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Sexual Orientation and Gender Identity Data Reporting Among U.S. Health Centers

  • Alex McDowell
    Correspondence
    Address correspondence to: Alex McDowell, PhD, MPH, MSN, RN, Mongan Institute Health Policy Research Center, Massachusetts General Hospital, 100 Cambridge Street, Suite 1600, Boston MA 02114.
    Affiliations
    Mongan Institute Health Policy Research Center, Massachusetts General Hospital, Boston, Massachusetts

    Department of Medicine, Harvard Medical School, Boston, Massachusetts
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  • Catherine Myong
    Affiliations
    Mongan Institute Health Policy Research Center, Massachusetts General Hospital, Boston, Massachusetts

    Vagelos College of Physicians & Surgeons, Columbia University Irving Medical Center, New York, New York
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  • Delaney Tevis
    Affiliations
    Mongan Institute Health Policy Research Center, Massachusetts General Hospital, Boston, Massachusetts

    School of Medicine, University of California San Francisco, San Francisco, California
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  • Vicki Fung
    Affiliations
    Mongan Institute Health Policy Research Center, Massachusetts General Hospital, Boston, Massachusetts

    Department of Medicine, Harvard Medical School, Boston, Massachusetts
    Search for articles by this author
Published:February 26, 2022DOI:https://doi.org/10.1016/j.amepre.2021.12.017

      Introduction

      Sexual orientation and gender identity data collection is necessary to address health inequities. This study examines sexual orientation and gender identity data reporting among community health centers.

      Methods

      Using the 2016–2019 Uniform Data System for 1,381 community health centers, trends in reporting of sexual orientation and gender identity data were examined. Multivariable logistic regression was used to assess associations between community health center characteristics and whether sexual orientation and gender identity data were available for ≥75% of a community health center's patients in 2019. Data were analyzed in 2021.

      Results

      In 2016-2019, the percentage of community health centers with sexual orientation and gender identity data for ≥75% of patients increased from 14.9% to 53.0%. In 2019, community health centers were more likely to have this data for ≥75% of patients if they were in nonmetro counties (OR=1.48, 95% CI=1.04, 2.10 versus metro), were in the South (OR=2.27, 95% CI=1.57, 3.31) or West (OR=1.91, 95% CI=1.27, 2.88 versus the Northeast), and had more patients aged between 18 and 39 years (OR=1.04, 95% CI=1.02, 1.07), between 40 and 64 years (OR=1.04, 95% CI=1.02, 1.06 vs <18 years), or veterans (OR=1.10, 95% CI=1.01, 1.20). This was less likely among community health centers serving 10,000–20,000 patients (OR=0.70, 95% CI=0.52, 0.95) and >20,000 patients (OR=0.44, 95% CI=0.32, 0.61 vs <10,000) and community health centers with more patients of American Indian/Alaskan Native (OR=0.98, 95% CI=0.97, 0.99) or unknown race (OR=0.92, 95% CI=0.86, 0.97 versus White).

      Conclusions

      Collection of sexual orientation and gender identity data by community health centers has increased substantially since 2016, although gaps remain.
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