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Lookup NU author(s): Dr Donna Wakefield
This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).
Copyright: © 2024 Rosa et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. CONTEXT: LGBTQIA+ people worldwide experience discrimination, violence, and stigma that lead to poor health outcomes. Policy plays a crucial role in ensuring health equity and safety for LGBTQIA+ communities. Given Lancet Commissions' substantial impact on health policy across domains, we aimed to determine how LGBTQIA+ communities and their care needs are incorporated throughout Lancet Commission reports and recommendations. METHODS: Using critical discourse analysis, we analyzed 102 Commissions for inclusion of and reference to LGBTQIA+ communities using 36 key terms. Three levels of analysis were conducted: 1) micro-level (overview of terminology use); 2) meso-level (visibility and placement of LGBTQIA+ references); and 3) macro-level (outlining characterizations and framing of references with consideration of broader social discourses). FINDINGS: 36 of 102 (35%) Commissions referenced LGBTQIA+ communities with 801 mentions in total. There were minimal (9/36) references made in the "Executive Summary," "Recommendations," and/or "Key Messages" sections of reports. LGBTQIA+ communities were most frequently discussed in reports related to HIV/AIDS and sexual and reproductive health. Few Commissions related to public health, or chronic conditions (9/60) referenced LGBTQIA+ communities. Some reports made non-specific or unexplained references; many discussed the LGBTQIA+ population without specific reference to sub-groups. LGBTQIA+ communities were often listed alongside other marginalized groups without rationale or a description of shared needs or experiences. We identified framings (legal, vulnerability, risk) and characterizations (as victims, as blameworthy, as a problem) of LGBTQIA+ communities that contribute to problematizing discourse. CONCLUSIONS: LGBTQIA+ people were rarely included in the Commissions, resulting in an inadvertent marginalization of their health needs. Policy initiatives must consider LGBTQIA+ groups from a strengths-based rather than problematizing perspective, integrating evidence-based approaches alongside community-based stakeholder engagement to mitigate inequities and promote inclusive care and policymaking.
Author(s): Rosa WE, Weiss Goitiandia S, Braybrook D, Metheny N, Roberts KE, McDarby M, Behrens M, Berkman C, Stein GL, Adedimeji A, Wakefield D, Harding R, Spence D, Bristowe K
Publication type: Article
Publication status: Published
Journal: PLoS ONE
Year: 2024
Volume: 19
Issue: 10
Online publication date: 04/10/2024
Acceptance date: 18/09/2024
Date deposited: 21/10/2024
ISSN (electronic): 1932-6203
Publisher: Public Library of Science
URL: https://doi.org/10.1371/journal.pone.0311506
DOI: 10.1371/journal.pone.0311506
Data Access Statement: The current study uses third-party data available free of charge from The Lancet family of journals. Two URLs can be used to access all 102 Lancet Commission reports (which served as the dataset) that were analyzed for the current study: https://www.thelancet.com/global-health/commissions and https://www.thelancet.com/clinical/commissions. Interested researchers will be able to replicate our findings as described in our methods by accessing commission reports at the provided URLs. These authors had no special access privileges beyond basic internet access that would restrict others from accessing the data used from this third party source.
PubMed id: 39365801
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