Health Center News, Social Determinants of Health

Better Data for Health: Tracking Sexual Orientation and Gender Identity Data

Do you want to know how many transgender people are served by community health centers? …

So do many leaders at NACHC, including Pedro Carneiro, Clinical Data Scientist. But at this point, we have no clear answer.  

It’s safe to assume Community Health Centers serve the vast majority of transgender and LGBTQIA+ individuals around the country. For generations, health centers have been the most accessible and non-discriminatory providers in America. At many other health care locations, LGBTQIA+ patients experience extreme stigma, rejection, and are refused or denied care (like hormones, HIV prevention, or breast cancer screening). While health centers have open doors, most have incomplete sexual orientation and gender identity (SO/GI) data so they aren’t informed in ways that could improve equity, quality of life and actually save LGBTQIA+ lives.

Currently, Pedro and others at NACHC are working to help health centers, PCAs and HCCNs build capacity and competency around SO/GI data. Pedro explains:

“If more health centers were equipped to understand this population and their syndemic stressors, they could address the mental health, substance use, medical health, cancer and HIV prevention issues (among others) that are unique for LGBTQIA+ individuals.”

The social determinants and stigma affecting the health of this population are often more extreme and relate to negative health impacts that could easily be prevented or completely avoided.

For example, in the U.S., 1 in 7 people don’t know they have HIV, and more than 1 out of every 2 Black gay men will become HIV positive. LGBTQIA+ health center patients are at higher risk and should certainly be screened so when relevant, they can be offered PEP (post-exposure prophylaxis) and/or PrEP (pre-exposure prophylaxis) to prevent HIV. To enact HIV clinical screening guidance, clinicians must be taught about HIV screening and prevention, and patients must be taught how to help themselves.

To support relevant LGBTQIA+ care at health centers, in general, NACHC is developing a seamless and easy-to-use informatics tool for SO/GI and other social determinant of health data collection. This screening and tracking tool is being designed to save time for health center clinicians as they identify and track patients through an interoperable clinical decision support tool. It will be available with related NACHC training events for health centers in the coming years.

With correct social data, including SO/GI, we can know exactly how many trans patients receive services at health centers and in turn, health centers can identify opportunities for more culturally and medically adept LGBTQAI+ services. Look out for information from NACHC in the coming months.