Is the GLBT community eating, drinking and being a little too merry for its own good? According to a few recently published surveys, gays and lesbians are getting lost somewhere on the road to good health. But how true is this – and how realistic are the surveys in their reflection of gay and lesbian life?

A recent California Health Interview Survey (CHIS) says gay men between the ages of 18 and 65 smoke about 54 percent more than their heterosexual California counterparts with lesbians of the same age smoking 66 percent. This is a typical survey reporting gay and lesbian health practices, but there is some crucial information left out – and it’s often left out of these kinds of surveys. The San Francisco Bureau’s CHIS study doesn’t report, for instance, the number of people surveyed, their genders, ethnicities or socioeconomic status. The age range reflected in the study suggests that all participants are viewed equally, but it’s more likely that an 18 year old smokes for different reasons than a 65 year old, and is viewed differently among their peer groups.

However, the study, conducted by the Center for Health Policy Research at the University of California, Los Angeles, does report what it says healthcare specialists have long believed: The tobacco industry targets minorities – including GLBTs – and often spends up to $3 million a day advertising in the smoking Golden State.

Bob Gordon, of the San Francisco Tobacco-Free Project, in an April 23 Tobacco Education Network News release, said, “California leaders need to look at the facts. The gay and lesbian community and the American Indian community both have prevalence rates nearly double that of the general population.”

Another recent, and widely reported, survey conducted by the Kansas City Health Department and the Lesbian and Gay Community Center of Greater Kansas City, polled 1,000 gays, lesbians and bisexuals. Thirty-eight percent of the participants admitted to lighting up regularly. When asked about alcohol consumption, 34 percent of gays and 24 percent of lesbians said they drank to get drunk at least once a month.

Before gasping, consumers may want to pause for thought – and for a closer look. How many participants from each sexual orientation category were surveyed? What were their ages, ethnicities and economic status? Without scrutinizing the demographics, these published findings can paint a bleak picture of health for the community. The study does state that little national data on GLBT health currently exists. And although not intended to be statistically representative, the objective was to create some type of baseline data regarding the national GLBT community’s general health.

Depending on where one looks for information and how the information is gathered, statements about GLBT health can sometimes be deceptive. When looking to surveys for answers, in addition to checking various sources, consumers would be wise to investigate where the study took place and who participated in it. Was it a fair study, or did the findings represent only a small sampling used to make blanket statements about large groups of people?

Dr. Ellen Stein is a lesbian professor of psychology at Alliant International University in San Diego, with a private practice in Hillcrest. Stein says those who are asked to participate in surveys may not always be a balanced or fair representation of the intended population – such as the general population of the GLBT community.

“Poorly constructed surveys can skew the data which is collected and render conclusions which may not be accurate,” says Stein. “Such data may not fairly represent the wide variety of people within unique demographics, such as the LGBT community.” She points to San Diego’s annual Pride weekend as evidence that a blanket statement is difficult to make about the community. “In just one weekend you can look around and see the tremendous diversity that our community represents, existing right here in San Diego.”

While the Kansas City survey was newsworthy for being the first comprehensive look at GLBT health practices, Stein is skeptical about using the findings for blanket generalizations and questions how the Midwestern population used in the Kansas City survey would compare to other locations such as Boston, Miami or San Diego. “When you pull an article about the Midwest and generalize the findings to other locales, you will undoubtedly end up with some inaccurate statements,” Stein says – a bit like polling San Diegans about their experiences with frostbite: Undoubtedly, tallying those answers, then attributing them to a national blanket response would be ludicrous.

Stein suggests that improving one’s understanding of the problems with which a community may struggle is more valuable than drawing conclusions based on comparisons with other people.

“Healthcare problems are prevalent in our community, just like any other,” she says. “Awareness of how a community experiences healthcare problems empowers it to begin approaching the subject of how to best access the quality care it deserves.”

Homosexuality was still considered a mental disorder by the American Psychiatric Association until late 1973. Within that climate, U.S. healthcare has often been geared toward treating the presumed heterosexual patient. Doctors have traditionally not considered the sexual orientation of their patient in terms of the cookie-cutter approach taken during an exam. Stein refers to the typical office forms that are completed in the medical waiting room as an example. She notes, “Most forms offer us four choices for marital status: single, married, widowed or divorced. It’s as if we do not exist when we see this form. How likely are we to feel accepted or understood in this climate?”

Suzann Gage, executive director of Progressive Health Services’ Lesbian Health Clinic, reports that some patients have indeed shared their fear of healthcare discrimination. Perhaps it is ignorance or homophobia that keeps many LBT women in the closet when accessing care.

“The inability to talk frankly about sexual orientation and identity can lead to inappropriate treatment, and even misdiagnosis,” she says. Gage recalls the experience of one lesbian patient whose symptoms included frequent urination. “When the clinic learned that her period happened to be late, they insisted on doing a pregnancy test,” she says. “Of course, it was negative. Then, the patient was sent on her way without receiving treatment for a bladder infection.”

The LBT women’s health experience, says Gage, can also offer a unique and insightful perspective on health.

“When lesbian and bi women go through menopause their women partners are often having the same experience,” she says. “This can enable them to compare notes, commiserate and even celebrate this milestone.”

In contrast, Gage asserts, “Heterosexual women often feel isolated and less valued in this phase of life. While aging men are often viewed as becoming more distinguished, our society’s double standard categorizes women as less attractive and simply getting older.”

There may be additional encouraging considerations for LBT women when it comes to breast self-examination (BSE). “Self-exam may be less mystifying for some LBT women because of the experience of having felt other women’s breasts,” says Gage, “and therefore having an understanding that the normal texture of women’s breasts can vary greatly.”

Whether or not the health surveys reflect our community accurately, many health specialists are in agreement that the GLBT community would be better off if it weren’t targeted by tobacco advertising. The American Legacy Foundation is one organization that’s taken a stand against tobacco advertising specifically targeted toward the GLBT population. A settlement reached between the tobacco industry and state governments enabled the foundation to provide $2 million to a nationwide campaign for GLBT smoking cessation projects.

By now, many have seen the local version of the “Cigarettes Are My Greatest Enemy” campaign. One such ad depicts a young man delivering the message, “I didn’t survive hustling so I could die from lung cancer. I will stop smoking.”

Another of the campaign’s messages features a young woman, with the tag line, “I didn’t survive drugs and alcohol so I could die from lung cancer. I had to stop smoking.”

Even though some authorities are claiming the campaign is too negative, others say it’s just what the doctor ordered, and is working. However, budgetary constraints at the American Legacy Foundation is likely to end that debate since payments into the fund ended in March.

No matter what the studies say, or what level of discrimination currently exists in the health care arena – the trend is changing for the better. In large metropolitan areas across the country, GLBTs’ healthcare needs are becoming increasingly more recognized, and more consumers now have access to GLBT health fairs and resources that were unavailable not so long ago.

In addition to local resources, the Gay and Lesbian Medical Association (GLMA) is one organization worth checking out. It is dedicated to expanding GLBT access to high-quality health care for patients throughout North America. To contact the GLMA, go to www.gaylesbiantimes.com and click on this article for a link to the GLMA.

Is the GLBT community’s health in jeopardy? How much discrimination truly exists when it comes to equal healthcare access for all? It depends on who is asked.

As more surveys are undertaken and their results are debated, perhaps it’s most important to remember that community health starts with yourself.