Boosting preventive care among LGBTQ+ patients: How to close gaps in awareness, access, and representation
By Jackie Drees
While preventive care is vital to the well-being of all types of patients, members of the lesbian, gay, bisexual, transgender and queer and/or questioning community face unique barriers that impact their preventive health awareness and access – setting many of them up for poorer overall health outcomes and even impacting their trust in pharma.
Preventive care has the potential to save more than 100,000 lives in the United States every year, according to the Centers for Disease Control and Prevention. However, not all patients are getting the messages they need to inform their preventive health decisions. For instance, one-quarter (25 percent) of patients who identify as LGBTQ+ said they felt “not at all confident” that they knew what preventive screenings they might currently need, and 42 percent feel equally unconfident in knowing what cancer screenings they should schedule, according to survey data Phreesia Life Sciences and Klick Health collected from more than 1,500 patients in early 2022 as they were checking in for their doctor’s appointments.
From a lack of education and adequate physician support to underrepresentation in pharma messaging, there are various challenges impacting LGBTQ+ patients and their use of preventive health services. However, there are key opportunities for pharma marketers to address these issues and support the LGBTQ+ community in accessing preventive care.
Tackle affordability challenges
Data from the Center for American Progress shows that close to 30 percent of LGBTQ+ Americans face difficulties accessing care because of the cost, and the problem extends to preventive health. According to Phreesia and Klick’s report, only 28 percent of LGBTQ+ patients surveyed said that preventive care is completely covered by their insurance, compared with 48 percent of the total surveyed population. Furthermore, 14 percent of LGBTQ+ patients don’t have insurance at all, which is a steep increase from the 3 percent of all surveyed patients who fall into that category.
Considering these insurance barriers, it’s not surprising that LGBTQ+ patients attribute cost as the main reason they’re unlikely to seek preventive health screenings in the next 12 months, with 38 percent of surveyed LGBTQ+ patients listing it as a factor. Low awareness of insurance coverage may also impact LGBTQ+ patients’ use of preventive care, as 41 percent of surveyed LGBTQ+ patients say they don’t know if their insurance covers these services. Engaging LGBTQ+ patients directly with resources that can help them afford screenings that aren’t covered by their insurance or help them better understand the services that are covered is a strong way to help boost their preventive care.
Address discrimination in healthcare settings
While cost is a main driver affecting preventive care for LGBTQ+ patients, negative interactions with the healthcare system and care settings are also a contributing factor.
“There needs to be more effort to create welcoming and stigma-free healthcare environments for affirming care,” says Amy Gómez, Ph.D., senior VP, diversity strategy, Klick. “Many LGBTQ+ patients are treated at the point of care in a way that makes them feel uncomfortable or unsafe, which results in avoiding or postponing needed care.”
Making LGBTQ+ patients feel safe and comfortable within medical settings is crucial to ensuring they take advantage of available preventive care services. However, creating atmospheres of inclusion and open dialogue won’t be enough on its own; as trusted, go-to sources for health information, physicians must elevate their topics of discussions with LGBTQ+ patients about preventive health. While 62 percent of all surveyed patients say they have learned about preventive care from their provider, only half (50 percent) of LGBTQ+ patients get their preventive health information from that source.
Ramp physician training and support
Many LGBTQ+ patients say their providers are not mentioning preventive care screenings to them, which can potentially contribute to these patients’ lack of awareness. When asked which screenings their doctor recommended to them over the past two years, surveyed LGBTQ+ patients listed HIV (30 percent), sexually transmitted diseases (33 percent) and depression (25 percent) as the three most-recommended screening suggestions for all LGBTQ+ patients. Yet, well below half of eligible LGBTQ+ patients say their providers have recommended routine cancer checks, including colorectal cancer screening (recommended to 40 percent of eligible surveyed LGBTQ+ patients) and cervical cancer screenings (recommended to 24 percent of eligible surveyed LGBTQ+ patients).
It is vital that physicians focus on whole-person health, rather than restricting their LGBTQ+ screening recommendations to conditions for which this population is thought to be higher risk. And while the industry can support more initiatives to educate providers, there are ways for healthcare professionals who do not feel knowledgeable about or confident providing affirming care for these patient populations to be proactive, says Thea Briggs, associate director, content strategy, Phreesia Life Sciences.
“Some materials have already been created to help care teams better understand how to support effective interaction with LGBTQ+ patients, such as not misgendering nonbinary and trans patients, asking open questions and fostering natural, personable dialogue that includes discussion of sexual orientation and gender identity in care settings.”
Open patient-provider discussions start with inclusion
While educational and support resources for both physicians and LGBTQ+ patients will help improve preventive care, these materials are more likely to resonate with members of the LGBTQ+ community if they see themselves represented in them.
Less than half (44 percent) of surveyed LGBTQ+ patients agreed that pharma ads reflect their experience as a member of the LGBTQ+ community, and just 45 percent believe that pharma understands their unique needs. Perhaps as a result, about two in five LGBTQ+ patients (41 percent) say they don’t trust pharma ads at all, with another 26 percent saying they trust them “only a little” and 23 percent reporting that they trust them “somewhat.”
Despite these perceptions of misunderstanding and lack of trust, there’s still good news for pharma marketers: overall, 82 percent of surveyed LGBTQ+ patients said they have more positive feelings toward pharma companies that conduct outreach to the LGBTQ+ community. And leveraging opportunities to connect with these patients can help ensure pharma marketing efforts are truly aligned to their needs, explains David Linetsky, Phreesia’s senior VP, life sciences.
“We’re proud to be using our platform to connect with members of the LGBTQ+ community to learn from them directly about their experiences in navigating and accessing healthcare,” he says. “Our hope is that the insights we generate from this work will help advance and guide efforts among providers and pharma manufacturers to address biases and create more equitable healthcare experiences for these communities.”
Jackie Drees is content specialist, life sciences for Phreesia.