All too often, health disparities reinforce stigma and moral judgment rather than prompting us to ask why these differences exist. We ascribe race-related disparities to poverty, drug abuse and genetics. And we blame higher rates of disease among LGBTQ people to promiscuity.
But it’s actually a person’s membership in a stigmatized minority that exposes them over time to disproportionately higher levels of stress related to prejudice, harassment, discrimination, rejection, hostility, sexual assault and hate crimes. That stress leads to worse mental health and, in turn, worse physical health – and more healthcare spending.
Sure, stress and socio economic positioning affect health. So does being buggered 20 times in an afternoon down at the bath house.
Thus there’s a certain distinction to be made over which illnesses and diseases we might be talking about. sickle cell anaemia is pretty much restricted to those with (some) West African heritage (however white they might look as a number of Americans have found out about their family tree). Tay Sachs hugely more common in those of Ashkenazi descent. Lung cancer and heart disease in the poor partly (note, partly!) as a result of greater prevalence of smoking.
And yes, promiscuity does lead to higher STD rates. But it is the promiscuity (HIV is different), not the LGBTQ bit.
That is, it’s necessary to be specific over what we are talking about.