More than 200,000 LGBT adults in California have medical conditions that increase their vulnerability to the effects of COVID-19, according to new research by Kathryn O’Neill, a policy analyst with the Williams Institute at the UCLA School of Law.
O’Neill found that of 1.7 million LGBT Californians, an estimated 210,000 have asthma, 110,000 have diabetes, 80,000 have heart disease and 110,000 have HIV — all of which can make the effects of COVID-19 more severe. “The LGBT community experiences these conditions at a greater rate than the general population,” O’Neill says. “A lot of previous research exists that shows this population is at heightened risk in various realms. That includes an increased likelihood of poverty, especially among certain groups, like bisexual women or transgender people.”
O’Neill found that as of 2018, about 612,000 LGBT Californians were already living with incomes below 200 percent of the federal poverty level, about 140,000 were unemployed and more than 300,000 faced food insecurity. “All of those figures are likely getting worse now, since about 814,000 were working in industries that recently experienced dramatic pandemic job losses, such as health care, construction, hospitality and retail,” she says.
Using data from the UCLA Center for Health Policy Research’s annual California Health Interview Survey, O’Neill found that 134,000 LGBT Californians lack health insurance. “A large proportion of the LGBT population has trouble paying medical bills for themselves or their family,” O’Neill says. “Cost, lack of insurance and other insurance-related reasons caused 150,000 LGBT Californians to delay or skip needed medical care.”
Discrimination also can prevent LGBT individuals from accessing health care. O’Neill notes that in a separate study, the U.S. Transgender Survey, one-third of transgender people reported having a negative experience the last time they got medical care. “Fortunately, California has state laws which protect LGBT people from discrimination,” O’Neill says. “But in the 28 states without those protections, the Trump administration is essentially allowing people to discriminate against transgender people, and that increases the harm they will experience when trying to get health care in the middle of a pandemic.”
O’Neill hopes her report will lead to interventions that keep these data in mind. She also urges emergency-response organizations and those providing resources during the pandemic to reach out to LGBT people and ensure that they are inclusive and welcoming. “We need to help those who are vulnerable, but it’s best not to have a one-size-fits-all approach,” O’Neill says.
She notes that there is a general lack of data on the impact of discrimination in the LGBT community. “My professional work centers on poverty and inequity,” O’Neill says. “At the Williams Institute, we all started strategizing the first week of quarantine about projects that would be helpful at this moment in history. Looking at variables exposing people to harm from coronavirus was an obvious choice.”
— Alison Hewitt
Kathryn O’Neill