Session: Conducting Health Disparities Research in LGBTTS Communities: Methodological Constraints and Opportunities (Society for Social Work and Research 14th Annual Conference: Social Work Research: A WORLD OF POSSIBILITIES)

Equity in health is of critical societal importance given its ethical and social justice implications. Despite tremendous advancements in medicine and improved health for many Americans, historically disadvantaged communities continue to bear higher levels of illness, disability and premature death (National Institute of Health, 2008). Sexual minority status has been proposed as a key social influence on health outcomes. Although empirical evidence exists documenting that sexual minorities encounter social inequalities related to health disparities, these communities are often neglected in health disparities research and policy. In this symposium a panel of experts will discuss health disparities in lesbian, gay, bisexual, transgender and two-spirit (LGBTTS) communities and present findings from state-of-the-art research projects. Each paper will highlight specific methodological issues in conducting health disparities research in hard-to-reach communities.

It is difficult to obtain population based data on these populations and most studies of LGBT health rely on relatively small, non-probability samples limiting their generalizability. The first paper by Drs. Fredriksen-Goldsen and Hyun-Jun Kim will present findings from the Washington State Behavioral Risk Factor Surveillance System (BRFSS) survey, a population-based telephone survey. The paper assesses the similarities and differences in health care access, health behaviors and conditions, and general physical and mental health by sexual orientation. The strengths and limitations of using a population-based telephone survey to obtain data on health disparities in these communities are discussed. Incorporating sexual orientation questions into large scale health surveys is an important step forward, yet findings to date illustrate their limitations in reaching subgroups within these communities. The second paper by Dr. Walters focuses specifically on health disparities in the American Indian and Alaska Native (AIAN) lesbian, gay, bisexual, transgendered individuals (two-spirits), a hard to reach and at-risk population. Based on an interdisciplinary and intertribal team approach with six American Indian agencies, this paper examines a culturally-based theoretical model of stress and coping as it relates to health and tests a strategy for assesising sexual networks in this population as well as a modified respondent driven sampling strategy to approximate a representative sample of two spirits. Drs. Balsam and Fieland, in the third paper, highlight the complexities involved in designing a sampling strategy to reach ethnically diverse populations in LGBT communities. Based on targeted and respondent-driven sampling methodologies, this paper discusses the utility and limitations of specific sampling strategies for recruiting ethnic minority LGBT participants.

This symposium will provide a unique opportunity to consider and discuss the benefits and constraints associated with different methodologies and sampling techniques to access hidden and hard-to-reach populations. These presentations will provide insights into the health disparities experienced by culturally diverse sexual minorities; demonstrate ways to build the capacity and sustainability of research teams to assess health disparities; and, illustrate how social work research can be utilized to influence public health policy addressing health disparities in sexual minority communities.