Improving health care in a vulnerable group
COLUMBIA, Mo 11/15/13 (Beat Byte) -- Roughly 160 lesbian and bisexual women 40 years and older are working on a 16-week health program in St. Louis and Columbia to reduce so-called "health disparities" -- unhealthy conditions or behaviors that disproportionately affect one population over others.  Health disparities are often found in minority groups.

One of only five such projects nationwide -- and the only one representing a smaller community (Columbia) -- Missouri's Project LOLA is a Federally-sponsored joint effort between Mizzou and the University of Chicago.

The 4-month program breaks the women into different groups that participate in health education; physical fitness with a personal trainer; support group sessions; nutrition workshops; and assessments that become part of a final report.

Good health is a big issue among lesbian and bisexual women, who suffer significantly higher rates of obesity and related problems such as heart disease, explained Jane McElroy, Ph.D., a Mizzou family and community medicine faculty member and Project LOLA's principal investigator.

Health problems often start early.  "Lesbian adolescents have been reported to have higher rates of overweight compared to heterosexual adolescents -- 70.5 percent to 50.3 percent," McElroy told the Heart Beat.

Breast cancer -- and death from it -- also occurs more frequently in lesbian than in heterosexual women, she added.  A 2012 study of data from 1997-2003 "found women in same-sex couples had an increased risk of breast cancer mortality compared to women in different-sex couples," McElroy explained.

Health disparities can also involve treatment disparities, a major problem in the black community, where chronic diseases such as diabetes appear with higher frequency than in other populations, but are treated less frequently.   Treatment disparities can affect lesbian and bisexual women, who are discriminated against at surprisingly higher rates than African-American women.

"One study estimated that 33 percent of African American women and 56 percent of Caucasian lesbian or bisexual women experienced discrimination," McElroy told the Heart Beat.  "Additionally, lesbian and bisexual women may conceal their sexuality in an effort to avoid stigma, which in turn causes stress."

Stress can lead to depression, aggravated mental illness, and worsening health, a vicious cycle in minority populations Project LOLA seeks to alleviate.   The goal: discover which approaches work best with which women, so that preventive measures can be taken early to avoid health problems later.