The specific demographic group I will be addressing in this project is the LGBTQ+ community. This category comprises people whose characteristics deviate significantly from those of the general population (Nadal, 2019). This category includes those who identify as lesbians, homosexuals, bisexuals, queers, and transgender. Approximately 20% of individuals in this group refrain from getting medical care in healthcare facilities due to concerns about encountering discriminatory treatment. This demographic is classified as a vulnerable population owing to the unique healthcare obstacles they encounter in medical facilities and the social hardships they experience.
Key Health Issues Impacting LGBTQs Living in a Rural Community
Individuals who identify as LGBTQ and reside in rural areas face a range of healthcare obstacles. Initially, this group has the predicament of being geographically isolated in their communities, which poses a greater difficulty in obtaining healthcare services (Gahagan & Subirana-Malaret, 2018). Furthermore, this population has an excessive burden of chronic diseases compared to other members of the community. Rural LGBTQ individuals have a significant lack of knowledge and understanding of health-related matters.
Determinants of Health Relevant to Each of the Three Issues
Geographic isolation may impact health via several factors, such as transportation, access to safe housing and communities, lack of health coverage, delays in receiving care, and residential segregation (Gahagan & Subirana-Malaret, 2018). LGBTQ individuals have more hardships compared to the general population while living in a geographically secluded enclave apart from the rest of the nation. These individuals have inadequate or nonexistent access to healthcare owing to an unstable source of income and discrimination in essential health promotion efforts. Similar to other individuals living in a rural region, LGBTQ individuals have obstacles related to transportation that deter them from accessing medical services. In this context, the exorbitant gasoline prices discourage the majority of individuals in the community from providing transportation services to those requiring assistance. Once more, the distance between the rural location and the next accessible hospital might be substantial, necessitating individuals to endure prolonged times of travel. Consequently, individuals who identify as LGBTQ may choose not to travel because they anticipate encountering more difficulties in healthcare settings as a consequence of their sexual orientation. The absence of a well-developed road infrastructure in a remote town might provide mobility difficulties for LGBTQ individuals.
Furthermore, the factors that significantly contribute to the unequal burden of chronic diseases include discrimination, inadequate access to preventative healthcare, prevailing societal attitudes and norms, poor dietary habits, limited health education, and insufficient social support (Hall et al., 2018). Discrimination against LGBTQ individuals significantly impacts the health outcomes of this population residing in a rural setting. Rural locations often exhibit restricted availability and attainment of education among the local population. Consequently, they maintain the obsolete discriminatory cultural norms and attitudes towards those who are viewed as different from the rest of the group (Hall et al., 2018). LGBTQ individuals have an additional health obstacle as a result of their exclusion from social activities, leading to social isolation. The LGBTQ community may have significant obstacles in obtaining healthcare treatments while residing in rural areas, mostly owing to the unequal distribution of resources that hinders their access to scarce social services, including transportation.
Furthermore, inadequate health literacy is linked to insufficient access to high-quality health education initiatives, limited availability of resources, discriminatory practices, and the absence of a main healthcare provider. Rural LGBTQ individuals may have restricted availability of public health education as a result of their detachment from the dominant community (Hall et al., 2018). Furthermore, the absence of adequate healthcare facilities is a challenge for this demographic to access equitable healthcare. Due to the high demand for accessible services in mainstream culture, this population has restricted access to primary care preventative programs. Consequently, individuals are deprived of the opportunity to acquire knowledge about the precautions they should use in order to reduce the likelihood of experiencing certain ailments.
Three Common Issues Similar to LGBTQs Living in Urban Areas
Regardless of their location, all individuals who identify as LGBTQ experience health prejudice. Given the distinctive characteristics of this group, nurses and other medical personnel may feel inclined to engage in bullying behavior against them. Studies indicate that LGBTQ individuals face prejudice in both rural and urban healthcare settings, which puts their well-being at risk due to the refusal or delay of essential medical treatment (Zeeman et al., 2019). The worry is equally applicable in both rural and urban settings since nurses working in healthcare institutions have almost identical obstacles. Contrary to other types of discrimination, such as racial segregation, LGBTQ individuals include individuals from many ethnic backgrounds, making them distinct.
Consequently, the group experiences prejudice from nurses and doctors who belong to the same racial background.
Consequently, the group may not experience advantages from receiving treatment at a healthcare facility that mostly employs nurses from the LGBTQ race background. A prevalent issue faced by LGBTQ individuals, regardless of whether they reside in rural or metropolitan regions, is the absence of a reliable and consistent revenue stream. This difficulty arises from the group’s difficulties in securing employment opportunities across different businesses. Employment opportunities are often withheld from individuals in the LGBTQ community owing to their distinct sexual orientation. Studies indicate that individuals who identify as LGBTQ have a reduced likelihood of obtaining work inside a particular organization as a result of prejudiced interviewers who hold unfavorable attitudes toward this demographic (Zeeman et al., 2019). The geographical location of a particular firm may not significantly influence whether a person would experience employment discrimination or not. This is because an interviewer who does not support the interviewee’s sexual orientation may acquire a negative bias against them. Interviewers from many cultural origins may have similar views on LGBTQ individuals due to the general lack of acceptance of their actions within most communities.
Furthermore, those who identify as LGBTQ and reside in both rural and urban regions encounter restricted availability of preventative care initiatives. Due to high demand from the general population, both in rural and urban regions, LGBTQ individuals have restricted access to preventative health treatments (Zeeman et al., 2019). The comparability of this worry in rural and urban settings stems from the contrasting population densities in these regions. While metropolitan locations may experience advantages from an increased number of hospitals and other healthcare facilities, the high demand for these treatments may result in limited accessibility for LGBTQ individuals owing to the widespread existence of health inequalities. The healthcare infrastructure in remote places may vary. Nevertheless, it is worth noting that rural locations often have a lower population density, which means that both LGBTQ individuals in rural and urban areas have comparable obstacles when it comes to obtaining preventative healthcare.
Health Promotion Interventions for Health Discrimination, Limited Income Source, and Lack of Preventive Care Services for LGBTQs and Rationales
To effectively tackle these prevalent issues that impact LGBTQ individuals in the healthcare system, implementing the following treatments might be very beneficial. Increasing the knowledge and understanding of the distinct obstacles faced by LGBTQ individuals among healthcare providers and the general public might contribute to altering the mainstream society’s attitudes and viewpoints towards this group (Medina-Martínez et al., 2021). Consequently, this would foster a favorable disposition towards LGBTQ individuals among other members of the community and healthcare professionals, thus promoting equal access to healthcare services. The specific location would influence this intervention as educators would need to use distinct approaches to disseminate it to those living in rural and urban areas. Online provision and public awareness campaigns would be suitable for metropolitan areas. However, physical education would be necessary in rural areas owing to the restricted availability of technology in such regions. The justification for this intervention is that teaching both the public and the providers will foster an understanding of the difficulties faced by this group, therefore eliciting empathy from the general community.
Furthermore, addressing financial inequalities necessitates implementing legal measures to legitimize the distinct sexual practices shown by individuals within the group (Bosworth et al., 2021). An instance of such intervention is the landmark 2015 verdict by the United States Supreme Court, which granted legal recognition to same-sex relationships and marriages throughout the nation. As a result of this verdict, significant transformations took place in the employment sector. Previously, insurance coverage for operations related to same-sex couples was only available if the employer offered it prior to the decision. Nevertheless, one year after the decision, around 40 percent of companies in general and 85 percent of major firms opted to provide health insurance for same-sex couples. The effectiveness of this intervention would not be considerably influenced by geography since it would provide similar outcomes in both rural and urban regions. The justification for this intervention is that legalizing same-sex weddings would enable LGBTQ individuals to be recognized as legally valid, resulting in improved acceptance by employers, similar to their counterparts in the mainstream community. Expanding health insurance coverage to include all vulnerable members of the community would be a crucial measure in addressing this issue (Bosworth et al., 2021). This would guarantee that all individuals who identify as LGBTQ have equal access to insurance coverage, irrespective of their financial means. Multiple studies have extensively demonstrated the positive impact of Medicaid expansion on healthcare accessibility, particularly for those with low incomes. Following the implementation of the Affordable Care Act (ACA), which extended health coverage to U.S. residents, including LGBTQ individuals, the percentage of uninsured LGBTQ individuals decreased from 17.4% in 2013 to 8.3% in 2016 (Bosworth et al., 2021). The justification for this intervention is that by increasing healthcare coverage, a greater number of individuals from disadvantaged communities would have access to inexpensive care.
Furthermore, it is essential for the government to financially support ongoing and vigorous public health screenings and immunizations in both rural and urban regions (Medina-Martínez et al., 2021). These screenings should provide comprehensive preventative services to the residents of the areas, including cancer screenings and HIV testing. Healthcare practitioners would use these programs to instruct individuals on adopting healthier lives. This intervention has the advantage of augmenting the capacity of healthcare facilities in the communities, hence expanding the accessibility to diverse segments of the population. Once again, this intervention necessitates distinct methodologies in both rural and urban regions. For example, public screenings would take place at public parks and sports facilities, which are popular destinations for leisure activities.
Nevertheless, rural populations may lack access to such amenities, hence posing difficulties in locating clusters of individuals within a certain region. Consequently, the health teams must implement a method of going from one house to another to carry out the tests and provide health education. This intervention aims to enhance accessibility to preventative care for all individuals, including the LGBTQ community, by mitigating obstacles that hinder their access to such treatment.
References
Bosworth, A., Turrini, G., Pyda, S., Strickland, K., Chappel, A., De Lew, N., & Sommers, B. D. (2021). Health Insurance Coverage and Access to Care for LGBTQ+ Individuals: Current Trends and Key Challenges. Office of the Assistant Secretary for Planning and Evaluation. https://www.aspe.hhs.gov/sites/default/files/2021-07/lgbt-health-ib.pdf
Gahagan, J., & Subirana-Malaret, M. (2018). Improving pathways to primary health care among LGBTQ populations and health care providers: key findings from Nova Scotia, Canada. International Journal for Equity in Health, 17(1), 1-9. https://equityhealthj.biomedcentral.com/articles/10.1186/s12939-018-0786-0
Hall, W. J., Witkemper, K. D., Rodgers, G. K., Waters, E. M., & Smith, M. R. (2018). Activating adult allies from a rural community on lesbian, gay, bisexual, transgender, and queer student issues in school using photovoice. Journal of gay & lesbian social services, 30(1), 49-63. https://doi.org/10.1080/10538720.2017.1408517
Medina-Martínez, J., Saus-Ortega, C., Sánchez-Lorente, M. M., Sosa-Palanca, E. M., GarcíaMartínez, P., & Mármol-López, M. I. (2021). Health Inequities in LGBT People and Nursing Interventions to Reduce Them: A Systematic Review. International Journal of Environmental Research and Public Health, 18(22), 11801. https://www.mdpi.com/1660- 4601/18/22/11801
Nadal, K. L. (2019). A decade of microaggression research and LGBTQ communities: An introduction to the special issue. Journal of Homosexuality, 66(10), 1309-1316. https://doi.org/10.1080/00918369.2018.1539582 Zeeman, L., Sherriff, N., Browne, K., McGlynn, N., Mirandola, M., Gios, L., … & Health4LGBTI Network
Taibjee Rafik Toskin Igor Jonas Kai van Der Veur Dennis Allen Odhrán Troussier Thierry De Sutter Petra. (2019). A review of lesbian, gay, bisexual, trans, and intersex (LGBTI) health and healthcare inequalities. European journal of public health, 29(5), 974-980. https://academic.oup.com/eurpub/articleabstract/29/5/974/5151209
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