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Rural Health Information Hub

Implementation Considerations for Advancing Health Equity among Rural LGBTQI+ Populations

As described in the Social Determinants of Health Toolkit, there are common characteristics of rural communities that may affect the health and well-being of LGBTQI+ populations. These characteristics include lack of knowledgeable and affirming healthcare and social service providers, limited support structures, and oppression and discrimination. In addition, rural areas are less likely to have laws that prohibit discrimination based on gender identity or sexual orientation. Discrimination influences the ability of LGBTQI+ people to have equal access to health-promoting services and other factors that affect health and well-being, such as jobs, education, and employment.

The Movement Advancement Project — in partnership with the Equality Federation, the National Black Justice Coalition, and the National Center for Lesbian Rights — released a report on LGBT people in rural areas that included health-related recommendations. Some suggestions focus on issues affecting LGBTQI+ people in rural areas, such as:

  • Enhancing research and data collection about LGBTQI+ people living in rural areas
  • Increasing the visibility of LGBTQI+ people in rural areas
  • Uplifting the voices of rural LGBTQI+ residents
  • Encouraging organizations and individuals in rural communities to accept LGBTQI+ people and support equity
  • Enhancing rural infrastructure and resources
  • Enacting legal protections and nondiscrimination policies for LGBTQI+ people in rural areas

The report also identified recommendations specific to improving healthcare and social services for LGBTQI+ people in rural areas. Rural communities can consider implementing training, education, and outreach to support healthcare and social service providers serving LGBTQI+ people. Additionally, communities may benefit from conducting assessments of LGBTQI+ populations' needs, tailoring services to their needs and preferences, and enhancing referrals to other organizations that provide inclusive services.

Our Online Library identifies additional resources related to rural LGBTQI+ populations. The Rural Monitor has also featured healthcare organizations that are building inclusive rural practices for LGBTQ+ people.

Resources to Learn More

Center of Excellence on LGBTQ+ Behavioral Health Equity: Session Recordings
Collection of credit and noncredit training webinars covering a range of LGBTQ+ health issues.
Organization(s): Center of Excellence on LGBTQ+ Behavioral Health Equity, University of Maryland School of Social Work

Health and Health Care of Rural Sexual and Gender Minorities: A Systematic Review
Presents the findings from a literature review describing the common challenges rural LGBT patients experience when receiving healthcare and how they contribute to health disparities. Highlights evidence-based recommendations and interventions to promote health for rural LGBT populations.
Author(s): Rosenkrantz, D. E., Black, W. W., Abreu, R. L., Aleshire, M. E., & Fallin-Bennett, K.
Citation: Stigma and Health, 2(3), 229-243
Date: 2017

National LGBTQIA+ Health Education Center
Provides free trainings to help providers and health centers better serve the LGBTQIA+ community.
Organization(s): The Fenway Institute

Nurses (HEALE)
Offers training for providers who serve aging LGBTQ populations. Includes a train-the-trainer option allowing providers to administer the curriculum to their colleagues.
Organization(s): Howard Brown Health