While there is local information about chronic disease and social determinants of health (SDoH) across gender and racial categories in Miami-Dade County and the City of Miami, there is little to no data in regard to Miami’s Lesbian, Gay, Bisexual, Transgender, Queer, Intersexual, Asexual + (LGBTQIA+) community. Miami-Dade County’s 2020 Community Health Assessment Report is an in-depth source for chronic disease, SDoH and health disparities analysis, but only mentions the local LGBTQIA+ population within the context of HIV/AIDS. This lack of data makes it challenging, if not impossible for local government and organizations to create LGBTQIA+ inclusive policies that address social determinants of health and offer chronic disease reduction solutions within this community.
The City of Miami (applicant/backbone agency) via its Human Services Department and Urban Health Partnerships (implementing partner agency) propose to develop a Miami LGBTQIA+ SDoH Accelerator Plan (SDoH Plan)project that will reduce this gap, and provide a framework for policy, systems, and environmental (PSE) change within City of Miami government and within organizations of the multi-sectoral partnerships engaged for this project, to reduce this population’s chronic disease burden.
The SDoH Plan will focus on two primary SDoHs: Built Environment and Social Connectedness. The built environment encompasses many aspects of our communities including streets, public spaces, parks, public transportation, and public community and cultural services buildings. How these are designed, utilized, promoted, and maintained has a significant impact on residents’ sense of belonging and safety and whether these spaces are accessible for everyone. This is particularly true for the LGBTQIA+ population for whom fear is a common emotion in public spaces due to experiences of discrimination, harassment, and violence. In this way, the built environment is also intricately connected to social connectedness. Avoiding public spaces and public transportation due to fear or lack of accessibility can lead to social isolation, lack of access to critical health and social services, less opportunity to engage in physical activity, and the reduced ability to build community and social support.
The SDoH Plan will provide infrastructure, support and training that is needed to focus on the health of our communities and provide access to an entire ecosystem that supports Miami’s LGBTQIA+ population. This project will be using a Community Liaison (CL) Framework to engage community members throughout the process. As a social justice strategy, CLs are community members who are paid for their time for personal and professional development. If awarded, CDC funding will be allocated towards salaries and wages UHP’ multidisciplinary team of experts who will work with the City of Miami to develop the SDoH Plan, hiring of four Community Liaisons, Community Liaison support, travel, costs to support 3-6 small non-profit/grassroots organizations’ participation in the project to reduce barriers to participation, supplies, and marketing.
The evaluation of this program will have three areas of focus:
1. Outcomes & Impact: Is the SDoH Plan completed? Were PSE recommendations submitted to the City of Miami LGBTQIA+ Advisory Board and accepted as strategies to present to the Miami Board of Commissioners and/or external organizations?
2. Community Engagement: How is the community integrated into the work of the committee? How are LGBTQIA+ residents and allies from the City of Miami engaged in the development of the SDoH Plan?
3. Collaborative Capacity: Is there an increase in capacity for committee members and for Community Liaisons (CLs) around their knowledge and skills in developing PSE strategies in support of the LGBTQIA+ population? Is there capacity to create and/or strengthen new/existing collaborations that will extend the outcomes and impacts beyond this project?