Environmental injustice and sexual minority health disparities: A national study of inequitable health risks from air pollution among same-sex partners

Collins, Timothy W.; Grineski, Sara E.; Morales, Danielle X.

doi:10.1016/j.socscimed.2017.08.040

Cited by 69 publications

(38 citation statements)

References 53 publications

(87 reference statements)

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“…Frisch et al evaluated the association of sexual orientation and malignancy and determined an increased incidence of NHL, as well as anal cancer and Kaposi sarcoma among homosexual men (38). Various studies note an increased incidence of depression in the LGBTI community as a result of stigmatization and discrimination; the presence of depression in general has been noted to increase the risk of malignancy (33,36,39,40). Additionally, compared with cis-gender patients and individuals in heterosexual relationships, LGBTI individuals often have lower rates of insurance coverage (35).…”

Section: Methodsmentioning

confidence: 99%

Disparities in lymphoma on the basis of race, gender, HIV status, and sexual orientation

2017

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Lymphoid malignancies account for the sixth leading cause of death in the US, and, although survival is improving overall, this trend is not applicable to all patients. In this review, we describe disparities in the initial presentation, treatment, and outcomes across a diverse group of lymphoma patients on the basis of gender, race, HIV status, and sexual orientation. Identifying these disparities will hopefully lead to improved outcomes in these groups of lymphoma patients in the future.

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Section: Methodsmentioning

confidence: 99%

Disparities in lymphoma on the basis of race, gender, HIV status, and sexual orientation

2017

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“…Of those, over 83 000 deaths could have been avoided if all states improved their care to the level of the best‐performing state. Health disparities are dramatically impacted by social determinants of health like socioeconomic status, urbanicity/rurality, sexual orientation, and gender identity . Inequality in care in the United States is also disproportionately detrimental to racial and ethnic minority groups .…”

Section: The Learning Health Care Modelmentioning

confidence: 99%

“…Health disparities are dramatically impacted by social determinants of health like socioeconomic status, urbanicity/ rurality, sexual orientation, and gender identity. [23][24][25][26][27][28][29] Inequality in care in the United States is also disproportionately detrimental to racial and ethnic minority groups. 30 This inequality has worsened for certain key measures-eg, at risk adults without a doctor visit; adults without a usual source of care; older adults without recommended preventive care-in the recent past.…”

Section: Benefits Of a Learning Health Care Systemmentioning

confidence: 99%

Leveraging the learning health care model to improve equity in the age of genomic medicine

Blizinsky

Bonham

2017

Learning Health Systems

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To fully achieve the goals of a genomics-enabled learning health care system, purposeful efforts to understand and reduce health disparities and improve equity of care are essential. This paper highlights 3 major challenges facing genomics-enabled learning health care systems, as they pertain to ancestrally diverse populations: inequality in the utility of genomic medicine; lack of access to pharmacogenomics in clinical care; and inadequate incorporation of social and environmental data into the electronic health care record. We advance a framework that cannot only be used to directly improve care for all within the learning health system but can also be used to focus on the needs to address racial and ethnic health disparities and improve health equity. KEYWORDShealth equity, health disparities, genomic medicine, precision medicine, learning health care system 1 | INTRODUCTION Electronic health records (EHRs) are revolutionizing the practice of medicine. Not only does the digitalization and standardization of medical records help to improve patient outcomes by facilitating integrated care within complex medical settings, 1 these properties also enable the improvement of the health care system itself 2-4 by simplifying the periodic assessment of system function and quality, 5,6 the socalled learning health system model. With the adoption of EHRs also comes changes to the content of the medical record. For example, the burgeoning ubiquity of genomic information in the clinical setting, from the increased use of genetic tests as an element of clinical care to direct to consumer testing results provided by patients, has galvanized efforts to integrate these data into the medical record. 7,8 This surge has also spurred the development of means of providing of relevant clinical knowledge and patient-specific information related to medical genomics, known as genomic clinical decision support (CDS). [9][10][11] However, the foundations for most integration and genomic CDS efforts, and indeed for the basis for many clinical genetic tests, rests in a body of work severely limited by the diversity of its participant populations. 12 In some cases, these shortcomings have been identified; yet without adequate data on diverse populations, we cannot truly know the extent of these limitations, potentially compounding already gaping disparities in health.Genomic integration into EHRs therefore comes with both significant caveats and substantial opportunity. On the one hand, care must be taken to assess the utility of genomic testing and the meaning of genomic results in specific contexts. 11,[13][14][15][16] On the other, the nature of EHRs and the facility with which they can be analyzed as a dataset allows health care systems to evaluate the effects of genetically enabled care on health outcomes, which have the potential to add not only to the improvement of patient care directly, through the refinement of clinical practices, but also indirectly through enhancement of the body of knowledge upon which biomedical discov...

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“…The absence of sexual orientation and gender identity (SOGI) metrics on the US Census, and national demographic and health studies and cancer registries like SEER, leaves us largely ignorant of prevalence and incidence of cancer among SGM people. What is now indisputable is that SGM people face significant health and health care disparities that translate to important differences in cancer risk factors and screening [3-7], morbidity [8, 9] and mortality [10]. What data exist suggest that there is a differential prevalence of cancer overall among bisexual and lesbian women compared with straight women, likely higher prevalence of breast cancer in those same groups, and anal cancer among men who have sex with men and gay men.…”

mentioning

confidence: 99%

Time to Change: Supporting Sexual and Gender Minority People—An Underserved, Understudied Cancer Risk Population

Obedin‐Maliver¹

2017

J Natl Compr Canc Netw

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Environmental injustice and sexual minority health disparities: A national study of inequitable health risks from air pollution among same-sex partners

Cited by 69 publications

References 53 publications

Disparities in lymphoma on the basis of race, gender, HIV status, and sexual orientation

Disparities in lymphoma on the basis of race, gender, HIV status, and sexual orientation

Leveraging the learning health care model to improve equity in the age of genomic medicine

Time to Change: Supporting Sexual and Gender Minority People—An Underserved, Understudied Cancer Risk Population

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