Project team:

Jonathan Hallett1 , Shoshana Rosenberg1 , Gemma Crawford1 , Michael Atkinson2 , Corie Gray1 , Thomas Trainer1

1. Collaboration for Evidence, Research and Impact in Public Health (CERIPH), School of Population Health, Curtin University, Western Australia.

2. Living Proud, Western Australia.  

 

Publications:

• Hallett, J., Rosenberg, S., Crawford, G., Atkinson, M., Gray, C. & Thomas, T. (2024). LGBTIQA+ Primary Health Care Priorities in Western Australia: Insights for Advocacy and Action. Collaboration for Evidence, Research and Impact in Public Health (CERIPH), Curtin University: Perth, Western Australia

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Background: Despite being identified as a priority population in various state and national strategies, LGBTIQA+ people experience elevated health risks due to experiences of discrimination, stigma, and exclusion. While regular engagement with primary health care (PHC) is acknowledged as a determinant of general health, the provision of services in a culturally safe and appropriate way, is imperative to optimise LGBTIQA+ health outcomes.

LGBTIQA+ community-controlled organisations play a crucial role in providing essential services and demonstrate utility in supporting health outcomes for LGBTIQA+ people. However, in Western Australia (WA), the limited presence and funding of LGBTIQA+ community-controlled organisations exacerbate reliance on mainstream PHC services where reports of insufficient acknowledgement of and respect for diverse sexualities, genders and sex characteristics prevail.

This study sought to better understand the existing primary health care services available for LGBTIQA+ people in Western Australia (WA) to provide recommendations for addressing gaps and improving services and policy. In partnership with Living Proud, we facilitated a needs assessment process to:

 

• explore service provider perspectives on LGBTIQA+ primary health care needs and priorities;

• describe the health status of LGBTIQA+ Western Australians using existing data sources; and

• identify relevant policy frameworks and documented strategic direction for LGBTIQA+ primary health care needs in WA.

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Approach: This project was a collaboration between Curtin University and Living Proud, one of the main LGBTIQA+ community-controlled organisations in WA. We conducted a mixed method examination of the health status and service provision for LGBTIQA+ individuals in WA, which included:

 

• A narrative evidence review synthesising findings into health domain snapshots and identifying gaps in WA data.

• An audit of public domain government policies in WA and nationally for LGBTIQA+ content and priority setting. community controlled LGBTIQA+ health services, metropolitan and regional LGBTIQA+ community groups, and representatives from mainstream organisations offering LGBTIQA+ targeted programs. These activities aimed to map existing service provision, discuss unaddressed health needs, and explore service gaps in both metropolitan and regional WA.

• A consultation process to inform the evidence review and gain further insights, involving stakeholder surveys and workshops: community controlled LGBTIQA+ health services, metropolitan and regional LGBTIQA+ community groups, and representatives from mainstream organisations offering LGBTIQA+ targeted programs. These activities aimed to map existing service provision, discuss unaddressed health needs, and explore service gaps in both metropolitan and regional WA.

Key insights:

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1. Community inclusion forms a consistent thread throughout the research on improving LGBTIQA+ health, as it enables local communities to shape health services according to their needs and ensures that health care providers remain attuned to the needs of their LGBTIQA+ clients and broader community.

2. The WA LGBTIQA+ community-controlled sector is primarily volunteer-driven, with scarce infrastructure to support operations however, services form a crucial and unique part of LGBTIQA+ health care.

3. An underfunded community-controlled sector relies on partnership and collaborative approaches with mainstream Government and Community Health Services.

4. There remain significant health disparities affecting LGBTIQA+ people across a broad range of health outcomes. More accurate and localised data on the health experiences and outcomes for LGBTIQA+ people in WA is still needed.

5. There are multiple intersecting factors that influence health and wellbeing for LGBTIQA+ people. Accordingly, a range of priority populations have been identified requiring additional consideration in all primary health care responses.

6. While there are significant gaps in providing LGBTIQA+ inclusive health care globally, rural and remote LGBTIQA+ communities experience greater inequity and barriers to accessing appropriate and safe health care.

7. Both global and Australia-specific research indicates a need for significant improvements amongst health care professionals and medical training institutes (particularly mainstream organisations) to provide quality care to LGBTIQA+ people.

8. The operations and physical spaces of clinics and other medical environments where health care is delivered provide a significant opportunity to improve LGBTIQA+ inclusion.

9. Health promotion action can contribute to population-level benefits in health and quality of life outcomes. However current programs and strategies are limited that specifically address the health needs of LGBTIQA+ people.

10. Government and policy changes can significantly improve LGBTIQA+ health outcomes. Without government-level support and funding, adverse health outcomes experienced by many LGBTIQA+ Western Australians will remain.

 

Agenda for Action:

This research has yielded important implications to support future action to support action on LGBTIQA+ health disparities in Western Australia. While we have identified priority actions we recognise that further work is required. However, acting on these priorities will make some inroads into a currently underserved area of health and social policy. 
Our Agenda for Action proposes specific strategies to address each of the following action areas including assigning priority responsibilities: 

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• Mobilising Resources for LGBTIQA+ Community Controlled Services 

• Prioritising Policy and Legal Reform to Improve LGBTIQA+ Health 

• Involving LGBTIQA+ People in Mainstream Health and Social Service Provision 

• Improving Primary Health Care for LGBTIQA+ People 

• Improving Prevention and Health Promotion for LGBTIQA+ People 

• Developing a Research Agenda to Support LGBTIQA+ Health 

• Supporting Intersectional Priority Populations 

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By proposing a series of interconnected strategies within each of these action areas, the Agenda for Action is intended to support the move from rhetoric to action on LGBTIQA+ health in WA. It is envisaged that the proposed Agenda for Action will be discussed, considered and debated by stakeholders and our communities, playing a support role in guiding action in new LGBTIQA+ health strategies and action. ​

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For more information: 

Dr Jonathan Hallett

j.hallett@curtin.edu.au