But some health experts say one of the most significant health disparities among LGBTQ adults is often overlooked.
This data confirms what clinicians and those who study LGBTQ health have been observing for decades: communities face specific and widespread barriers that negatively impact the brain and body. .
Cardiovascular disease is the leading cause of death in the United States. The Centers for Disease Control and Prevention estimates that 80% of early-onset heart disease and strokes are preventable. However, there are disparities in where this burden falls among the general public. We spoke to doctors and health researchers to learn why these disparities persist and what steps LGBTQ adults can take to strengthen their heart health.
stress strain
Experts said LGBTQ adults face unique stressors such as stigma, discrimination and fear of violence that can indirectly and directly lead to illness.
Stress directly affects certain hormones that regulate blood pressure and heart rate, said Billy Caceres, assistant professor at Columbia University’s School of Nursing and Center for Sexual and Sexual Minority Health Research.
Hypervigilance (the feeling of being constantly alert and always on the lookout for the next threat) can cause spikes in cortisol levels, which can lead to long-term cardiovascular problems, says Dr. Carl Streed, assistant professor of medicine at Boston University School of Medicine. He said there is.
Additionally, stress can cause chronic inflammation, and stress can increase blood pressure and heart rate, says Dr. Erin Mikos, associate director of preventive cardiology at Johns Hopkins University School of Medicine. .
Scott Bertani, advocacy director at HealthHIV, a nonprofit focused on promoting HIV prevention and care for at-risk populations, said researchers sometimes find that allostatic load, or chronic stress, affects the brain and body. He said that he sometimes refers to the cumulative burden on people. “To explain why our bodies respond to these really complex and difficult life events and demands,” he said. For example, he added, the act of coming out, and in some cases coming out repeatedly, is often deeply stressful.
Research has also identified a link between sleep and heart health, Dr. Caceres said. Growing evidence suggests that LGBTQ adults experience more sleep problems and interruptions than the general population, which may also be related to chronic stress.
Barriers to seeking care
A 2017 survey of nearly 500 LGBTQ adults by researchers at the Harvard T.H. Chan School of Public Health and the Robert Wood Johnson Foundation found that more than one in six had not sought medical care because of concerns about discrimination. It turned out that they answered that they were avoiding it. This hesitancy means LGBTQ adults are less likely to access potentially lifesaving preventive care, Dr. Michos said. All adults should be tested for cardiovascular risk factors at least once a year, she said, and this is usually part of an annual health exam.
Experts say finding a health care provider you feel comfortable with is key to preventing heart disease. Dr. Streed recommends that LGBTQ adults seek out supportive health care providers. The Gay and Lesbian Physicians Association provides a directory on her website where patients can find medical professionals. The Human Rights Campaign annually produces the Healthcare Equality Index, a list of medical facilities that claim to accept LGBTQ patients.
What LGBTQ adults need to know to improve heart health
Dr. Mikos said that while gender-affirming hormones have been shown to have a positive impact on mental health, there is also some evidence that high amounts of testosterone and estrogen may pose cardiovascular risks. . People taking these hormones should talk to their doctor about ways to maintain heart health.
The American Heart Association recommends seven steps for optimal heart health. These are managing blood pressure, keeping cholesterol levels low, lowering blood sugar levels, exercising daily, eating a nutritious diet, maintaining a healthy weight, and not smoking. Dr. Michos also recommends minimizing your intake of processed foods, sugary drinks, and highly refined carbohydrates, and instead choosing whole grains, lean proteins, and plenty of fruits and vegetables. recommended. Adults should also aim for at least 30 minutes of moderate-intensity exercise, such as brisk walking, jogging, or cycling, each day.
These are important aspects of preventing heart disease, “but preaching ‘you need to live a healthy lifestyle’ only works when individuals are exposed to significant psychological distress and discrimination.” That’s no good,” she added.
“LGBT health is about more than just HIV prevention,” Dr. Caceres says. “Oftentimes, we end up focusing on that. Sexual health isn’t the only aspect of health that we queer people need to think about.”
audio creator kate winslet.
