Office of Health Equity

Visualizations and Dashboards

The Healthcare Equality Index (HEI) recognizes healthcare facilities that demonstrate equitable treatment and inclusion of Lesbian, Gay, Bisexual, Transgender, and Queer (LGBTQ+) patients, visitors, and employees in the following areas:

• Non-discrimination and staff training
• Patient services and support
• Employee benefits and policies
• Patient and community engagement
• Responsible citizenship

Healthcare facilities that receive a score of 100 on the benchmarking tool are designated as a "Leader in LGBTQ+ Healthcare Equality." Facilities with a score of 80 to 95 are designated as a "Top Performer."

For the 2022 HEI, 115 VA medical centers participated and 77 were designated as a Top Performer in LGBTQ+ Healthcare Equality. Read the full HEI Report.

Health Disparities Evidence-based Synthesis Reviews

• Prevalence of and Interventions to Reduce Health Disparities in Vulnerable Veteran Populations: A Map of the Evidence

VA Health Services Research & Development Publication Briefs

The VA Health Services Research and Development Service (HSR&D) pursues research that underscores all aspects of VA healthcare: patient care, care delivery, health outcomes, cost, and quality.

• LGBT Women Veterans Report Missing Needed Health Care Due to Concerns about Interacting with Other Veterans
  This study sought to examine LGBT women Veterans’ experiences within the VA healthcare system, and whether their experiences impact use of VA care. Findings showed that the majority of women Veterans reported feeling welcome at their VA. However, fewer LGBT women reported feeling welcome and safe at VA compared with non-LGBT women Veterans. After controlling for demographics, health status, and positive trauma screens, LGBT identity was predictive of women Veterans experiencing harassment from male Veterans at VA in the past 12 months, as well as feeling unwelcome or unsafe at VA. LGBT women Veterans were about 3 times more likely than non-LGBT women Veterans to attribute missing needed care in the previous 12 months to concerns about interacting with other Veterans. Study participant descriptions of harassment indicated that male Veterans’ comments and actions were distressing and influenced LGBT women Veteran’s healthcare accessing behavior. Despite VA’s ongoing efforts to educate employees and change the culture toward a more inclusive environment, more targeted work addressing the needs of LGBT women Veterans may be needed. (July 1, 2018)
• Medical Care Supplement Features Articles by VA Researchers on Improving the Quality and Equity of Health and Healthcare
  In 2016, HSR&D’s Center for Health Equity Research and Promotion (CHERP) and the Health Equity and Rural Outreach Innovation Center (HEROIC) hosted a state-of-the-science conference. This field-based meeting to “Engage Diverse Stakeholders and Operational Partners in Advancing Health Equity in the VA Healthcare System” brought together health equity investigators, representatives of vulnerable Veteran populations, and operational leaders to identify strategies to advance the implementation of evidence-based interventions to improve the quality and equity of health and healthcare. The conference focused on three specific vulnerable Veteran populations: racial and ethnic minorities, homeless Veterans, and Veterans from the LGBT community. This supplement features several articles that emanated from this meeting. (September 1, 2017)
• Issues for Sexual and Gender Minority Veterans Receiving VA Healthcare
  This article summarizes emergent research findings regarding sexual and gender minority (SGM) Veterans, and the first initiatives that have been implemented by VA to promote quality care. Being a member of both the Veteran and SGM communities may contribute to a higher level of risk for poor health than membership in just one of these populations. A recent VA study indicated that only 33% of SGM Veterans reported open communication about their sexual orientation with VA healthcare providers, while 25% reported avoiding certain VA services because of concerns about stigma. In another study of 202 VA providers and 58 SGM Veterans, less than one-third of all participants viewed VA as welcoming to SGM Veterans. To address these issues, VA has created new programs, such as the Office of Health Equity LGBT Workgroup, which works to address inequities in the healthcare environment for SGM Veterans. VA also created two new part-time LGBT Program Coordinator positions, through the Office of Patient Care Services, who advise leadership on policy and practice issues related to SGM Veterans. In June 2011, VA released the first national policy to describe the services that are available to transgender Veterans. Other recent VA policy changes include “sexual orientation” and “gender identity and expression” now being included in VA non-discrimination and caregiver policies. Educational resources and trainings have been developed for VA staff about culturally appropriate care for SGM Veterans. Further research is needed to better understand the SGM population, their healthcare needs, and how these needs vary in relation to gender, race/ethnicity, and other factors, as well as in evaluation of provider training and policies. (July 1, 2013)

PubMed Search Results

VA National Partners

The Office of Health Equity is committed to working closely with our VA colleagues to ensure that Veterans receive appropriate individualized health care in a way that eliminates disparate health outcomes and assures health equity. OHE's VA Partners include:

• VHA LGBTQ+ Health Program
• LGBTQ+ Veteran Care Coordinator Locator Tool
• VA Office Resolution Management, Diversity & Inclusion
• VHA Office of Health Equity - QUERI National Partnered Evaluation Initiative

External Partners

The Office of Health Equity is committed to working closely with other government agencies and non-governmental organizations to ensure that Veterans receive appropriate individualized health care in a way that eliminates disparate health outcomes and assures health equity. OHE's External Partners include:

• Human Rights Campaign (HRC) - Healthcare Equality Index

VHA TRAIN Portal for CME Transgender Trainings

• An Introduction to Transgender Veteran Health Care
• Transgender Health: Prescribing Cross-Sex Hormones
• Transgender Mental Health Services Program

Cultural Competence Training

• Veteran Health Administration HEI Participation and Resources
• LGBTQ+ Veteran Trainings
• VA Office of Diversity and Inclusion Training Resources
• US Department of Health and Human Services Think Cultural Health Education Programs
• Health Resources and Services Administration Culture, Language, and Health Literacy Resources

VHA Providers Explore Unconscious Bias

VHA providers share their stories of creating awareness of unconscious bias within their clinical practice and how bias impacts us all. A bias is a tendency. Most biases are natural. However, biases can cause problems when we are not aware of them and we apply them inappropriately to our everyday choices, which can lead to discriminatory practices and result in poorer health outcomes and experiences for patients. The brief videos were created by the VA Office of Health Equity and Employee Education System in an effort to ensure all Veterans receive high quality and equitable healthcare. The videos were recorded April 2013.

• Developing Clinical Awareness (3:44)
• Impact on Clinical Practice (3:15)
• Importance of Knowing Your Own Bias (3:37)
• Health Equity Stories to Share (6:15)

Harvard Implicit Associations Test

The Implicit Association Test measures attitudes and beliefs that people may be unwilling or unable to report. This tool may be especially interesting if it shows that you have an implicit attitude that you did not know about.

Visualizations and Dashboards

The Healthcare Equality Index (HEI) recognizes healthcare facilities that demonstrate equitable treatment and inclusion of Lesbian, Gay, Bisexual, Transgender, and Queer (LGBTQ+) patients, visitors, and employees in the following areas:

• Non-discrimination and staff training
• Patient services and support
• Employee benefits and policies
• Patient and community engagement
• Responsible citizenship

Healthcare facilities that receive a score of 100 on the benchmarking tool are designated as a "Leader in LGBTQ+ Healthcare Equality." Facilities with a score of 80 to 95 are designated as a "Top Performer."

115 VA medical centers participated in the 2022 HEI and 77 were designated as a Top Performer in LGBTQ+ Healthcare Equality.

Health Disparities Evidence-based Synthesis Reviews

• Prevalence of and Interventions to Reduce Health Disparities in Vulnerable Veteran Populations: A Map of the Evidence

VA Health Services Research & Development Publication Briefs

The VA Health Services Research and Development Service (HSR&D) pursues research that underscores all aspects of VA healthcare: patient care, care delivery, health outcomes, cost, and quality.

• LGBT Women Veterans Report Missing Needed Health Care Due to Concerns about Interacting with Other Veterans
  This study sought to examine LGBT women Veterans’ experiences within the VA healthcare system, and whether their experiences impact use of VA care. Findings showed that the majority of women Veterans reported feeling welcome at their VA. However, fewer LGBT women reported feeling welcome and safe at VA compared with non-LGBT women Veterans. After controlling for demographics, health status, and positive trauma screens, LGBT identity was predictive of women Veterans experiencing harassment from male Veterans at VA in the past 12 months, as well as feeling unwelcome or unsafe at VA. LGBT women Veterans were about 3 times more likely than non-LGBT women Veterans to attribute missing needed care in the previous 12 months to concerns about interacting with other Veterans. Study participant descriptions of harassment indicated that male Veterans’ comments and actions were distressing and influenced LGBT women Veteran’s healthcare accessing behavior. Despite VA’s ongoing efforts to educate employees and change the culture toward a more inclusive environment, more targeted work addressing the needs of LGBT women Veterans may be needed. (July 1, 2018)
• Medical Care Supplement Features Articles by VA Researchers on Improving the Quality and Equity of Health and Healthcare
  In 2016, HSR&D’s Center for Health Equity Research and Promotion (CHERP) and the Health Equity and Rural Outreach Innovation Center (HEROIC) hosted a state-of-the-science conference. This field-based meeting to “Engage Diverse Stakeholders and Operational Partners in Advancing Health Equity in the VA Healthcare System” brought together health equity investigators, representatives of vulnerable Veteran populations, and operational leaders to identify strategies to advance the implementation of evidence-based interventions to improve the quality and equity of health and healthcare. The conference focused on three specific vulnerable Veteran populations: racial and ethnic minorities, homeless Veterans, and Veterans from the LGBT community. This supplement features several articles that emanated from this meeting. (September 1, 2017)
• Issues for Sexual and Gender Minority Veterans Receiving VA Healthcare
  This article summarizes emergent research findings regarding sexual and gender minority (SGM) Veterans, and the first initiatives that have been implemented by VA to promote quality care. Being a member of both the Veteran and SGM communities may contribute to a higher level of risk for poor health than membership in just one of these populations. A recent VA study indicated that only 33% of SGM Veterans reported open communication about their sexual orientation with VA healthcare providers, while 25% reported avoiding certain VA services because of concerns about stigma. In another study of 202 VA providers and 58 SGM Veterans, less than one-third of all participants viewed VA as welcoming to SGM Veterans. To address these issues, VA has created new programs, such as the Office of Health Equity LGBT Workgroup, which works to address inequities in the healthcare environment for SGM Veterans. VA also created two new part-time LGBT Program Coordinator positions, through the Office of Patient Care Services, who advise leadership on policy and practice issues related to SGM Veterans. In June 2011, VA released the first national policy to describe the services that are available to transgender Veterans. Other recent VA policy changes include “sexual orientation” and “gender identity and expression” now being included in VA non-discrimination and caregiver policies. Educational resources and trainings have been developed for VA staff about culturally appropriate care for SGM Veterans. Further research is needed to better understand the SGM population, their healthcare needs, and how these needs vary in relation to gender, race/ethnicity, and other factors, as well as in evaluation of provider training and policies. (July 1, 2013)

PubMed Search Results

VA National Partners

The Office of Health Equity is committed to working closely with our VA colleagues to ensure that Veterans receive appropriate individualized health care in a way that eliminates disparate health outcomes and assures health equity. OHE's VA Partners include:

• VHA LGBTQ+ Health Program
• LGBTQ+ Veteran Care Coordinator Locator Tool (VA facilities)
• VA Office of Resolution Management, Diversity & Inclusion
• VHA Office of Health Equity - QUERI National Partnered Evaluation Center

External Partners

The Office of Health Equity is committed to working closely with other government agencies and non-governmental organizations to ensure that Veterans receive appropriate individualized health care in a way that eliminates disparate health outcomes and assures health equity. OHE's External Partners include:

• Human Rights Campaign (HRC) - Healthcare Equality Index

VHA TRAIN Portal for CME Transgender Trainings

• An Introduction to Transgender Veteran Health Care
• Transgender Health: Prescribing Cross-Sex Hormones
• Transgender Mental Health Services Program

Cultural Competence Training

• Veteran Health Administration HEI Participation and Resources
• LGBTQ+ Veteran Trainings
• VA Office of Diversity and Inclusion Training Resources
• US Department of Health and Human Services Think Cultural Health Education Programs
• Health Resources and Services Administration Culture, Language, and Health Literacy Resources

VHA Providers Explore Unconscious Bias

VHA providers share their stories of creating awareness of unconscious bias within their clinical practice and how bias impacts us all. A bias is a tendency. Most biases are natural. However, biases can cause problems when we are not aware of them and we apply them inappropriately to our everyday choices, which can lead to discriminatory practices and result in poorer health outcomes and experiences for patients. The brief videos were created by the VA Office of Health Equity and Employee Education System in an effort to ensure all Veterans receive high quality and equitable healthcare. The videos were recorded April 2013.

• Developing Clinical Awareness (3:44)
• Impact on Clinical Practice (3:15)
• Importance of Knowing Your Own Bias (3:37)
• Health Equity Stories to Share (6:15)

Harvard Implicit Associations Test

The Implicit Association Test measures attitudes and beliefs that people may be unwilling or unable to report. This tool may be especially interesting if it shows that you have an implicit attitude that you did not know about.

Visualizations and Dashboards

The Healthcare Equality Index (HEI) recognizes healthcare facilities that demonstrate equitable treatment and inclusion of Lesbian, Gay, Bisexual, Transgender, and Queer (LGBTQ+) patients, visitors, and employees in the following areas:

• Non-discrimination and staff training
• Patient services and support
• Employee benefits and policies
• Patient and community engagement
• Responsible citizenship

Healthcare facilities that receive a score of 100 on the benchmarking tool are designated as a "Leader in LGBTQ+ Healthcare Equality." Facilities with a score of 80 to 95 are designated as a "Top Performer."

115 VA medical centers participated in the 2022 HEI and 77 were designated as a Top Performer in LGBTQ+ Healthcare Equality.

Health Disparities Evidence-based Synthesis Reviews

• Prevalence of and Interventions to Reduce Health Disparities in Vulnerable Veteran Populations: A Map of the Evidence

VA Health Services Research & Development Publication Briefs

The VA Health Services Research and Development Service (HSR&D) pursues research that underscores all aspects of VA healthcare: patient care, care delivery, health outcomes, cost, and quality.

• LGBT Women Veterans Report Missing Needed Health Care Due to Concerns about Interacting with Other Veterans
  This study sought to examine LGBT women Veterans’ experiences within the VA healthcare system, and whether their experiences impact use of VA care. Findings showed that the majority of women Veterans reported feeling welcome at their VA. However, fewer LGBT women reported feeling welcome and safe at VA compared with non-LGBT women Veterans. After controlling for demographics, health status, and positive trauma screens, LGBT identity was predictive of women Veterans experiencing harassment from male Veterans at VA in the past 12 months, as well as feeling unwelcome or unsafe at VA. LGBT women Veterans were about 3 times more likely than non-LGBT women Veterans to attribute missing needed care in the previous 12 months to concerns about interacting with other Veterans. Study participant descriptions of harassment indicated that male Veterans’ comments and actions were distressing and influenced LGBT women Veteran’s healthcare accessing behavior. Despite VA’s ongoing efforts to educate employees and change the culture toward a more inclusive environment, more targeted work addressing the needs of LGBT women Veterans may be needed. (July 1, 2018)
• Medical Care Supplement Features Articles by VA Researchers on Improving the Quality and Equity of Health and Healthcare
  In 2016, HSR&D’s Center for Health Equity Research and Promotion (CHERP) and the Health Equity and Rural Outreach Innovation Center (HEROIC) hosted a state-of-the-science conference. This field-based meeting to “Engage Diverse Stakeholders and Operational Partners in Advancing Health Equity in the VA Healthcare System” brought together health equity investigators, representatives of vulnerable Veteran populations, and operational leaders to identify strategies to advance the implementation of evidence-based interventions to improve the quality and equity of health and healthcare. The conference focused on three specific vulnerable Veteran populations: racial and ethnic minorities, homeless Veterans, and Veterans from the LGBT community. This supplement features several articles that emanated from this meeting. (September 1, 2017)
• Issues for Sexual and Gender Minority Veterans Receiving VA Healthcare
  This article summarizes emergent research findings regarding sexual and gender minority (SGM) Veterans, and the first initiatives that have been implemented by VA to promote quality care. Being a member of both the Veteran and SGM communities may contribute to a higher level of risk for poor health than membership in just one of these populations. A recent VA study indicated that only 33% of SGM Veterans reported open communication about their sexual orientation with VA healthcare providers, while 25% reported avoiding certain VA services because of concerns about stigma. In another study of 202 VA providers and 58 SGM Veterans, less than one-third of all participants viewed VA as welcoming to SGM Veterans. To address these issues, VA has created new programs, such as the Office of Health Equity LGBT Workgroup, which works to address inequities in the healthcare environment for SGM Veterans. VA also created two new part-time LGBT Program Coordinator positions, through the Office of Patient Care Services, who advise leadership on policy and practice issues related to SGM Veterans. In June 2011, VA released the first national policy to describe the services that are available to transgender Veterans. Other recent VA policy changes include “sexual orientation” and “gender identity and expression” now being included in VA non-discrimination and caregiver policies. Educational resources and trainings have been developed for VA staff about culturally appropriate care for SGM Veterans. Further research is needed to better understand the SGM population, their healthcare needs, and how these needs vary in relation to gender, race/ethnicity, and other factors, as well as in evaluation of provider training and policies. (July 1, 2013)

PubMed Search Results

VA National Partners

The Office of Health Equity is committed to working closely with our VA colleagues to ensure that Veterans receive appropriate individualized health care in a way that eliminates disparate health outcomes and assures health equity. OHE's VA Partners include:

• VHA LGBTQ+ Health Program
• VHA LGBTQ+ Veteran Care Coordinator Locator Tool (VA facilities)
• VA Office of Resolution Management, Diversity & Inclusion
• VHA Office of Health Equity - QUERI National Partnered Evaluation Center

External Partners

The Office of Health Equity is committed to working closely with other government agencies and non-governmental organizations to ensure that Veterans receive appropriate individualized health care in a way that eliminates disparate health outcomes and assures health equity. OHE's External Partners include:

• Human Rights Campaign (HRC) - Healthcare Equality Index

VHA TRAIN Portal for CME Transgender Trainings

• An Introduction to Transgender Veteran Health Care
• Transgender Health: Prescribing Cross-Sex Hormones
• Transgender Mental Health Services Program

Cultural Competence Training

• Veteran Health Administration HEI Participation and Resources
• LGBTQ+ Veteran Trainings
• VA Office of Diversity and Inclusion Training Resources
• US Department of Health and Human Services Think Cultural Health Education Programs
• Health Resources and Services Administration Culture, Language, and Health Literacy Resources

VHA Providers Explore Unconscious Bias

VHA providers share their stories of creating awareness of unconscious bias within their clinical practice and how bias impacts us all. A bias is a tendency. Most biases are natural. However, biases can cause problems when we are not aware of them and we apply them inappropriately to our everyday choices, which can lead to discriminatory practices and result in poorer health outcomes and experiences for patients. The brief videos were created by the VA Office of Health Equity and Employee Education System in an effort to ensure all Veterans receive high quality and equitable healthcare. The videos were recorded April 2013.

• Developing Clinical Awareness (3:44)
• Impact on Clinical Practice (3:15)
• Importance of Knowing Your Own Bias (3:37)
• Health Equity Stories to Share (6:15)

Harvard Implicit Associations Test

The Implicit Association Test measures attitudes and beliefs that people may be unwilling or unable to report. This tool may be especially interesting if it shows that you have an implicit attitude that you did not know about.