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Editorial: CA risks LGBTQ residents' health

by BAR Editorial Board

State Senator Scott Wiener. Photo: Rick Gerharter
State Senator Scott Wiener. Photo: Rick Gerharter  

Gay state Senator Scott Wiener is absolutely right in calling for an audit of the California Department of Public Health to find out why it is still not collecting sexual orientation and gender identity (SOGI) data for COVID-19. We've been calling for this data since the pandemic started because information suggests the health crisis affects the LGBTQ community more than we know. Earlier this year, Governor Gavin Newsom signed Wiener's Senate Bill 932 to collect SOGI data as an urgency measure, yet, as Wiener wrote in a letter to CDPH, the agency "has not made public any SOGI data around COVID-19. Indeed, based on my own personal experience and numerous reports from others, major COVID-19 testing sites are not collecting this data at all." SB 932, he added, requires that all health care providers testing for COVID-19 collect this data. As we reported last month, tests in San Francisco do not ask about sexual orientation; for gender, the choices are male, female, or nonbinary. The city says it's working on it.

This week, a new report by the Movement Advancement Project adds evidence to Wiener's concerns. "Disproportionate Impacts of COVID-19 on LGBTQ Households in the U.S." was compiled using the findings and analysis of a nationally representative online and phone survey conducted by the Harvard T.H. Chan School of Public Health, NPR, and the Robert Wood Johnson Foundation. While it doesn't specifically address health care, the report did find that nearly two-thirds of LGBTQ people and their families experienced a job loss or disruption, compared to just under half (45%) of non-LGBTQ households. As we know, when there is a job loss or disruption, people often lose their health insurance if it is provided by employers. (The survey included 3,454 adults, of whom 8% identified as LGBTQ.)

In May, we pointed out that the Williams Institute, an LGBTQ think tank at the UCLA School of Law, revealed that more than 200,000 LGBTQ adults in the Golden State are at high risk for COVID-19. According to the institute, these LGBTQ state residents have one or more medical conditions that put them at high risk for COVID-19. The institute noted that approximately 361,000 LGBTQ adults in the state were in fair or poor health before the pandemic began earlier this year. The state is home to nearly 1.7 million LGBTQ adults, including 1,646,000 LGB people of any gender identity and 109,000 trans people of any sexual orientation, according to the institute. The vast majority of these adults — 92% — live in urban areas. The data in the institute's report came from the California Health Interview Survey. At that time, Wiener was getting SB 932 through the Legislature.

As we've also noted, CDPH has been woefully uncommunicative with the LGBTQ press over the years, and apparently it is just as silent with LGBTQ lawmakers, which is shameful. "As you know," Wiener, the San Francisco Democrat, wrote to acting CDPH director Dr. Erica Pan last week, "data collection isn't an academic exercise. Rather, it has life or death consequences. It is only because of data that we know, for example, that COVID is killing Black people at outrageous rates and that our Latinx communities have very high infection rates. And, it is only because of data collection that we understand COVID's impacts on different age groups."

But the disease's impacts on the queer community are largely invisible, he added, due to the lack of data collection. He passed SB 932 so that our community would not be erased, yet that is exactly what's happening without this necessary information.

It wasn't supposed to be this way. The state health department should already be collecting SOGI data that includes COVID-19 information. Assemblyman David Chiu (D-San Francisco) authored the original legislation a few years ago and even gave state departments, including CDPH, more time to get their systems up and running. Delays have hampered this effort. COVID does not discriminate but LGBTQ health experts have pointed out that health disparities do. As the B.A.R. and other outlets have reported, the National LGBT Cancer Network anticipates that LGBTQ people have more risk from COVID-19 because of higher rates of cancer, HIV-infection, smoking and its attendant respiratory illnesses, and structural discrimination in the medical field.

Wiener's letter also pointed out that with the state vaccine distribution plan being formulated, which is based on data around risk levels, "the LGBTQ community will be left out entirely."

Newsom recently announced that he's named Dr. Tomás Aragón, San Francisco's health officer, to be the new CDPH director. Aragón has been at San Francisco's Department of Public Health for many years, so he surely knows the importance of accurate and timely data around LGBTQ health issues. We hope that his leadership of the state agency will be a breath of fresh air, not only for queer people but for all state residents. We urge him to immediately have the department begin collecting SOGI data per SB 932 on COVID so that our community can have the same information that other demographic groups have — and get treatment and the vaccine accordingly.

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