Sexual and gender minorities experience disparities in mental and physical health often attributed to structural discrimination through policies that do not promote equal rights and interpersonal–intrapersonal processes. Social issues research on stigma and intergroup relations can explicate the intervening processes that explain health. In this introduction to the special issue entitled Translating Stigma and Intergroup Relations Research to Explain and Reduce Sexual and Gender Minority Health Disparities, we call social issues researchers to focus their work on sexual and gender minority stigma and intergroup relations processes in order to understand and ultimately reduce health disparities.

Sexual and gender minorities experience disparities in mental and physical health often attributed to structural discrimination through policies that do not promote equal rights and interpersonal–intrapersonal processes. Social issues research on stigma and intergroup relations can explicate the intervening processes that explain health. In this introduction to the special issue entitled Translating Stigma and Intergroup Relations Research to Explain and Reduce Sexual and Gender Minority Health Disparities, we call social issues researchers to focus their work on sexual and gender minority stigma and intergroup relations processes in order to understand and ultimately reduce health disparities.

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Purpose of review Transgender individuals experience unique health disparities but are the subject of little focused health research. This manuscript reviews current literature on transgender medical and mental health outcomes and proposes research priorities to address knowledge gaps. Recent findings Published research in transgender healthcare consists primarily of case reports, retrospective and crosssectional studies, involving largely European settings. Challenges to US-based transgender health research include a diverse population where no single center has sufficient patient base to conduct clinical research with statistical rigor. Treatment regimens are heterogeneous and warrant study for best practices. Current research suggests increased mortality and depression in transgender individuals not receiving optimal care, and possibly a modest increase in cardiovascular risk related to hormone therapy. Current evidence does not support concerns for hormone-related malignancy risk. Summary The priorities for transgender medical outcomes research should be to determine health disparities and comorbid health conditions over the life span, along with the effects of mental health, medical, and surgical interventions on morbidity and mortality. Specific outcomes of interest based on frequency in the literature, potential severity of outcome, and patient-centered interest, include affective disorders, cardiovascular disease, malignancies, fertility, and time dose-related responses of specific interventions.

Purpose: To determine the difference of Body Mass Index (BMI), the prevalence of overweight and obesity, and their predictors among residents of different urbanization levels in China. Methods: A stratified, multistage, random cluster sampling method was used to select a representative sample aged 18-60 years in metropolitan, prefecture, and rural areas in 4 provinces and Beijing City in China. A total of 6,159 residents were interviewed. Multiple logistic regression was used to evaluate the association between urbanization levels and the prevalence of overweight/obesity adjusted for sociodemographic characteristics and lifestyle factors. Findings: The prevalence of overweight and obesity was 21.0% and 2.5%, respectively. Compared to metropolitan residents (BMI = 22.76 ± 3.20 kg/m2), rural and prefecture residents had a higher BMI, 23.17 ± 3.49 kg/m2 (P <001) and 23.06 ± 3.31 kg/m2 (P =.004), respectively. Multiple logistic regression showed that, compared to the rural residents, those in prefecture and metropolitan areas were less likely to be overweight and obese (OR = 0.80 [95% CI: 0.68-0.94] and OR = 0.68 [95% CI: 0.57-0.80], respectively). The prevalence of overweight/obesity was higher in males (OR = 1.68 [95% CI: 1.43-1.97]) and patients with noncommunicable chronic diseases (NCD; OR = 2.50 [95% CI: 2.16-2.89]). Less frequency of physical activity was associated with a higher prevalence of overweight/obesity (OR: 0.85, [95% CI: 0.74, 0.97]). Conclusions: The rural population had an increased prevalence of overweight/obesity compared to both the prefecture and metropolitan populations. Male gender, older age, and NCD were positively associated with the prevalence of overweight/obesity. Policies are urgently needed to combat the overweight and obesity challenge in rural China.

Purpose: The purposes of this study were to translate current knowledge regarding cardiovascular risk factors, screening, and prevention to a disparate population of women and to ascertain the cardiovascular health status and risk factors in a sample of minority and underserved Appalachian women.Data sources: Demographic data were collected from a voluntary sample of women from a disparate population living in Appalachian Tennessee. A coronary risk profile recorded family health history, personal health history, and lifestyle habits affecting risk for cardiovascular disease. Physiologic measurements included body mass index, blood pressure, fasting glucose, cholesterol levels, ankle brachial index, and carotid artery stenosis.Conclusions: Women in Appalachia Tennessee from a disparate population have high risks for heart disease and stroke. This is a critical time to address any modifiable risk factors and aggressively treat underlying cardiovascular diseases such as hypertension and hypercholesterolemia.Implications for practice: Nurse practitioners (NPs) often provide primary care to women who may not be aware of their cardiovascular risks or actual disease. NPs can ensure that their practice incorporates primary and secondary cardiovascular prevention through screening, individual health education, and aggressive evidence-based treatment plans for women.

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Distributive justice is a bioethical principle concerned with the fair distribution of resources and benefits in society. In the context of orthopaedic surgery management, distributive justice is an important consideration in ensuring that all patients have equal access to the resources and care in the treatment of their injuries. The literature well documents demographic and socioeconomic factors in the allocation of elective orthopaedic surgeries, but unfortunately a similar analysis is lacking when it comes to orthopaedic trauma surgeries. This study examines fundamental philosophical perspectives that underly healthcare delivery specifically pertaining to orthopaedic trauma. In doing so, the influence of race, socioeconomic status, insurance status and other factors on access to care and allocation of resources are described. Findings for various orthopaedic trauma surgery cases suggest decreased allotment to those of black race, lower socioeconomic, educational, and non-insurance status. Although the reason is multifactorial and complex, I suggest a shift in focus to the equity and fair distribution of surgical resources by considering the role of population health, understanding multidisciplinary interactions, improving research methodology, and community partnership. / Urban Bioethics

Whereas disability is a significant risk factor and contributor to various chronic conditions that lead to decline in the quality of life and to early death among older US Armed Forces veterans (> 64 years), little research exists focused on more granular levels of analysis to determine community level risk factors (such as rurality) associated with disability prevalence. A quantitative and cross-sectional design used 2010 – 2014 and 2015 – 2019 data sets from the United States Census Bureau American Community Survey. Results obtained have shown that disability is most prevalent among the older (>64) veteran population, overtime, rates are getting worse, rural areas are most affected, and primary care physicians are needed in areas where rates of disability is high. The findings help to improve our understanding of disability prevalence among older veterans and non-veterans and provide a foundation for the development and implementation of appropriate geographically targeted policy and program interventions to support the development and enhancement of services made at the federal, state, and local/community levels. Through effective interventions, the risk of having increased rates of poor health status, poor quality of life, and risk of death can be reduced substantially, particularly among older veterans in rural areas of the United States.

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