Rainbow Health Initiative: On the Way to Health Equality
At the time of the website’s relaunch in February 2013, Rainbow Health Initiative (RHI) was hopeful that its goal of connecting more members of the GLBTQ community with essential health resources would be a success. Yet no one expected just how quickly things would be moving.
“We have been pleasantly surprised by how fast our website took off and the number of hits and interaction we were getting and continue to get,” says Tiffany Paulson, Communications and Marketing Manager for RHI. “As more people are becoming aware of our Provider Directory and the number of healthcare providers increase, we are seeing a noticeable and steady increase in use.”
The Provider Directory is one of the more exciting features of the new website. Healthcare providers self-submit to be included on a list of GLBTQ-friendly and –identified providers. “We have a drop down search option in which people can specify, for example, that they are looking for a provider that has specialties/sensitivity working with lesbians or they can search for a provider who is a lesbian,” says Brianna McMichael, RHI’s Policy and Education Coordinator. “Providers self-identify themselves and their specialties. We add options as they are identified by providers, so providers are not forced to choose between one description or another.”
With over 100 providers currently listed, the directory continues to add additional providers on a consistent basis. “We strive to provide users with numerous, quality options,” McMichael says, who is quick to point out why providers would choose to join the growing list. By listing with RHI, providers are more visible to the people in need of healthcare services and joining the list proves a desire to make sure they receive those services in a supportive environment.
Visitors to the website will notice that some categories of providers are more heavily represented than others. For example, there are no dentists listed. As the list is a self-selected option for providers, RHI is at a standstill as to how to address issues like this. “We do not prevent or encourage any one type of provider over another,” Paulson says. “We believe people deserve access to culturally competent providers across the board.”
With the directory relying solely on self-reporting, it begs the question: how can patients be sure that the listed providers are actually GLBTQ-friendly, as they say they are? By requiring providers to fill out the request to be placed on the directory, RHI is ensuring that providers themselves are invested in the directory. “Providers are able to add comments in the notes section to specify any specific experiences they have working with a certain population or personal experiences,” Paulson says. “For example one provider might just check all the boxes, while another might write that they have experience with assisted reproductive technology or that they have a family member who identifies as trans*.”
For those who are still leery of the process, Paulson says RHI is currently in the process of developing a user-rating system. “One thing we have learned from our research is that GLBTQ survey respondents reported poor quality health care and discrimination from staff in every part of the clinic (administration staff, support staff, nurses, mental health providers, etc.),” she says. RHI hopes to combat issues like this by developing a rating system. Users will be able to rate their experiences, thus helping others make informed choices.
The website relaunch includes more than just the directory service, however, as it also makes research and statistics available to the community. These statistics (such as lesbian and bisexual females are more likely to be overweight and obese, or, transgender individuals are less likely to have health insurance than heterosexual or GLB individuals) make it clear that some issues impact different areas of the community in various ways. “This is why data collection on our communities is so important,” Paulson says. “We collect specific demographic information from community members so that we know what health concerns are relevant for which populations within GLBTQ communities.”
“What we do to address this [variance between populations] is collect the data and disseminate our results,” she continues. “We do systems work, which means we aren’t providing direct services to clients, but instead helping to educate the systems that are set up to provide these services. For example, some of the people we bring our data to are public health officials, social service workers, medical providers, schools, and community members.”
Disseminating this information takes on various roles, one of which is RHI’s education program. With a curriculum focused on discussing health disparities collected from RHI’s annual health assessment survey, the education program outlines GLBTQ concepts and terms, providing participants with the skills to create supportive environments for GLBTQ clients and staff. Centered on a core base, the trainings can be catered upon request toward specific organizations seeking to become more culturally competent.
RHI’s training sessions have traveled throughout the state of Minnesota, receiving positive feedback from participants. With a goal of expanding trainings and presentations, RHI wants to be able to reach as many healthcare providers and workers as possible. For example, this winter and spring, RHI will be hosting four trainings at the new office building off of East Hennepin Avenue (anyone interested is encouraged to email RHI for more information). “Our trainings and presentations are ongoing and will be updated every year with our new survey data and community member feedback,” says John Salisbury, RHI’s Program Manager. “We will host ongoing focus groups about GLBTQ health with community members to inform our trainings and make sure that they reflect community priorities.”
The core of RHI’s research is its annual Voices of Health Survey, which is largely funded through Blue Cross Blue Shield’s Center for Prevention. Every year RHI asks thousands of GLBTQ Minnesotans to complete an annual health and wellness survey. The survey covers topics such as tobacco use, alcohol consumption, exercise, healthy eating, and experience with health care. The results of this survey are used to help healthcare providers and policymakers better understand the needs of GLBTQ Minnesotans, and to inform GLBTQ Minnesotans about the health of their community.
“Currently, RHI is finishing up an assessment of in-store marketing of e-cigarettes to GLBTQ people,” says Dylan Flunker, the Policy and Community Organizing Coordinator for RHI. “That study was supported by the Minnesota Department of Health’s Tobacco-Free Communities fund.”
Other recent research projects include an analysis of inclusion, or lack of inclusion in some cases, of the GLTBQ population in funding streams related to health equity, which was supported through the Center for Urban and Regional Affairs at the University of Minnesota. “RHI is continually looking for organizations willing to support future research projects,” Salisbury adds. “There is still a lot that isn’t known about GLBTQ health and it is important to advance our understanding of that area.”
A central aspect of RHI’s work involves creating healthier spaces and promoting essential community resources that support a healthier GLBTQ community. This is done with three initatives (research, education, and advocacy) and six areas of health in mind (healthy eating, active living, tobacco cessation, recovery, youth pregnancy, and social support). “We try to make sure we’re adding publications, resources and events on a consistent basis so that the public can stay informed of what’s happening in GLBTQ health and what RHI is working on,” Paulson says.
RHI is committed to increasing statewide knowledge of the health disparities that the GLBTQ communities experience. Joann Usher, the Executive Director, confirms that RHI will continue to work with the Minnesota Department of Health, other GLBTQ organizations through the GLBTQ Health Advocacy Roundtable, and other organizations which are committed to addressing health disparities, to highlight and address the health issues of GLBTQ communities. She says, “We want to work with a variety of organizations to begin to develop a State of the GLBTQ communities status report and develop strategies and partnerships to improve the health and well-being of our communities.”
Usher describes how RHI is also committed to improving healthcare access, promoting MNsure as an opportunity for the 21% of the community without insurance, to get coverage. At the same time, RHI continues to focus on providing educational opportunities for healthcare providers, ensuring individuals receive competent care.
Based on RHI’s current data, Usher discerned a need to identify policy, systems and environmental approaches to address the health disparities in the community. She says, “As the only organization in the state and one of the few in the country that collects GLBTQ data, we want to expand the scope and types of data that we collect. And we want to begin to offer this expertise to other organizations across the country.”
Through it all, Usher stresses the need for collaboration. “Every state and Federal health agency is focused on addressing ‘Health in All Policies,’” she says. “They understand the interconnectedness of the social determinants of health and their impact. Having insurance is important; getting competent care is important; having access to good health food is important; safe housing is important; employment is important; a safe and supportive education system is important. To be truly healthy, the GLBTQ communities need to have all of these determinants of health in place. No one agency can do all of this. Collaboration and cooperation is imperative to improving the health of our community.”
With this strong tie to the community, RHI actively engages through social media. “We get a lot of people taking survey’s on GLBTQ health and engage people in talking about health, the disparities and what we can do about it,” Paulson says. “Health is necessary for any kind of good life, we need to pay special attention to our health in the GLBTQ communities, because as it stands we’re fighting some large disparities.”
Leaders in Healthcare Equality
In the Human Rights Campaign’s Health Equality Index 2013, an unprecedented 464 healthcare facilities—representing 74% of total participants—met all Core Four criteria for LGBT patient-centered care. The Core Four criteria include patient non-discrimination, equal visitation, employment non-discrimination, and training in GLBT patient-centered care. Seven facilities out of Minnesota have earned the coveted status of “2013 Leader in LGBT Healthcare Equality.”
Hennepin County Medical Center
VA Minneapolis Health Care System
VA St. Cloud Health Care System
Park Nicollet Methodist Hospital
St. Louis Park
Family Tree Clinic
HealthEast Care System (18 facilities)
Be sure to check out these other Health features:
Ten Things Gay and Bisexual Men Should Discuss with Their Healthcare Provider
Ten Things Lesbian and Bisexual Women Should Discuss with Their Healthcare Provider
Ten Things Transgender Persons Should Discuss with Their Healthcare Provider