CONNECT Announces Health Equity Paper Competition Winners

For the third year, the Institute for Sexual and Gender Minority Health and Wellbeing (ISGMH)'s CONNECT Program held the Data Science & SGM Health Equity Paper Competition to stimulate student research at the intersection of data science and SGM health equity. Students, young professionals, activists, and emerging researchers were invited to submit papers to the competition. The submissions were carefully evaluated across a rubric that considered innovation, strength of the argument and analysis, writing quality, and the overall potential impact of the paper on the fields of data science and SGM health.

We are delighted to announce that the competition winners are Aranka Viviënne Ballering, Grace Bellinger, and Krystal Rae Kittle! 

We spoke to each of the winners about their paper and their future research plans, presented in Q&As below.

The winners will also discuss their papers at a virtual event on Thursday, December 2, from 12:00 – 1:30pm CT over Zoom. Register here.

Aranka Viviënne Ballering

How to Ensure Inclusivity in Large-Scale Data Studies? Lessons Learned on Sex, Gender and Sexual Orientation in Large-Scale General Population Cohort Studies

Ballering obtained master degrees from VU University Amsterdam (MSc in Biomedical Sciences) and Maastricht University (MSc in Global Health) and is currently a third-year Ph.D. candidate at the University Medical Center Groningen. Ballering can be contacted at a.v.ballering@umcg.nl

Q: What are the main findings of your paper and why did you want to explore this topic?

A: Although literature shows that sex, gender, and sexual orientation (SO) are important health-related factors, little attention is given to these factors in large-scale general population cohort studies. Omission of these concepts from general population cohort studies is problematic as it pushes health research about gender or sexual minority populations towards purposive sampling, potentially resulting in selection bias. Also, it reinforces the unintentional notion of irrelevance of these concepts to health research.

We experienced a lack of information about these topics ourselves when we wanted to assess the influence of sex and gender on common somatic symptoms: we used data from a large general population cohort (N=~160,000), but we found out no detailed information on participants' gender, sex, or SO was known. This is often the case for large-scale general population cohort studies. In this paper we described our own experiences with conducting research into sex, gender and SO, what kind of information on these topics is usually lacking in cohort studies and what strategies we applied to ultimately obtain information about participants' sex, gender, and SO. Additionally, we aimed to raise awareness about including this information in health research, and we aim to provide practical considerations for researchers who are thinking of including participants' sex, gender and SO into their research. We hope that our research provides some hands-on support to researchers on why and on how to include sex, gender, and SO in health research.

The Importance of Accurate and Affirming Measurement of Sex and Gender Identity in the Behavioral Risk Factor Surveillance System and Other Surveys</em>

Grace Bellinger is a Ph.D./M.P.H. candidate in the Northwestern University Interdepartmental Neuroscience (NUIN) program. She received her B.S. and M.S. in Kinesiology from the University of Wisconsin-Madison before entering NUIN. Grace conducts stroke rehabilitation research within the Department of Physical Therapy and Human Movement Sciences and uses big data to study sexual and gender minority health as part of her public health training.
Q: Could you describe the main findings of your paper?
A: The paper reviews measurement of sex and gender identity in the Behavioral Risk Factor Surveillance System (BRFSS) and emphasizes the importance of collecting this demographic information to assess the health of gender minority populations. The analyses demonstrate the high response rates to questions pertaining to gender identity across a large portion of states from 2014-2020 as well as the number of transgender respondents identified through use of the current Sexual Orientation and Gender Identity module. Finally, the paper advocates for improved measurement of sex assigned at birth, gender identity, and gender modality in alignment with best practices endorsed by the community and includes actionable recommendations for the BRFSS that can be applied to other federal surveys.

Q: Why did you want to explore this topic?

A: As part of my public health training, my Applied Practice Experience used data from the 2019 BRFSS survey to explore the cardiovascular health of gender minority populations. Working with that data, I became interested in the measurement of sex and gender identity because the survey language could be much more inclusive and affirming.

Q: Where do you see your research moving in the future?

A: I will continue to use big data such as the Behavioral Risk Factor Surveillance System to assess the health of marginalized populations and identify inequities in healthcare access. For my Culminating Experience, I am extending my previous work by using electronic health records to study the cardiovascular health of gender minority patients in a Chicago-based healthcare system.

Krystal Rae Kittle, Ph.D.

Healthcare of Lesbian, Gay, Bisexual, and Transgender Middle-Aged and Older Adults: The Role of Minority Stress, Sociodemographic Characteristics and Social Resources

Kittle graduated from University of Massachusetts Boston Gerontology Department in May 2021 and is currently a postdoctoral scholar at the University of Nevada, Las Vegas in the School of Public Health.

Q: What are the main findings of your paper?

A: Findings suggested that lesbian and transgender respondents had larger social networks than gay respondents. Gay respondents had less social support than lesbians and both groups had more than transgender respondents. Lesbians had more community belonging than all other groups. Education and age moderated the association between LGBT identity and social support. College-level education had a buffering effect on social support among bisexual females, but a negative effect among gay respondents. Older age had a buffering effect on social support among bisexual female and transgender respondents.

Findings indicated associations between disclosure and health screenings, having a regular provider, and an association between internalized stigma and routine checkups. Higher levels of social support and disclosure in tandem increased the likelihood of health screenings.

Discrimination/victimization had an indirect effect on health screenings via fear accessing health services both inside and outside of the LGBT community, financial barriers to care or medication, and being uninsured. Discrimination/victimization also had an effect on routine checkups and having a regular provider, via fear seeking health services outside of the LGBT community, financial barriers and being uninsured.

Q: Why did you want to explore this topic?

A: Aging SGM individuals are underrepresented in research and recognizing their healthcare disparities and the factors associated with such disparities is a step toward eliminating disparities.