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University of Alabama at Birmingham School of Public Health appointed Sarah MacCarthy, Sc.D., as the first holder of the Magic City LGBTQ Health Studies Endowed Professorship. This community-funded professorship was established to create a high-visibility platform to champion research, education and service in the field of LGBTQ health. The Magic City professorship is the first of its kind in the country — particularly meaningful in the Deep South, where LGBTQ individuals have especially limited access to quality services, despite being vulnerable to a range of health problems.On Dec. 1, 2021, the
Why are LGBTQ communities especially vulnerable?
Over the life course, LGBTQ communities experience multiple, reinforcing layers of marginalization that affect how they live, work and play. For example, LGBTQ adolescents, who may be isolated from their families because of their sexual orientation or gender identity, have higher rates of homelessness or unstable housing. This often contributes to poor school attendance, making it difficult to complete an education. A lack of education makes it difficult to find a job. Once on the job, safeguards against discrimination for sexual orientation and identity are limited in Alabama.
These experiences contribute to daily stressors that, over time, “get under our skin” and affect our health. Even an LGTBQ individual who has insurance and can afford to get care may have a negative experience with a provider, triggering reluctance to have regular doctor appointments and screenings. Older LGBTQ individuals face additional barriers in allowing their partners and “families of choice” to be included in difficult, end-of-life decisions. Compounded over the life course, these experiences with stigma and discrimination are associated with higher rates of both chronic and infectious diseases.
In an effort to serve as a leader in addressing LGBTQ inequities, the UAB School of Public Health created the Magic City LGBTQ Health Studies Endowed Professorship in early 2017. Nearly 10 months after moving from Los Angeles to Birmingham, MacCarthy is excited to celebrate her first Pride Month in the Deep South. Here, she reflects on the ongoing need for health equity for LGBTQ communities, why addressing LGBTQ health is good for everyone and her goals for the future.
New position, new goals
The Magic City LGBTQ Health Studies Endowed Professorship has three core components: research, teaching and training, and community partnerships. These domains are distinct yet deeply interconnected.
Community-based participatory research requires building trusting relationships with community organizations; collaborating to identify their most pressing concerns; developing research tools to document what is happening and determine how best to intervene; collecting and analyzing data; then disseminating results collaboratively through multiple channels, targeted to the specific populations they are intended to reach.
MacCarthy has been initiating new research collaborations with organizations across the state, while also spotlighting LGBTQ-related research and activities already happening at UAB. She actively pursues grant opportunities that would enhance the relationships she is building with local organizations, thus crafting a research portfolio focused on addressing the most pressing health inequities voiced by LGBTQ Alabamians themselves.
MacCarthy’s teaching and training activities include developing LGBTQ curriculum at all levels of education that integrates knowledge (e.g., LGBTQ health inequities) and skills (e.g., how to advocate for LGBTQ communities). An overarching goal is to establish that training at UAB and build capacity to address LGBTQ health that will be far more advanced, and cutting-edge, than training anywhere else.
Over the last seven months, MacCarthy has been actively building relationships with LGBTQ-focused communities, not just within UAB, but in Birmingham, throughout the state and across the region. She views fostering these relationships as a way to highlight locally and nationally the degree to which UAB is already engaged with LGBTQ research and practice while also extending a network of support to expand and bolster the LGTBQ-related work that already exists.
For example, she is collaborating with a UAB student who is working with the Magic City Acceptance Academy to field a survey assessing a range of health outcomes. The plan is to draw from an existing CDC survey to explore differences over time between the charter school and national estimates to assess whether and how providing an LGBTQ-affirming school environment can improve health. In the Southwest Alabama Inclusion Project, multiple groups are organizing to conduct a needs assessment of LGBTQ adults and youth in Mobile, Baldwin and surrounding counties. MacCarthy is working with them to balance methods and their budget to develop an approach that engages all LGBTQ individuals in the region.
MacCarthy notes that, in her experience as a researcher and advocate addressing the unique needs of LGBTQ communities both locally and globally, she has learned that time and trust are essential for successful community-based participatory research. Thus, she works to build these essential relationships through listening, recognizing challenges and opportunities, and integrating research and practice to address needs identified by organizations that have long been engaged in this work themselves. And she is using her research skills to connect organizations that serve marginalized groups to financial resources to help improve the work they are already doing.
“We are extremely fortunate to have Dr. MacCarthy serve in the Magic City LGBTQ Health Studies Endowed Professorship,” said Paul Erwin, M.D., DrPH, dean of the School of Public Health at UAB. “It’s one thing to have the endowed professorship — a remarkable accomplishment indeed — but another thing altogether to have someone of Dr. MacCarthy’s stature here leading this work. We see this as a watershed moment for the health and well-being of LGBTQ communities in Alabama.”
Pride Month and the future
In 1979, nine years after the first Pride marches were held in New York, Chicago, Los Angeles and San Francisco, the first Pride celebration, known as “Day in the Park,” was held in Birmingham. According to the University of Alabama Libraries’ Special Collections, this gathering later grew to include a Pride parade and became a week of events known as Central Alabama Pride. When asked about anticipation for her first Pride Month in the Deep South, MacCarthy said she is most excited to connect with community partners and to see the ways in which people celebrate here, where individuals can dress and express themselves as they want.
“I’m learning that, here in Alabama, to be out as someone in the LGBTQ community, or to be an advocate for this community, you have had to fight so hard for it,” MacCarthy continued, “and there is incredible grit to that. I’m excited to celebrate the LGBTQ community — yes, for the month of June, but also beyond.”
Looking to the future, MacCarthy says she views herself as a facilitator, building on years of work that advocates, allies and researchers have already completed that led to the creation of the Magic City LGBTQ Health Studies Endowed Professorship and the founding of LGBTQ organizations statewide. As she puts it, she is riding on the coattails of decades of organizing that are contributing to a unique moment, enabling her to highlight both the valued contributions and the rich promise of LGBTQ-related efforts.