Empire State Pride Agenda has put out an interesting study of 3500 LGBT people who live in New York State and their access to health care. LGBT people generally receive less health care, and it's not just because of a lack of marriage or DP benefits. The number one reason is homelessness:
At the national level, researchers have estimated that LGBT people lag behind on seven of the ten targets set by the U.S. government to improve health nationally, called Healthy People 2010. In New York City, we know that LGBT lag behind on at least six of NYC's health goals, called Take Care New York. However, most states do not measure sexual orientation on their health surveys, and none have consistently measured gender identity.[...]
For example, fourteen percent of all LGBT people, including one-third of transgender New Yorkers, are or have been homeless at one time--and we know that people who are homeless also lack other basic services. As one service provider who works with youth told us, "Housing is health care." Youth and adults who are homeless frequently cannot access health services at all. Youth who are transgender are particularly vulnerable.
We blog every now and then about stories about LGBT people getting kicked out of religious and gendered homelessness services, a problem that exacerbates homelessness brought on both job discrimination and rejection by families of origin. But don't expect any action nationally on this issue, since homelessness is still one of the issues Congress finds easiest to put off - not only are homeless people unlikely to donate to political campaigns, they are also unlikely to vote. And the rest of us feel better just ignoring them.
The study explains more about the connection between health care and homelessness (pdf):
Key informants who participated in focus groups recognized the importance of housing to health and human services. One staff member of an urban program for LGBT homeless youth said, "For us, [the most pressing health and human service need] is housing...housing is healthcare. Once we've housed people who are unstably housed, their lifestyle changes. If they are engaging in unprotected sex, involved in street work...once they become steadily housed, they are more open to protecting themselves and using condoms. Once they become housed, they become more adherent to medical treatment. When they are on the street, they are not adherent to their medical regimens with HIV, etc. They feel more in control, and they have somewhere to live. It's more comforting and allows them to deal with other stuff." Another provider, a physician who works with LGBT youth of color said, "As a physician, I'd go out on a limb and say [the most pressing issue is] it's stable housing for LGBT youth, particularly trans youth."
Youth are particularly at risk for homelessness, and this study finds the same bizarre fact that that study in Vancouver that made headlines earlier this year did, LGB youth are more likely than heterosexual youth to get pregnant:
In New York City, LGB youth are more likely to have been pregnant or made someone pregnant, to have missed school or been injured in a physical fight, to have been physically hurt by an intimate partner or forced to have sex.
The Needs Assessment survey included 13% of respondents between the ages of 18 and 24. Because the survey could not ask questions of people under 18, the survey results on youth are limited to those who were in this young adult category.
Young adults aged 18-24 were more than six times as likely to report that they are currently homeless than were older adults in this sample. Several key informants who participated in focus groups or interviews suggested that homelessness for LGBT youth is one of the most pressing health and human services issues. A staff member at an LGBT health center explained that homelessness and poverty have specific negative consequences for LGBT youth, saying, "Homelessness [is something] we see a lot among young clients we work with. One of the things we hear recently in terms of the economy is that based on the difficulty getting part-time jobs, people looking for summer jobs, it looks like there may be more young people turning to sex work this year, this spring and this summer, than have in the past...How do we support them in a way that doesn't encounter violence and protects their health?"
The report cites other issues that result in us having worse health than the population at large: higher than average rates of substance abuse, social isolation and loneliness, and finding culturally competent medical care top the list.
Health care access is fundamentally a question of poverty and how wealth is distributed. And while it's important to demand that the White House and Congress move on providing health care benefits to same-sex partners of federal employees, addressing basic issues like housing right in our own backyards would probably do more to increase access to health care than expanding the scope of the copulative relationships we reward with health care access.