Health care issues among lesbian, gay, bisexual, transgender and intersex (LGBTI) populations in the United States: Introduction

This supplemental issue of the Journal of Homosexuality presents research that explores a variety of health care issues encountered by lesbian, gay, bisexual, transgender and intersex (LGBTI) population groups in the United States over the 10-year period from 1993 to 2002. Topics include access to health care, utilization of care, training of medical and mental health providers, and the appropriate preparation of clinical offices and waiting areas. Authors used a variety of community-based public health research methods, including participant and provider surveys and retrospective chart reviews of patients, to develop this body of research, providing a recent-historical perspective on the complex health care and health-related needs of sexual and gender minorities. Particularly for transgender and intersex populations, the state of research describing their health care needs is in its infancy, and much remains to be done to design effective medical and mental health programs and interventions.     

Reexamining the moving to opportunity study and its contribution to changing the distribution of poverty and ethnic concentration

For the past decade and a half a concerted effort has been undertaken to determine whether policy interventions in residential location can solve the problems of inner-city poverty and racial concentration. Studies based on data from the Gautreaux litigation and the U.S. Department of Housing and Urban Development (HUD)-sponsored Moving to Opportunity (MTO) program have provided an overall optimistic interpretation of the possibilities of improving inner-city lives via mobility vouchers and counseling. A reanalysis of the data from the MTO program, focusing specifically on African American households, suggests greater caution in the interpretation of the findings from either Gautreaux or the MTO program. No statistically significant difference exists between the percentage of poor or the percentage of African Americans in the current neighborhoods between MTO and Section 8 experimental groups. In some cases, there is no statistically significant difference between those who move with a voucher and those who move without any assistance at all. Although there is some evidence that MTO programs have brought specific gains for individual families, claims for the MTO program as a whole need to be treated with a great deal more caution than they have been to date.     

The potential impact of discrimination fears of older gays, lesbians, bisexuals and transgender individuals living in small- to moderate-sized cities on long-term health care

As an exploration of the potential impact of fears of discrimination against GLBTs in long-term health care settings, this study compared perceptions of GLBT persons and heterosexuals. A total of 132 GLBT persons and 187 heterosexuals living in Eastern Washington completed a survey that contained demographic questions and perceptions of discrimination in long-term care settings. Most respondents suspected that staff and residents of care facilities discriminate against GLBTs. GLBT respondents who believed that residents of care facilities are victims of discrimination were more likely to believe that they would have to hide their sexual orientation if admitted to a care facility. GLBT respondents were more likely than heterosexual respondents to believe that GLBTs do not have equal access to health care and social services, that GLBTs residents of care facilities are victims of discrimination, that GLBT sensitivity training programs would benefit staff and residents of care facilities, and that GLBT retirement facilities would be a positive development for older GLBTs. This study is offered as a preliminary investigation of concerns about GLBT discrimination in health care settings, how concerns are expressed, and the implications of those concerns for health care needs.     

An intuitive risk factors search algorithm: usage of the Bayesian network technique in personalized medicine

The article focuses on the application of the Bayesian networks (BN) technique to problems of personalized medicine. The simple (intuitive) algorithm of BN optimization with respect to the number of nodes using naive network topology is developed. This algorithm allows to increase the BN prediction quality and to identify the most important variables of the network. The parallel program implementing the algorithm has demonstrated good scalability with an increase in the computational cores number, and it can be applied to the large patients database containing thousands of variables. This program is applied for the prediction for the unfavorable outcome of coronary artery disease (CAD) for patients who survived the acute coronary syndrome (ACS). As a result, the quality of the predictions of the investigated networks was significantly improved and the most important risk factors were detected. The significance of the tumor necrosis factor-alpha gene polymorphism for the prediction of the unfavorable outcome of CAD for patients survived after ACS was revealed for the first time.     

Cultural Endorsement of Broad Leadership Prototypes and Wealth as Predictors of Corruption

Corruption is a social ill that involves public officials’ misuse of entrusted power, which is a function of sociocultural factors. Rarely, however, do researchers view corruption as a leadership-related problem. In the current research, we conceptualize corruption as a leadership-related problem, and propose three broad leadership prototypes based on social value orientation theory and research. We seek to examine (1) how cultural endorsement of self-serving, prosocial, and individualistic leadership prototypes is related to corruption at the societal level and (2) how wealth moderates the relationship between cultural endorsement of self-serving leadership and corruption. Using archival data of 53 societies, we found that cultural endorsement of self-serving leadership was positively related to corruption, strengthened by wealth. Cultural endorsement of prosocial leadership and individualistic leadership, however, was not significantly related to corruption, and wealth did not moderate either of the relationships. The implications of these findings for theory and future research are discussed.     

Immigrant Gateways and Hispanic Migration to New Destinations1

Our understanding of the underlying demographic components of population change in new Hispanic destinations is limited. In this paper, we (1) compare Hispanic migration patterns in traditional settlement areas with new growth in emerging Hispanic destinations; (2) examine the role of immigration vis‐à‐vis domestic migration in spurring Hispanic population redistribution; and (3) document patterns of migrant selectivity, distinguishing between in‐migrants and non‐migrant Hispanics at both the origin and destination. We use several recent datasets, including the 1990 and 2000 Public Use Microdata Samples (which include new regional geocodes), and the 2005 and 2006 files of the American Community Survey. Our results document the widespread dispersion of the Hispanic population over the 1990–2006 period from established Hispanic gateways into new Hispanic areas and other parts of the country. Nearly one‐half of Hispanic net migration in new destinations comes from domestic gains. In contrast, both established and other Hispanic areas depend entirely on immigration, with each losing domestic migrants to high growth areas. Migrant flows also are highly differentiated by education, citizenship, and nativity. To fully understand the spatial diffusion of Hispanics requires a new appreciation of the complex interplay among immigration, internal domestic migration, and fertility.     

A Bayesian Approach for Analyzing Results of Vehicle Collision Tests

Certain motor vehicle safety standards stipulate a collision test speed and a set of performance criteria that vehicles must satisfy during or after the collision test. For example, Federal Motor Vehicle Safety Standard 301 requires a 30 mile per hour (mph) barrier collision and specifies a certain maximum allowable limit on the total spillage of fuel. Vehicle designs are required to meet this standard; however, when collision tests are conducted at speeds higher than the standard, vehicles do not always satisfy the performance criteria. This paper develops a mathematical model for estimating the probability of meeting the standard by using a Bayesian framework to incorporate engineering judgment with collision test results. The model is based on the idea that there are random features to a vehicle's ability to meet performance standards in a collision, especially at such elevated speeds. Example calculations are included to illustrate the estimation of the probability of meeting the standard and to compare it with a maximum likelihood approach.