Better health through better understanding
For School of Behavioral and Organizational Sciences (SBOS) Professor Allen Omoto, the key to improving health could lie in improved understanding of diverse patients and the unique stressors they face.
Access to health care is a clear determinant of quality of life and life expectancy. When a minority group or subgroup underutilizes medical services, the result is needless suffering and preventable death. That is one reason why Omoto’s two-year, $132,000 grant to study stress and health among sexual-minority immigrants, with a particular focus on individuals of Latino or Asian descent, was recently funded by the National Institute of Child Health and Human Development, one of the institutes of the National Institutes of Health.
Eliminating health disparities among different segments of the population are key public-health priorities. These disparities are likely exacerbated when individuals belong to one or more stigmatized groups, such as immigrants or ethnic minority-group members who are also gay, lesbian, or bisexual. Despite this, little research has been done on the vulnerable subgroup of sexual-minority immigrants, which makes Omoto’s new project both unique and important.
The most common approach in research and public-health tracking is to focus only on a single identity or group membership in examining health disparities. For example, a Mexican immigrant who is also lesbian may be classified only as an immigrant or sexual-minority member, even though she is likely to be impacted by stigma and prejudice associated with both group memberships and their unique combination.
Omoto and his students are working from psychological models that emphasize the unique stressors faced by members of minority groups relative to the general population. Based on these models, members of multiple minority groups, such as sexual-minority immigrants, are expected to face more and more varied stressors. The cumulative effect is compromised health. “What researchers traditionally focus on are ethnic or gender differences, rather than a combination of identities and memberships,” said Omoto. “We are interested in better understanding the interactions of different identities, both in terms of unique and special sources of stress but also opportunities for effective coping and social support. With better understanding, ideally, effective actions can be taken to reduce discrepancies.”
His new research project consists of two complementary studies. The first uses a large public-health data set representative of California residents to quantify health-care utilization, such as frequency of doctor or emergencyroom visits, among sexual-minority immigrants.
The second is based on interviews conducted by Omoto and his team of SBOS student researchers. These interviews will elicit a better understanding of a sexual-minority immigrant’s multiple identities, the benefits and risks of their connections to different communities, and the perceived conflicts between their cultural practices and the prevailing mores of society. “We want to learn about these individuals’ challenges, their barriers, and their coping mechanisms when it comes to health-care use and perceived stigmatization and discrimination. We want to understand when and how people feel stigmatized and what they do about it; and why people may not go to a hospital or seek other health care when they’re sick,” said Omoto.
The interviews for the project began this spring, with invaluable assistance from a team of SBOS students. Ivy Carrete, a PhD student in SBOS, trained the interviewers and is helping oversee them. SBOS PhD student Sarah Boyle has also been instrumental in recruiting participants, and will be helping to coordinate work on the public-health data set.
Though this research is still in its early stages, it has both the potential for expansion and a clear value to policy makers and training programs. “I think this research will contribute substantive findings that have implications for psychological theories, but also that it has the potential to make contributions to public health policies and practices especially in Southern California,” Omoto said. “And growing out of what we learn, we hope to transition into a bigger project where we further fine-tune our knowledge and the models we are developing.”