This June, in conjunction with Pride Month, the Harvard Pilgrim Health Care Institute announced the launch of the LGBTQ Health Center of Excellence, a partnership with Harvard T.H. Chan School of Public Health. With a mission of advancing health equity for LGBTQ communities, this first-of-its-kind center will leverage the distinctive research and teaching capabilities that both institutions are renowned for. 

For the Center’s founding director Brittany Charlton, the respect, protection, and promotion of equal human rights for all were woven into the fabric of her upbringing. “My parents met at UC Berkeley during the Free Speech Movement, so our dinner conversations often focused on social justice,” she notes. When it came time to choose a career path after college, she did a year of AmeriCorps service at an LGBTQ community health center and worked for various organizations, including the ACLU. 

She soon landed at the Harvard T.H. Chan School of Public Health to complete her MSc and ScD in Epidemiology before joining the faculty at Boston Children's Hospital. “My family includes a long line of nurses—so my pursuit of research, rather than clinical medicine, was a pretty unsuccessful attempt at rebellion,” she reflected. Charlton joined the Institute faculty in August of 2021 amidst the remote work of the pandemic and as the Institute’s focus sharpened on health inequities. She settled in seamlessly and rapidly got to work collaborating with colleagues in the Institute and across the globe on a wide range of LGBTQ health initiatives. 

With philanthropic and federal grant support, Charlton created Harvard’s LGBTQ Health Mentoring Program. She has since trained hundreds of faculty, fellows, and students nationwide on how to optimize mentoring relationships and address the unique needs of LGBTQ mentees (e.g., navigating ‘coming out’ during graduate or medical school). She has also been awarded several large-scale grants, including a $4.3 million grant from the National Institutes of Health (NIH) on sexual orientation-related inequities in obstetrical and perinatal health. With an eye toward disseminating her work beyond the ivory tower, Charlton also created a wildly popular seminar series about LGBTQ health that is open to the public. Despite these achievements, she knew there was more work to be done.

The first of its kind, right in time
As the LGBTQ population in the United States rises–1 in 10 people identify as LGBTQ, with the number twice as high in young people–so does the urgency for action, says Charlton. LGBTQ people experience widespread discrimination, resulting in adverse physical and mental health. For example, as Charlton and colleagues have found, lesbian and bisexual women die 26% sooner than their heterosexual peers, and they’re more likely to experience adverse health throughout their lives. Inequities include mental health conditions like depression and physical health conditions like cancer. With an eye on the next generation, LGBTQ people are more likely to develop hypertension during their pregnancies and have their babies born preterm. These inequities will only be exasperated by the wave of new anti-LGBTQ policies that sweeping across the country.

Dr. Charlton notes that while the public health field holds the keys to addressing inequities in LGBTQ health, it lacks the infrastructure to cohesively generate ideas and evidence, prepare learners to have the necessary skills to protect the health of this marginalized population and to be leaders, and secure the funding needed to propel this important work. While the NIH now acknowledges LGBTQ people as a population with health disparities, only 1% of NIH-funded research focuses on LGBTQ health.

It is profoundly meaningful to me as a queer woman to help build this Center to be a diverse, inclusive, and equitable home for LGBTQ health work.
-Brittany Charlton

That, Dr. Charlton hopes, will change as the Center rolls out its plans for the first year and looks to the future. “In the twenty years that I have been doing this work, the field has transformed from one focused primarily on HIV/AIDS to one that focuses on diverse LGBTQ communities impacted by a range of health inequities. It is profoundly meaningful to me as a queer woman to help build this Center to be a diverse, inclusive, and equitable home for LGBTQ health work,” she adds.

Widespread support for the Center and its mission
Working with partners across Harvard and around the world, the Center has three foci in its mission to advance LGBTQ health: training to prepare the next generation of LGBTQ health leaders, research to expand the evidence base of LGBTQ health, and dissemination to inform policymakers, healthcare providers, and the larger public about how to improve LGBTQ health most effectively. 

The Institute is distinctive for aligning researchers and resources to optimize health care policy, care delivery, and outcomes. The LGBTQ Health Center of Excellence stands poised to create the change needed to right the inequities that face this population.
-Emily Oken

The proposal to establish the Center was received with encouragement and support from the Institute’s Executive Committee, including president and department chair Emily Oken. “The Institute is distinctive for aligning researchers and resources to optimize health care policy, care delivery, and outcomes. The LGBTQ Health Center of Excellence stands poised to create the change needed to right the inequities that face this population,” says Emily Oken, president of the Harvard Pilgrim Health Care Institute and Harvard Medical School professor and chair of the department of population medicine at the Harvard Pilgrim Health Care Institute. “Dr. Charlton has assembled what you might call a ‘dream team’ of researchers across both institutions for this purpose.”

Also key, according to Dr. Charlton, are the generosity and impact of philanthropic gifts from fellow champions of LGBTQ health equity. She cites one of the Center’s founding donors, Michael Dillon, as instrumental in fueling this work – and an example of how those who are passionate and have vision about the cause can create change. “While researchers depend on project-specific funding from federal sources, gifts like Mike’s are truly transformative: they allow us to build the infrastructure needed to allocate resources to emerging issues in the LGBTQ health arena that may not receive as much recognition as, say, HIV/AIDS research,” she added.

Health disparities scholars and trainees unite for the cause
Dr. Charlton has assembled a robust roster of faculty, staff, fellows, and trainees to work together to achieve the Center’s mission. Their expertise ranges from optimizing HIV prevention in health care settings, to human-centered study design, to teaching science as a tool for promoting health equity and justice, and novel research methods. The Center will be guided by advisors who will help Dr. Charlton on aligning priorities, reviewing metrics for success, and more.

Inaugural Harvard Pilgrim Health Care Institute faculty members include Julia Marcus, Douglas Krakower, Alon Peltz, and Jessica Young. Center faculty from Harvard T.H. Chan School of Public Health include Jarvis Chen, Christy Denckla, Heather Eliassen, Sebastian Haneuse, Maggie McConnell, Alecia McGregor, Shoba Ramanadhan, Deepali Ravel, and Natalie Slopen.

The group stands poised to make an impact overall by executing a carefully crafted strategic plan. “We have a clear vision of how our Center will train the next generation of leaders not only to continue to document that inequities exist but also to design interventions and advocate for policy changes that tangibly improve the lives of LGBTQ people,” noted Dr. Charlton. Several initiatives for the Center’s inaugural year are in the works, including:

• Awarding tuition scholarships to students focused on LGBTQ health
• Designing new student course on LGBTQ health research methodology
• Awarding pilot grants for LGBTQ health research
• Launching a fellowship to train public health leaders to engage the public about LGBTQ health issues via op-eds, social media content, and more

The Center launches with an event held at the Harvard T.H. Chan School of Public Health Kresge Cafeteria. All are welcome, including children and families. For more information or to RSVP, click here.