterosexual (p<0.05)
Source: 2006 – 2009, Colorado Behavioral Risk Factor Surveillance System; Health Statistics Section, Colorado Department of
Public Health & Environment.
42. Results: Health Services and Screenings
16.6%
No Health Insurance 31.3% *
14.2%
20.7%
No Regular Primary Care Provider 26.0%
24.5%
Heterosexual
61.8%
Never had an HIV test 37.4% Bisexual
29.7% *
Homosexual
60.2%
Did Not Get Flu Shot 71.6% *
60.2%
76.7%
Did Not Get Pneumonia Vaccine 78.4%
74.3%
*Statistically Significant Difference compared to Heterosexual (p<0.05)
Source: 2006 – 2009, Colorado Behavioral Risk Factor Surveillance System; Health Statistics Section, Colorado Department of
Public Health & Environment.
43. Results: Risk Behaviors
6.70%
Don't Always Use a Seatbelt 5.80%
8.80%
17.2%
Physically Inactive 20.2%
12.4% *
16.4% Heterosexual
Binge Drink 28.2%* Bisexual
25.0%* Homosexual
17.3%
Current Smokers 35.4%*
34.1%*
74.9%
Insufficient Fruits and Vegetables 73.1%
75.5%
*Statistically Significant Difference compared to Heterosexual (p<0.05)
Source: 2006 – 2009, Colorado Behavioral Risk Factor Surveillance System; Health Statistics Section, Colorado Department of
Public Health & Environment.
44. Results: Chronic Disease
Diagnosed Heart Disease or Angina 4.5%
2.5%
Diagnosed with Diabetes 3.2%
3.4%
Current Asthma 13.8% Heterosexual
14.3% *
Bisexual
21.3% Homosexual
Diagnosed Hypertension 20.8%
22.3%
High Cholesterol 34.5%
32.3%
55.90%
Overweight or Obese 50.50%
48.90%
*Statistically Significant Difference compared to Heterosexual (p<0.05)
Source: 2006 – 2009, Colorado Behavioral Risk Factor Surveillance System; Health Statistics Section, Colorado Department of
Public Health & Environment.
45. Results: Homosexual Respondents
Diagnosed Heart Disease or Angina 2.5%
Diagnosed with Diabetes 3.4%
Don't Always Use a Seatbelt 8.80%
Fair or Poor General Health 9.6%
Drinking and Driving 9.80%
Physically Inactive 12.4%
No Health Insurance 14.2%
Current Asthma 14.3%
Some Physical Disability 20.9%
Diagnosed Hypertension 22.3%
No Regular Primary Care Provider 24.5%
Binge Drink 25.0%
Never had an HIV test 29.7%
High Cholesterol 32.3%
Current Smokers 34.1%
Overweight or Obese 48.90%
Don't Always Get Needed Emotional Support 57.20%
Did Not Get Flu Shot 60.2%
Did Not Get Pneumonia Vaccine 74.3%
Insufficient Fruits and Vegetables 75.5%
0.0% 10.0% 20.0% 30.0% 40.0% 50.0% 60.0% 70.0% 80.0%
Source: 2006 – 2009, Colorado Behavioral Risk Factor Surveillance System; Health Statistics Section, Colorado Department of Public Health & Environment.
46. Results: Bisexual Respondents
Diagnosed Heart Disease or Angina 4.5%
Diagnosed with Diabetes 3.2%
Don't Always Use a Seatbelt 5.80%
Fair or Poor General Health 14.4%
Drinking and Driving 2.10%
Physically Inactive 20.2%
No Health Insurance 31.3%
Current Asthma 13.8%
Some Physical Disability 30.1%
Diagnosed Hypertension 20.8%
No Regular Primary Care Provider 26.0%
Binge Drink 28.2%
Never had an HIV test 37.4%
High Cholesterol 34.5%
Current Smokers 35.4%
Overweight or Obese 50.50%
Don't Always Get Needed Emotional Support 71.40%
Did Not Get Flu Shot 71.6%
Did Not Get Pneumonia Vaccine 78.4%
Insufficient Fruits and Vegetables 73.1%
0.0% 10.0% 20.0% 30.0% 40.0% 50.0% 60.0% 70.0% 80.0% 90.0%
Source: 2006 – 2009, Colorado Behavioral Risk Factor Surveillance System; Health Statistics Section, Colorado Department of Public Health & Environment.
47. Results: Heterosexual Respondents
Diagnosed Heart Disease or Angina 2.7%
Diagnosed with Diabetes 5.5%
Don't Always Use a Seatbelt 6.70%
Fair or Poor General Health 12.0%
Drinking and Driving 4.10%
Physically Inactive 17.2%
No Health Insurance 16.6%
Current Asthma 7.9%
Some Physical Disability 17.8%
Diagnosed Hypertension 21.3%
No Regular Primary Care Provider 20.7%
Binge Drink 16.4%
Never had an HIV test 61.8%
High Cholesterol 34.3%
Current Smokers 17.3%
Overweight or Obese 55.90%
Don't Always Get Needed Emotional Support 50.10%
Did Not Get Flu Shot 60.2%
Did Not Get Pneumonia Vaccine 76.7%
Insufficient Fruits and Vegetables 74.9%
0.0% 10.0% 20.0% 30.0% 40.0% 50.0% 60.0% 70.0% 80.0% 90.0%
Source: 2006 – 2009, Colorado Behavioral Risk Factor Surveillance System; Health Statistics Section, Colorado Department of Public Health & Environment.
48. Results: Summary
Diagnosed Heart Disease or…
Diagnosed with Diabetes
Don't Always Use a Seatbelt
Fair or Poor General Health
Drinking and Driving
Physically Inactive
No Health Insurance
Current Asthma
Some Physical Disability
Diagnosed Hypertension Heterosexual
Bisexual
No Regular Primary Care…
Homosexual
Binge Drink
Never had an HIV test
High Cholesterol
Current Smokers
Overweight or Obese
Don't Always Get Needed…
Did Not Get Flu Shot
Did Not Get Pneumonia Vaccine
Insufficient Fruits and Vegetables
0.0% 10.0% 20.0% 30.0% 40.0% 50.0% 60.0% 70.0% 80.0% 90.0%
Source: 2006 – 2009, Colorado Behavioral Risk Factor Surveillance System; Health Statistics Section, Colorado Department of Public Health & Environment.
49. Conclusions
Disparities in health behaviors and health conditions
do exist between Colorado’s heterosexual and LGB
populations
LGB populations are not homogenous
The prevalence of health behaviors and health
outcomes varies within the LGB population
50. Limitations and Future Opportunities
No data on transgender Coloradans
No statewide data on LGBT youth
Insufficient sample size to conduct analysis of
rotating core and state added BRFSS questions by
sexual orientation
51. HIV OR AIDS
Colorado HIV Surveillance Report
Colorado Department of Public Health and Environment
4th Quarter, 2010
52. Background: HIV or AIDS
In Colorado, physicians, health care providers,
hospitals, or any other person providing testing
and/or counseling or treatment to a person with HIV
infection are required by law to report HIV and
AIDS related information to the Colorado
Department of Public Health and Environment, or
local health department.
Laboratories must report tests that indicate HIV
infection.
53. Overview: HIV or AIDS in Colorado
The first case of Acquired Immune Deficiency Syndrome
(AIDS) was diagnosed in 1982.
Between 1982 and 2010, nearly 16,600 people have
been diagnosed with HIV disease in Colorado.
Between 2006 and 2010, new HIV diagnoses averaged
430 per year.
Between 2006 and 2010, HIV/AIDS deaths averaged
103 per year.
Since highly active antiretroviral therapy (HAART)
became widely available in 1996, both AIDS diagnoses
and HIV/AIDS related deaths have declined significantly.
54. New Cases of HIV by year, Colorado
350
302
300 279
Number of New HIV Cases
256 249 249
250
200
150 Male-male sex
Heterosexual contact
100 72 76
64
52 48
50
0
2006 2007 2008 2009 2010
Year
Source: 4th Quarter, 2010, Colorado HIV Surveillance Report; Colorado Department of Public Health & Environment.
55. Racial/ethnic categories of individuals living with HIV
due to male-male sex exposure, December 31, 2010
Percent
0.5%
0.7% 0.7%
White
16.0%
Black
Hispanic
9.0%
Asian/Pacific Islander
American
73.0% Indian/Alaska Native
Multiple/Unknown
Source: 4th Quarter, 2010, Colorado HIV Surveillance Report; Colorado Department of Public Health & Environment.
56. FILLING IN THE DATA GAPS: THE
HEALTH OF LGBT ADULTS IN
COLORADO
One Colorado Education Fund’s Needs Assessment
ONE Colorado
2010
57. Methods: 2010 Conversation with
Coloradans
One Colorado Education Fund’s Needs
Assessment (AKA Needs Assessment)
Purpose: start a dialogue about issues affecting
LGBT people in Colorado
Online or print survey of over 4,600 respondents
Strength: sample size and inclusion of
transgender people
Weakness: not population-based; cannot
generalize to the entire state
58. Results: 2010 Conversation with
Coloradans
One Colorado Education Fund’s Needs Assessment
Results by Topic Area
Demographics
Housing Discrimination
Employment Discrimination
Spirituality
Philanthropy
Top 5 Most Important Social Services
59. Health Equity
Health Begins Where You Live, Learn, Work and Play
NATIONAL INFLUENCES
GOVERNMENT POLICIES
U.S. CULTURE & CULTURAL NORMS
+ =
SOCIAL DETERMINANTS OF HEALTH POPULATION
LIFE COURSE
HEALTH FACTORS OUTCOMES
ACCESS ,
HEALTH
PREGNANCY ECONOMIC PHYSICAL SOCIAL MENTAL UTILIZATION
BEHAVIORS & HEALTH & QUALITY QUALITY OF LIFE
OPPORTUNITY ENVIRONMENT FACTORS
CONDITIONS
CARE
EARLY
• Nutrition • Mental health • Health
MORBIDITY
CHILDHOOD • Income Built • Participation
Environment • Physical status insurance
• Employment • Social
• Education •Recreation support activity • Stress coverage MORTALITY
•Food • Tobacco use • Substance • Received
CHILDHOOD • Housing • Leadership
abuse needed care
•Transportation
• Political • Skin Cancer LIFE EXPECTANCY
• Injury • Functional • Provider
influence
Environmental status availability
• Organization • Oral health
ADOLESCENCE quality • Preventive
al networks • Sexual health
•Housing care
• Violence
•Water
• Racism • Obesity
ADULTHOOD •Air
• Cholesterol
Safety • High Blood
Pressure
OLDER ADULTS
Public Health’s Role in Addressing the Social Determinants of Health
•Advocating for and defining public policy to achieve health equity •Data collection, monitoring and surveillance
•Coordinated interagency efforts •Population based interventions to address health factors
•Creating organizational environments that enable change •Community engagement and capacity building
Colorado Department of Public Health - Social Determinants of Health Workgroup
60. Demographics: Sexual Orientation
Respondents
2% 1%
5% 9%
Bisexual
Lesbian
29% Gay
Queer
Chose not to label
54% Self-Identify
Source: 2010, Needs Assessment; One Colorado.
61. Demographics: Gender Identity
Respondents
3% 1%
39% Female
Male
Transgender/Transsexual
Self-Identify
57%
Source: 2010, Needs Assessment; One Colorado.
62. Demographics: Gender Identity
Transgender People
13%
26%
Female to Male
Male to Female
Self-Identify
61%
Source: 2010, Needs Assessment; One Colorado.
63. Demographics: Age
Age Group
100%
90%
80%
70%
60%
50%
40%
30% 25% 24% 22%
20% 15%
12%
10% 3%
0%
18-24 25-34 35-44 45-54 55-64 65 or older
Source: 2010, Needs Assessment; One Colorado.
64. Housing Discrimination
Report Being Denied Housing
100%
90% 87%
80%
70%
60%
50%
40%
30%
20%
10% 5% 7%
4% 2%
0%
No one Attorney Colorado Civil Police Other
Rights
Commission
Six (6) percent of respondents reported being denied housing due to sexual
orientation or sexual identity
Source: 2010, Needs Assessment; One Colorado.
65. Employment Discrimination
Report Employment Discrimination
100%
90%
80% 72%
70%
60%
50%
40%
30% 22%
20%
7% 9%
10% 3% 3%
0%
0%
No one Human Attorney Colorado Police School Other
Resources Civil Rights Official
Commission
Twenty-seven (27) percent of respondents experienced employment discrimination
due to sexual orientation or sexual identity
Source: 2010, Needs Assessment; One Colorado.
66. Spirituality: Attending religious service
100%
90%
80%
70%
60%
50% LGBT
41%
40% Transgender Only
31%
30% 23%23%
20% 17% 15%15%
12%14%
9%
10%
0%
1 or more 1-3 Few times/yr 1 time/yr Never
times/wk times/mth
Source: 2010, Needs Assessment; One Colorado.
67. Philanthropy: Contributing to Charity
100%
90%
80%
70%
62%
60% 58%
50% LGBT
40% Transgender Only
30%
20% 16% 14% 15%
10% 10% 8%
10% 4% 3%
0%
$0 $1-499 $500-999 $1,000-4,999 $5,000
Source: 2010, Needs Assessment; One Colorado.
68. Top 5 Most Important Social Services
100%
90%
80%
70%
60%
50%
LGBT
40% 34%
30%
20%
10% 9% 8%
10%
0%
Ensuring school safety for LGBT Access to LGBT-welcoming health Increasing services for people living Ensuring parents have information
youth care w/ HIV/AIDS for supporting LGBT youth
Source: 2010, Needs Assessment; One Colorado.
70. Data Contacts
Indira Gujral, MS PhD, Epidemiologist, CDPHE
Indira.Gujral@state.co.us
Kyle Legleiter, MPH, Program Director, CDPHE
Kyle.Legleiter@state.co.us
Fran Simon, Simon Analytics
Simonanalytics@gmail.com
Kieu Vu, MSPH, BRFSS Coordinator, CDPHE
Kieu.Vu@state.co.us
71. Resources
The Affordable Care Act and the LGBT Community:
http://lgbthealth.webolutionary.com/sites/default/files/ACA%20final.pdf
The Affordable Care Act and LGBT Americans:
http://www.healthcare.gov/news/factsheets/new_options_for_lgbt_americans.html
Boulder County Youth Risk Behavior Survey:
http://www.bouldercounty.org/help/health/lgbtiq/pages/yrbsresultslinks.aspx
Bullying: www.StopBullying.gov
Colorado HIV Surveillance Report:
http://www.cdphe.state.co.us/dc/HIVandSTD/HIV_STDSurv/HIV.AIDS.Surv.rpt.4thQuarter.20
10.pdf
One Colorado Needs Assessment: http://www.one-colorado.org/issues/2010-needs-
assessment/
Sexual Identity, Sex of Sexual Contacts and Health-Risk Behaviors Among Students in Grades
9 – 12 – Youth Risk Behavior Surveillance, Selected Sites, United States, 2001 – 2009:
http://www.cdc.gov/mmwr/preview/mmwrhtml/ss6007a1.htm
Sexual Behavior, Sexual Attraction, and Sexual Identity in the United States: Data from the
2006 – 2008 National Survey of Family Growth:
http://www.cdc.gov/nchs/data/nhsr/nhsr036.pdf
U.S. Health and Human Services: http://minorityhealth.hhs.gov/lgbt/