New article published by HERLab collaborator!

Dr. Aaron Breslow recently published a paper on housing insecurity and healthcare costs for transgender patients in a safety-net system. Read more here: https://academic.oup.com/healthaffairsscholar/advance-article/doi/10.1093/haschl/qxaf226/8371030

Abstract

Introduction

Routine screening for health-related social needs (HRSNs) is inconsistent, creating disparities in who gets identified and supported. Transgender patients, already facing structural stigma, may be especially affected.

Methods

We analyzed electronic health records from a large urban safety-net system (2018–2023). We identified 2,639 transgender patients with at least one outpatient visit and created an approximately 11:1 comparison cohort of 23,944 cisgender patients. Overall, 7.5% (n=1,997) completed a Social Needs Questionnaire (SNQ), including 1,840 cisgender and 157 transgender patients. We compared screening rates using chi-square tests and assessed adjusted odds for HRSN with logistic regression.

Results

Transgender patients were screened less often than cisgender patients (5.9% vs. 7.7%, p=0.001). Among those screened, they had more than twice the odds of housing instability, poor-quality housing, and healthcare costs. Odds for interpersonal violence were three times higher. Findings were consistent in sensitivity analyses adjusting for age, insurance and neighborhood.

Conclusion

Transgender patients were underscreened yet faced greater HRSNs. Standardized screening and expanded supports are critical to support transgender communities.