Lincoln Medical School, University of Lincoln, Brayford Pool, Lincoln LN6 7TS, UK.
School of Applied Social Sciences, De Montfort University, Leicester LE1 9BH, UK.
Int J Environ Res Public Health. 2020 Oct 19;17(20):7614. doi: 10.3390/ijerph17207614.
Internationally, there is increasing recognition that lesbian, gay, bisexual and trans (LGBT) populations experience substantial public health inequalities and require interventions to address these inequalities, yet data on this population is often not routinely collected. This paper considers the case study of the UK, where there are proposals to improve government and health data collection on LGBT populations, but also a degree of apparent uncertainty over the purpose and relevance of information about LGBT status in healthcare. This paper applies a health capabilities framework, arguing that the value of health information about LGBT status should be assessed according to whether it improves LGBT people's capability to achieve good health. We draw upon 36 older LGBT people's qualitative accounts of disclosing LGBT status within UK general practice healthcare. Participants' accounts of the benefits and risks of disclosure could be mapped against multiple domains of capability, including those that closely align with biomedical accounts (e.g., longevity and physical health), but also more holistic considerations (e.g., emotion and affiliation). However, across all domains, individuals tend to assess capabilities at an individual level, with relatively little reference to population-level impact of disclosure. Clearer articulation of the benefits of disclosure and data collection for the collective capabilities of LGBT populations may be a beneficial strategy for improving the quality of information on LGBT populations.
在国际上，越来越多的人认识到，女同性恋、男同性恋、双性恋和跨性别（LGBT）人群经历着严重的公共卫生不平等，需要采取干预措施来解决这些不平等问题，但关于这一人群的数据通常没有被常规收集。本文以英国为例进行了研究，英国政府提议改善 LGBT 人群的政府和卫生数据收集工作，但在医疗保健中关于 LGBT 身份的信息的目的和相关性方面也存在一定程度的不确定性。本文应用健康能力框架，认为 LGBT 身份健康信息的价值应根据其是否能提高 LGBT 人群实现健康的能力来评估。我们借鉴了 36 位英国普通医疗保健中公开自己 LGBT 身份的老年 LGBT 人群的定性描述。参与者对公开 LGBT 身份的好处和风险的描述，可以映射到多个能力领域，包括与生物医学描述密切相关的领域（如寿命和身体健康），以及更全面的考虑因素（如情感和归属感）。然而，在所有领域中，个人往往会在个体层面评估能力，而很少参考公开对 LGBT 人群集体能力的人口层面影响。更明确地阐述公开和数据收集对 LGBT 人群的集体能力的好处，可能是提高 LGBT 人群信息质量的一个有益策略。
