On the day after Equality Forum’s week-long stampede finished trampling me, I’m able to stagger back to my computer and pick up a piece from last Saturday’s collaborative programming that I didn’t want to leave behind. (Tomorrow I hope to be able to post on the National Equality Rally that took place on Sunday.)
One of the panels I stopped in on, Health Care Reform: What Does it Mean for the LGBT Community?, ended up ranging over a wide swath of issues concerning the community. This wasn’t surprising, because the panel was conducted by the Mazzoni Center, an organization that delivers a staggering array of health-related services to the community; mostly for free. In addition to primary care, the Center: does anonymous HIV testing (and services for those infected with the virus); offers mental health counseling; provides a smoking cessation program as well as an array of support groups; and has a number of education outreach programs, importantly including “The Collective.” This is a collaborative effort that does culturally targeted HIV prevention and services for gay and non-gay identified men who have sex with men (MSM, in the accepted public health acronym). This approach is generally recognized as the only one with a decent chance of working in communities that, for historical reasons, harbor a deep distrust of public health.
In short, the Mazzoni Center stands at the intersection of private health care and public health, recognizing that the prevention and education efforts at the center of the public health mission can reduce the need for chronic and acute medical care that consumes much of the health care time and dollar. So it was natural that the conversation was similarly expansive.
Listen to Nurit L. Shein, Executive Director, speaking of the need for coverage of services that are specific to the transgender community: “This is an issue that the LGBT community needs to coalesce around.” Is it reasonable to believe that whatever health care reform is on the table at the federal level will address this issue? Not unless advocates, like the Mazzoni Center and those they serve, get in touch with their officials, show up at public hearings, and agitate. Thus far, the LGBT response has been, too often, to let the “T” kind of dangle from the end of the alphabet string.
Mazzoni’s vital work, though, is often frustrated by the failures of public and private health elsewhere. Robert Winn, the Center’s Medical Director, somewhat surprised me by stating that he’d lost track of how many times patients had come to him after being informed by their former primary care providers that they didn’t want to care for gay people. (I just checked my iPhone’s calendar; yes, it’s 2009.) Of course, this is a strictly illegal position in Philadelphia, but most people don’t sue: they just find another doctor. But until those with a public health, population-based approach combine with the AMA to drive these homophobic views out of existence, private prejudice will continue to negatively influence the medical and mental health outcomes of the community.
It’s well known that sexual, racial, and other minorities have much worse health outcomes than the majority. Every day, Mazzoni’s dedicated workers try to push a very large boulder up a very steep hill.