Yulin Hswen1, Kara C Sewalk2, Emily Alsentzer3, Gaurav Tuli2, John S Brownstein4, Jared B Hawkins5. 1. Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Informatics Program, Boston Children's Hospital, Boston, MA, USA. Electronic address: yuh958@mail.harvard.edu. 2. Informatics Program, Boston Children's Hospital, Boston, MA, USA. 3. Department of Health Science and Technology, Massachusetts Institute of Technology, Boston, MA, USA. 4. Informatics Program, Boston Children's Hospital, Boston, MA, USA; Department of Pediatrics, Harvard Medical School, Boston, MA, USA; Department of Biomedical Informatics, Harvard Medical School, Boston, MA, USA. 5. Informatics Program, Boston Children's Hospital, Boston, MA, USA; Department of Pediatrics, Harvard Medical School, Boston, MA, USA.
Abstract
RATIONALE: Persons who identify as lesbian, gay, bisexual, and transgender (LGBT) face health inequities due to unwarranted discrimination against their sexual orientation or identity. An important contributor to LGBT health disparities is the inequitable or substandard care that LGBT individuals receive from hospitals. OBJECTIVE: To investigate inequities in hospital care among LGBT patients using the popular social media platform Twitter. METHOD: This study examined a dataset of Twitter communications (tweets) collected from February 2015 to May 2017. The tweets mentioned Twitter handles for hospitals (i.e., usernames for hospitals) and LGBT related terms. The topics discussed were explored to develop an LGBT position index referring to whether the hospital appears supportive or not supportive of LGBT rights. Results for each hospital were then compared to the Healthcare Equality Index (HEI), an established index to evaluate equity of hospital care towards LGBT patients. RESULTS: In total, 1856 tweets mentioned LGBT terms representing 653 unique hospitals. Of these hospitals, 189 (28.9%) were identified as HEI leaders. Hospitals in the Northeast showed significantly greater support towards LGBT issues compared to hospitals in the Midwest. Hospitals deemed as HEI leaders had higher LGBT position scores compared to non-HEI leaders (p = 0.042), when controlling for hospital size and location. CONCLUSIONS: This exploratory study describes a novel approach to monitoring LGBT hospital care. While these initial findings should be interpreted cautiously, they can potentially inform practices to improve equity of care and efforts to address health disparities among gender minority groups.
RATIONALE: Persons who identify as lesbian, gay, bisexual, and transgender (LGBT) face health inequities due to unwarranted discrimination against their sexual orientation or identity. An important contributor to LGBT health disparities is the inequitable or substandard care that LGBT individuals receive from hospitals. OBJECTIVE: To investigate inequities in hospital care among LGBT patients using the popular social media platform Twitter. METHOD: This study examined a dataset of Twitter communications (tweets) collected from February 2015 to May 2017. The tweets mentioned Twitter handles for hospitals (i.e., usernames for hospitals) and LGBT related terms. The topics discussed were explored to develop an LGBT position index referring to whether the hospital appears supportive or not supportive of LGBT rights. Results for each hospital were then compared to the Healthcare Equality Index (HEI), an established index to evaluate equity of hospital care towards LGBT patients. RESULTS: In total, 1856 tweets mentioned LGBT terms representing 653 unique hospitals. Of these hospitals, 189 (28.9%) were identified as HEI leaders. Hospitals in the Northeast showed significantly greater support towards LGBT issues compared to hospitals in the Midwest. Hospitals deemed as HEI leaders had higher LGBT position scores compared to non-HEI leaders (p = 0.042), when controlling for hospital size and location. CONCLUSIONS: This exploratory study describes a novel approach to monitoring LGBT hospital care. While these initial findings should be interpreted cautiously, they can potentially inform practices to improve equity of care and efforts to address health disparities among gender minority groups.
Authors: Yulin Hswen; Amanda Zhang; Kara C Sewalk; Gaurav Tuli; John S Brownstein; Jared B Hawkins Journal: J Med Internet Res Date: 2020-07-31 Impact factor: 5.428
Authors: Yulin Hswen; Jared B Hawkins; Kara Sewalk; Gaurav Tuli; David R Williams; K Viswanath; S V Subramanian; John S Brownstein Journal: J Med Internet Res Date: 2020-08-21 Impact factor: 5.428