142nd APHA Annual Meeting and Exposition

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Health Care Utilization of Rural Kentucky Sexual and Gender Minorities

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Monday, November 17, 2014

Keisa Bennett, MD, MPH , Department of Family and Community Medicine, University of Kentucky, Lexington, KY
Background: In 2011 the Institute of Medicine (IOM) reported on disparities in health and healthcare access for sexual and gender minorities (SGM), emphasizing the need to examine health and health care through the lens of social ecology. There is a paucity of research on health care access and utilization for rural SGM, even though discomfort addressing SGM health needs and social stigma against SGM are likely to be more prevalent in rural areas.  The purpose of this study was to characterize general health and health care utilization in rural and urban Kentuckians.

Methods: Cross-sectional survey conducted at two Pride Festivals in Kentucky as well as online in 2012. Analysis included description, t-tests, and Chi Square as appropriate.

Results: 285 SGM responded to the survey; 21% from a rural ZIP code. There were no differences in self-reported general or mental health between urban and rural.  Fewer than half (48%) of rural SGM had a local primary care provider, though nearly as many reported no barriers to health care. Barriers related to negative experiences and fears about discrimination were reported only by a small minority (5-10% on respective items). Social networking sites were the predominant method of connecting with other SGM and getting information on general SGM issues; however, Google was the predominant web source of health information. 

Discussion: This presentation will present survey results, contrast them with the literature, and generate discussion concerning health care utilization issues for SGM, especially those specific to rural residents.

Learning Areas:

Advocacy for health and health education
Assessment of individual and community needs for health education
Diversity and culture
Planning of health education strategies, interventions, and programs
Provision of health care to the public

Learning Objectives:
Describe similarities and differences in self-reported health and measures of health care utilization between rural and urban SGM Kentuckians. Identify barriers and facilitators to health care access and health information-seeking among rural and urban SGM. Discuss the evidence concerning rural SGM access to care and possible interventions.

Keyword(s): Lesbian, Gay, Bisexual and Transgender (LGBT), Rural Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I personally directed the project described, and collected and analyzed the data, which was part of a career development award for research focusing on the health of rural lesbian, gay, bisexual and transgender (LGBT) people. I am a practicing family physician and faculty at the University of Kentucky. I am the co-chair of the Faculty subcommittee of education of GLMA and the immediate past co-chair of the STFM Group on LGBT Health.
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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