A new study to better understand the health outcomes of sexual and gender minority people
Mitchell R. Lunn, MD, MAS, FACP, FASNAssistant Professor of Medicine and of Epidemiology and Population Health at Stanford University School of Medicine
HEALTH OUTCOMES OF SEXUAL AND GENDER MINORITY PEOPLE: Data from the All of Us Research Program
Our group at Stanford University, PRIDEnet, studies sexual and gender minority people, including lesbian, gay, bisexual, transgender, queer, and other minority sexual orientations and gender identities. We are an All of Us National Community Engagement Partner that focuses on engaging sexual and gender minority (SGM) people to participate in health research.
Many SGM people may avoid accessing healthcare due to fear of discrimination, being misunderstood, or being provided the wrong information due to lack of research. Yet, the lack of research about the SGM communities and their health needs also limits our ability to educate health care providers about SGM-competent care.
What we find most compelling about the All of Us program are the dedication and goals of All of Us to ensure every group in our country is represented in this historic program.
In our All of Us research project, we are asking, “Are sexual and gender minority (SGM) people at greater risk for certain health conditions compared to cisgender and heterosexual (non-SGM) people?” To do this, we are using primarily electronic health record (EHR) data to examine 11 health conditions. These include hypertension, diabetes, cancer, heart disease, anxiety, asthma, depression, HIV, tobacco use, substance use disorder, and elevated body mass index.
We are looking to see if these health conditions are more common in SGM groups compared to non-SGM groups and are using statistical methods to adjust for other factors such as race, ethnicity, age, and income.
SGM status does not cause various health conditions. Instead, it is a proxy for things like, among others, discrimination, violence, and limited legal protections that negatively influence the health of SGM communities.
The thing we’re most excited about is the diversity of the All of Us cohort. We’re seeing people of all races and ethnicities, all geographies across the country, all incomes, and all education levels.
Mitchell R. Lunn, MD, MAS, FACP, FASN
The long-term vision for how we will use these data is to improve the health for SGM people in the United States. Many LGBTQ+ people have difficulty accessing adequate care and achieving optimal health because of a long history of discrimination, stigma, and medical neglect. Many are also marginalized from health care due to other biases related to age, race and ethnicity, language, class, or legal status.
Like many other groups, the voices of LGBTQ+ people have also been largely left out of research. And where research has included us in the past, results oftentimes stigmatized us further or were used to the detriment of our community. This further contributes to the distrust between patients and providers and is detrimental to the well-being of SGM community members.
Lacking access to and use of health care makes SGM people even more vulnerable and susceptible to diseases and conditions that can be prevented or easily treated. We envision a future where advances from the All of Us Research Program help health care providers provide more comprehensive care for SGM communities.
Key Benefits of All of Us Data
The quality and diversity of the data currently available in the All of Us Researcher Workbench matters because we need accurate data about the health and well-being of our nation in order to conduct relevant health research studies. If we’re missing a part of the population, then we’re missing a part of our country’s story. It’s not only important to have high-quality, diverse data to conduct accurate studies that may speed up medical breakthroughs in various populations, but it can also help researchers find similar patterns in the data, which can lead to comprehensive solutions for everyone.
Through the All of Us Research Program, at least one million participants will be able to provide valuable information, an idea that was previously unfathomable. It will provide a clearer picture of health needs based on demographics, environment, experiences in society, and other factors. The key benefits may be increased data precision to treat diseases, more comprehensive care, a better understanding of how populations are different and/or similar, and faster medical breakthroughs.