NYU Silver PhD Student Jackie Cosse has been awarded the American Public Health Association (APHA) LGBTQ Health Caucus’ Walter J. Lear Outstanding Student Research Award for her APHA Annual Meeting submission exploring the varying ways that health is conceptualized by a diverse sample of LGBTQ+ adults.
The qualitative study found that LGBTQ+ people not only think of health within the traditional Western model of illness, treatment, and medication, but also as connected to the mind, body, and spirit; as survival at the individual and community levels; and as access in terms of affirming care, information, insurance, and community support. Titled “Self-determined concepts of health: An intersectional study of personal, social, and political subjectivities among a diverse sample of LGBTQ adults,” the abstract was co-authored by Dr. Kimberly Hudson of Fordham University Graduate School of Social Service and Dr. Meghan Romanelli, PhD ’19, of the University of Washington School of Social Work
“Pulling out the threads of how diverse LGBTQ+ people think about health revealed insights that have implications for their access to care and for how we understand health more broadly in the social world,” said Jackie. She noted that healthcare researchers, practitioners and policy makers often make decisions without asking those affected what matters to them. “Our findings indicate that programming and health policy that centers the biomedical model may be incongruent with the needs and perceptions of LGBTQ+ communities.”
Centering Those Typically Marginalized
The study was based on in-depth interviews with 40 LGBTQ+ adults in New York City, over 90% of whom were Black, Indigenous, People of Color, predominantly Black/African American. Just over half of the sample self-identified as poor. About half were bisexual and nearly half expressed having a disability. A quarter were transgender or gender expansive, some of whom identified as heterosexual. “It’s important to remember that ‘LGBTQ’ is not just about sexuality,” said Jackie. “It’s about gender as well. And that’s something that we were mindful of and intentional about.”
Jackie, who identifies as a person navigating disability and chronic illness, a queer person of color, and a child of Latine immigrants, said “I’m part of the laundry list of communities that usually get stuck in research papers’ limitations sections as not being sufficiently represented in the study sample. This study was an amazing opportunity to put those people front and center.”
An Intersectional Lens
Jackie explained that the grounding theoretical framework for the study was intersectionality, taking into account how participants’ multiple marginalized identities shaped their definitions and concepts of health. “Given the many compounded experiences of oppression among our diverse sample, it was critical to consider the multiplicative effects of their coexisting identities,” she said, citing Dr. Ange-Marie Hancock’s article When Multiplication Doesn’t Equal Quick Addition: Examining Intersectionality as a Research Paradigm. “If we failed to do so, we wouldn’t get the whole picture.”
Jackie expressed appreciation for the support she has received from Silver’s PhD Program faculty, and in particular, from the other three students in her PhD cohort. “Community is so important and we’ve been together since day one,” she said. “As peer researchers, they have been my strongest supports here at Silver.”