Tagline: Until the Work Is Done
The Health Equity and Accountability Act
June 3, 2018 at 1:49 pm

In This Section


By Valerie Ploumpis

Behind the blandly named “Health Equity and Accountability Act” looms a mountain of alarming data about racial and ethnic health disparities compiled by the U.S. Department of Health and Human Services Office of Minority Health. Compared to Whites, for example:

  • African American women are 40% more likely than White women to die from cancer;
  • Asian American and Pacific Islander (AAPI) men are twice as likelyto die from stomach cancer compared to Whites;
  • AAPI women are 2.4 times as likely to die from stomach cancer as White women;
  • Asian Americans are twice as likelyto develop chronic hepatitis B, as compared to Whites, and 7.5 times more likely to die from the disease;
  • In 2016, African Americans were still 4 times more likelyto be diagnosed with HIV infection compared to Whites;
  • 1 in 5 Asian Americans living with HIV do not even know they have it;
  • American Indians and Alaska Nativesand Native Hawaiians and Pacific Islanders are 2.4 times more likely to be diagnosed with diabetes; and
  • Hispanic women are 1.5 times as likely to die from diabetes.

As explained in the HEAA Fact Sheet, the bill not only addresses racial and ethnic health disparities, but it is powerfully “holistic” in that it includes sex, gender, sexual orientation, gender identity and expression, language, immigration status, age, disability, and socio-economic status.

Unique LGBTQ Health Conditions
Inclusiveness is essential to the LGBTQ community. Not only do men who have sex with men have a higher chance of getting HIV and AIDS but also viral hepatitis, a disease that attacks the liver. According to the CDC, about 10% of new Hepatitis A and 20% of all new Hepatitis B infections are among gay and bisexual men, who are also at an elevated risk of contracting Hepatitis C if they use intravenous drug and other activities that involve blood sharing.

Lesbians and bisexual women get less routine health care than other women, including colon, breast, and cervical cancer screening tests. Certain kinds of cancers, notably uterine and ovarian, are more common for women who have never been pregnant.

Transgender people also have unique and acute health concerns – approximately one-quarter (22-28%) of transgender women are living with HIV, and more than half (an estimated 56%) of African American transgender women are living with HIV. Among the 3 million HIV tests reported to CDC in 2015, the percentage of transgender people who received a new HIV diagnosis was more than 3 times the national average.

Heavy cigarette and alcohol use in the LGBTQ community are well-known, and is in part due to the widespread advertising and event sponsorship by tobacco and alcohol companies. The CDC finds that cigarette smoking among LGB individuals in the U.S. is higher than among non-LGB people. Nearly 1 in 4 LGB adults smoke cigarettes, compared with about 1 in 6 heterosexual/straight adults. The CDC website readily acknowledges that “limited information exists” regarding cigarette smoking by transgender adults, but is “reported to be higher than among the general population of adults. The transgender population is considered especially vulnerable because of high rates of substance abuse, depression, HIV infection, and social and employment discrimination, all of which are associated with higher smoking prevalence.”

Not surprisingly, tobacco use is linked to many kinds of cancers, some of which seem more pronounced for LGBTQ smokers. Gay men have high rates of HPV infection which, when coupled with cigarette smoking, increases their risk for anal and other cancers. And among women, secondhand smoke exposure is more common among non-smoking lesbian women than among non-smoking straight women.

For all of these reasons, and on behalf of every one of our 800,000 members and their families, Equality California strongly supports HEAA, a proposal that has been re-introduced every year since 2007 by the Congressional Black Caucus, the Congressional Hispanic Caucus and the Congressional Asian Pacific American Caucus (collectively known as the Congressional Tri-Caucus).

Regrettably, like every other piece of pro-equality legislation, the Health Equity and Accountability Act will not pass the current Congress – not a single Republican has cosponsored this inclusive healthcare bill. But EQCA is not deterred; as California Representatives Judy Chu and Barbara Lee said when they introduced HEAA, it is a “roadmap to health equity, so that everyone in our country can thrive.”

Putting LGBTQ people on the HEAA roadmap is Equality California’s goal too.

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