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2022 U.S. National Survey on LGBTQ Youth Mental Health by State

December 15, 2022

The Trevor Project, the leading suicide prevention organization for LGBTQ young people, produces innovative original research that amplifies the experiences of diverse LGBTQ young people and brings new knowledge and clinical implications to the suicide prevention field.Since 2019, our annual national surveys have been among the largest and most diverse surveys of LGBTQ young people in the U.S. For the first time ever, we're publishing the findings of our national survey, which captured the experiences of nearly 34,000 LGBTQ people ages 13-24 across the United States in 2022, segmented by all 50 states.These data provide critical insights into the suicide risk faced by LGBTQ young people, top barriers to mental health care, the prevalence of anti-LGBTQ victimization, and the negative impacts of recent politics. Importantly, this research also points to ways in which we can all support the LGBTQ young people in our lives by detailing per state LGBTQ young people's access to accepting communities, LGBTQ-affirming spaces, and social support among family and friends — protective factors that are consistently associated with better mental health and lower suicide risk.It's essential to emphasize that because we still do not have known counts or registries of the LGBTQ youth population comprehensive data on the mental health and well-being of LGBTQ youth remains limited. These findings strive to underscore the unique challenges faced by young LGBTQ people, a group consistently found to be at significantly increased risk for suicide because of how they are mistreated and stigmatized in society.We hope that LGBTQ young people in every state will see themselves reflected in these experiences that so many have bravely shared; and that these data will equip fellow researchers, policymakers, and other youth-serving organizations in every state with the data necessary to celebrate and uplift LGBTQ young people and advocate for policies that work to end the public health crisis of suicide.

Strengthening Medicaid: Challenges States Must Address As The Public Health Emergency Ends

May 31, 2023

Medicaid is an essential program that provides health services for millions of people who otherwise could not afford them. Medicaid improves health outcomes for recipients, improves their financial stability, provides access to potentially life-saving healthcare, creates thousands of jobs that bolster our local economies, and helps reduce economic and racial disparities in health insurance and healthcare access. While Medicaid improves the health and lives of recipients and benefits the healthcare system and the US economy, Medicaid systems for enrollment, renewal/redetermination, and using Medicaid coverage need improvement. All people who meet Medicaid eligibility criteria are guaranteed coverage. However, many who are eligible struggle to enroll in and maintain Medicaid coverage. Barriers to obtaining and renewing coverage and accessing services often make it challenging and time-consuming to navigate the system. Many who successfully enrolled face further dissatisfaction and stress as Medicaid leaves their needs unaddressed. Research shows that Medicaid recipients experience many barriers to accessing quality healthcare.

Medication abortion among Asian Americans, Native Hawaiians, and Pacific Islanders: Knowledge, access, and attitudes

May 30, 2023

Almost no research to date examines abortion attitudes and knowledge among Asian Americans, Native Hawaiians, and Pacific Islanders (AANHPIs) in the U.S. While previous research shows lower rates of abortion among Asian women compared to other racial ethnic groups, abortion rates vary by subgroups when disaggregating data by ethnicity or country of origin. In addition, no literature currently exists documenting AANHPI experiences with and/or use of medication abortion (MA).To help address this research gap, National Asian Pacific American Women's Forum (NAPAWF), in partnership with Ibis Reproductive Health, conducted a two-year study examining AANHPI people's knowledge of, access to, and attitudes about abortion, with a specific focus on medication abortion. While medication abortion accounts for over half of all abortions in the U.S., participants in this study described limited knowledge of abortion methods, including medication abortion.Our study identified a range of barriers to medication abortion. For AANHPI communities, this includes community stigma towards abortion and sexual and reproductive health (SRH), a lack of family support, and the unavailability of language support for limited-English or non-English speaking patients at abortion clinics. Other barriers included the high cost of abortion care, lack of insurance coverage, limited appointment availability, lack of transportation, legal restrictions, longer wait times at the clinic, and protesters outside of clinics.The taboo nature of SRH topics, including abortion, in addition to the general lack of openness among AANHPI community members impacts access to information and services related to their reproductive health. There is an overall need to provide accurate and culturally relevant information about all abortion methods to AANHPI communities to help bridge information gaps and overcome barriers to access. 

Primary and reproductive healthcare access and use among reproductive aged women and female family planning patients in 3 states

May 24, 2023

Public funding plays a key role in reducing cost barriers to sexual and reproductive health (SRH) care in the United States. In this analysis, we examine sociodemographic and healthcare seeking profiles of individuals in three states where public funding for health services has recently changed: Arizona, Iowa, and Wisconsin. In addition, we examine associations between individuals' health insurance status and whether they experienced delays or had trouble in obtaining their preferred contraception. This descriptive study draws on data collected between 2018 to 2021 in two distinct cross-sectional surveys in each state, one among a representative sample of female residents aged 18–44 and the other among a representative sample of female patients ages eighteen and older seeking family planning services at healthcare sites that receive public funding to deliver this care. The majority of reproductive-aged women and female family planning patients across states reported having a personal healthcare provider, had received at least one SRH service in the preceding 12 months, and were using a method of birth control. Between 49–81% across groups reported receiving recent person-centered contraceptive care. At least one-fifth of each group reported wanting healthcare in the past year but not getting it, and between 10–19% reported a delay or trouble getting birth control in the past 12 months. Common reasons for these outcomes involved cost and insurance-related issues, as well as logistical ones. Among all populations except Wisconsin family planning clinic patients, those with no health insurance had greater odds of being delayed or having trouble getting desired birth control in the past 12 months than those with health insurance. These data serve as a baseline to monitor access and use of SRH services in Arizona, Wisconsin, Iowa in the wake of drastic family planning funding shifts that changed the availability and capacity of the family planning service infrastructure across the country. Continuing to monitor these SRH metrics is critical to understand the potential effect of current political shifts.

Understanding Training and Workforce Pathways to Develop and Retain Black Maternal Health Clinicians in California

May 16, 2023

Despite evidence that greater diversity in health professions increases quality of care, the maternal health field has made little progress on increasing and sustaining the number of Black maternal health care workers. In this study, Urban researchers examine opportunities for and barriers to increasing the workforce of Black obstetrician/gynecologists (OB/GYNs), labor and delivery (L&D) nurses, and midwives, especially in light of the ongoing US maternal health crisis. Through interviews with Black maternal health clinicians and training program staff, we recommend actions that federal and state policymakers, leaders at higher education and health system institutions, and philanthropies can take to address structural barriers to entering and staying within the field and to support a thriving workforce.

Care in Crisis: Failures to guarantee the sexual and reproductive health and rights of refugees from Ukraine in Hungary, Poland, Romania and Slovakia

May 16, 2023

This report from The Center for Reproductive Rights and eight partner organizations documents the gaps and barriers in access to sexual and reproductive healthcare and gender-based violence support services that are faced by refugees from Ukraine in Hungary, Poland, Romania and Slovakia. The report found that legal restrictions, burdensome costs, information shortfalls and other barriers, mean that some refugees are facing a harrowing choice between returning to Ukraine to access essential reproductive healthcare, accessing care outside legal pathways in their host countries or going without much-needed care, according to the new report.

The Relationship Between Caring Teachers and the Mental Health of LGBTQ Students

May 10, 2023

Schools and the professionals who work within them play key roles in the lives of LGBTQ young people. Teachers, professors, and school counselors are important sources of information, support, and care for LGBTQ students, especially in the absence of support from their families or local communities. LGBTQ students who  identified a greater number of supportive school staff reported higher levels of self-esteem, lower levels of depression, and lower rates of having seriously considered suicide in the past year (Kosciw et al., 2022). Among LGBQ students, having caring teachers is associated with lower levels of negative mental health symptoms (Parmar et al., 2022). Using data from The Trevor Project's 2023 U.S. National Survey on the Mental Health of LGBTQ Young People, this brief examines the relationships between caring teachers and student mental health, including transgender and nonbinary students, as well as demographic differences in LGBTQ young people's access to caring relationships in schools. This brief additionally investigates rates of LGBTQ young people who report learning about LGBTQ topics from school staff and associations between learning about LGBTQ topics and mental health. 

2020 Mom Community Action Toolkit

May 8, 2023

2020 Mom developed this toolkit to serve as a roadmap for coalitions working to improve the continuum of care for maternal mental health (MMH) disorders in their communities. 2020 Mom is committed to facilitating A.C.T.I.O.N. (Advancing Collaboration through Toolkits, Initiatives, and Online Networking) among community coalitions.This project is intended for existing maternal child health community coalitions or group leaders looking to improve screening and treatment rates for MMH disorders in their communities. We believe local leaders understand the unique needs in their regions and are best suited to address gaps in care, drive policy change, and build partnerships to improve maternal mental health.The Community Action Toolkit is a manual for creating an MMH community action plan by working through the 2020 Mom Action Cycle. This process includes: assessing the community's MMH services, analyzing findings, setting priorities, determining local interventions, and ultimately drafting an evidence-based MMH Action Plan.The toolkit includes templates for developing a membership invitation, meeting agendas, meeting minutes, project workplans, a strategy grid, SMART objectives, a logic model, and the action plan with built-in evaluation. The toolkit also provides a menu of interventions with guidance for selecting those that will address local issues within a realistic budget.

No One Could Say: Accessing Emergency Obstetrics Information as a Prospective Prenatal Patient in Post-Roe Oklahoma

April 25, 2023

This report by the Center for Reproductive Rights, Physicians for Human Rights, and Oklahoma Call for Reproductive Justice raises concerns about pregnant patients' ability to access life-saving obstetric care in states where abortion is banned.

NHS Brain Cancer Healthcare and Research: Does It Matter Where You Are Treated?

April 21, 2023

This report presents extensive insights, collected in 2020-2022,  into 28 of the 30 NHS brain cancer centres in the UK.  It highlights significant geographical variation in treatment and care and sets out how to level up services. The report presents the most comprehensive dataset on NHS brain cancer services ever collected, providing the Mission with a unique strategic overview on how to drive change and innovation nationally.It reveals striking variation in brain cancer services across the UK, with disparities in the design, quality and extent of the treatment and care pathway. In all hospitals reviewed, treatment was delivered according to internationally recognised standards by a motivated team: however there was notable variability in access to genetic testing of tumour samples, involvement in clinical studies and the extent of nurse and allied health-led services. All of which have the potential to impact patient experience and outcomes.

Middle Eastern and Northern African LGBTQ Young People

April 20, 2023

LGBTQ young people are more likely to report mental health concerns – including  depression, anxiety, and suicidality – in comparison to their straight and cisgender peers (Johns et al., 2019; Johns et al., 2020). These reports are often due to minority stress experiences, such as identity-related discrimination and victimization, rather than simply being LGBTQ (Meyer, 2003). After a call for intersectional research on health disparities by the National Institutes of Health (NIH, 2015), some research has begun to illuminate the impact of having multiple marginalized identities (e.g., being LGBTQ and a person of color) on mental health outcomes (Cyrus, 2017). However, very little research has explored the mental health of Middle Eastern and Northern African (MENA) LGBTQ young people (Hayek et al., 2022). Despite representing over 20 countries and being considered non-White by the majority of other Western countries (Maghbouleh et al., 2022), MENA people have historically been considered both a monolithic population in the United States (U.S.) and White by the U.S. Census (Abboud et al., 2019). Thus, little research has explored the mental health of MENA people, as they are often combined with White people in literature. However, a systematic review found that MENA LGBTQ people frequently report symptoms of depression and posttraumatic stress, suicidal ideation, and substance misuse, which is often tied to societal and cultural stressors that are unique to MENA people, such as a lack of sexual health awareness and anti-LGBTQ stigma and persecution (Hayek et al., 2022). Specific to young people, research by GLSEN suggests that MENA LGBTQ young people experience higher rates of school-based victimization than their non-MENA peers, which is related to depressive symptoms and poor self-esteem (Truong & Kosciw, 2022). Using data from The Trevor Project's 2022 National Survey on LGBTQ Youth Mental Health, this brief will be one of the first to exclusively explore the mental health of MENA LGBTQ young people, separately from White LGBTQ young people.

Tobacco 21 Policy Evaluation: Reducing Youth Tobacco Use Through Policy Change in Greater Cincinnati

April 18, 2023

From 2019-2022, Interact for Health partnered with the Center for Public Health Systems Science at the Brown School at Washington University in St. Louis to conduct an evaluation of policy efforts in southwest Ohio to increase the minimum legal sales age of tobacco products from 18 to 21 (known as Tobacco 21) and related enforcement strategies. Findings and lessons learned illuminate the role local laws play in protecting youth in our communities, what it takes to move through the policymaking lifecycle, and the policy's impact - including a decrease of 27% in ease-of-access to tobacco products among Cincinnati youth from 2018 to 2022.