261523 Relationship between sexual minority discrimination and utilization of health services: Results from CRAS 2004

Sunday, October 28, 2012

Laura Hoyt D'Anna, DrPH , Center for Health Care Innovation, California State University, Long Beach, Long Beach, CA
Hannah Nguyen, PhD , Shidler College of Business, University of Hawai'i, Honolulu 96822, HI
Grace L. Reynolds, DPA , Center for Behavioral Research and Services, California State University, Long Beach, Long Beach, CA
Cristy Chen, MPH , Center for Health Care Innovation, California Statue University, Long Beach, Long Beach, CA
C. Kevin Malotte, DrPH , Center for Health Care Innovation, California State University, Long Beach, Long Beach, CA
Dennis G. Fisher, PhD , Center for Behavioral Research and Services, California State University, Long Beach, Long Beach, CA
Mike Janson, MPH , Office of AIDS Programs and Policy, County of Los Angeles, Department of Public Health, Los Angeles, CA
We examined the prevalence of and associations between sexual orientation-based verbal harassment and reported utilization of health services across levels of sexual orientation in a diverse sample of adult recipients (n = 1,995)of Los Angeles County-funded HIV-related health and social services. Thirty-two percent of Countywide Risk Assessment Survey (CRAS) participants experienced verbal harassment, the majority (80.3%) of who identified as lesbian, gay, or bisexual. Those who reported being verbally harassed received significantly more services overall than those who were not verbally harassed, and service utilization varied by sexual orientation. Specifically, among heterosexuals, those who experienced verbal harassment because of their sexual orientation used more overall health services from the OAPP-funded interviewing agency than heterosexuals who did not experience verbal harassment (t=-4.36, p<.001). The same was true for heterosexuals using OAPP-funded social support (t=-5.36, p<.001), social services (t=-4.26, p<.001) and medical treatment (t=-2.33, p<.05). Among gay men, those experiencing verbal harassment used social support (t=-2.22, p<.05) and social services (t=-1.93, p<.05) more often, whereas participants who identified as bisexual and had experienced verbal harassment used social support more often (t=-2.33, p<.05). Heterosexuals, gays and bisexuals who experienced verbal harassment used services available through other L.A. County agencies more often than individuals who did not experience the same type of discrimination. Among lesbians who experienced verbal harassment, no significant associations with service utilization within the OAPP-funded interviewing agency, or other L.A. County agencies, were found. However, a greater number of all OAPP-funded interviewing agency services, sexual health treatment, social support and medical services, and a greater number of all services and sexual health treatment within other L.A. County agencies were utilized by lesbians who experienced sexual identity-related verbal harassment compared to those who did not. These findings inform future efforts to identify and assess social discrimination in health and social service settings.

Learning Areas:
Diversity and culture
Provision of health care to the public

Learning Objectives:
1. Differentiate relationships between verbal harassment and health service utilization by sexual identity and service type. 2. Define challenges associated with measuring discrimination. 3. Identify areas of focus for future health equity research among sexual minority populations.

Keywords: Health Disparities, HIV/AIDS

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I obtained my doctorate from UCLA’s School of Public Health in 2006, and I have published two papers on reports of discrimination in health care settings. My research skills include study conceptualization, evaluation design, development of measurement tools, analyses of quantitative data, and preparation of findings in report, grant proposal and presentation formats. My research interests include racial and ethnic health disparities and specifically, how experiences of discrimination affect health and health disparities.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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