continued from p. 1

deliver to the general smoking
population effective for gays or

_ not or do they require a specif-

ic message? And I don’t know
the answer to that.

“If in fact we can
deliver a message that hits 60
percent of the entire popula-
tion, that’s a bigger bang for
the buck than targeting to a
smaller group. There’s a lot of
research [into] tobacco use. I
don’t know the answer to t s,
but generally that’s the ques-
tion: To what extent can you
develop a message that is effec-
tive for everyone versus specif-
ically a targeted population.”

Have you ever played
the telephone game? That’s
when a group of people sits in
a circle and one person whis-
pers a sentence‘ into the ear of
the person next to them and the
message travels around until it '
is repeated to the originator.
Inevitably, the-message is dif-
ferent. ‘Mary takes a walk to
school’ becomes ‘Mary pokes a
hole you fool.’ The game
works because people do not
hear things the same way. The
same thing happens with health
messages.

One of the reasons
for health disparities among
minority populations is that
health messages aimed at the
general population (read:
straight, white, and middle
class) fail to reach non-white,
queer, poor populations. We are
a diverse society. We think dif-
ferently when it comes to
health. For example, Centers
for Disease Control research on
tobacco control suggests mes-
sages that demonize smokers as
social misfits or outcasts are an
effective way to discourage
smoking. However, in focus
groups conducted in Seattle, I
found that such messages are
ineffective for an lgbt popula-
tion. Gay men-and lesbians
already feel demonized.
Furthermore, social marketing
research suggests sexual
minorities are often non-
responsive to negative cam-
paigns and perceive them as
anti-gay. »
The Bang-for-the- »
Buck approach is one way pub-
lic health officials dismiss the
needs of minorities. It’s the
idea that resources should be
spent in such a manner as to
reach as many people as possi-
ble. This is like building a
school where the greatest con-
centration of children is and
dismissing the educational

needs of those children who ‘
live too far to walk to school ' E
every day. While education in.
the United States abandoned
this practice years ago — the
Supreme Court ruled it uncon-
stitutional — public health offi-
cials routinely justify policy
and programming based on this
approach.

In 1999, I was a V
member of the Seattle/King l
County Tobacco Council. We
were able to create a funding
allocation formula that divided
the financial pie in a more
equitable, inclusive manner.
Using data gathered locally, we
were able to prioritize popula-'
tions whose tobacco use rates
were disproportionately higher
than those of the general popu-
lation. We are also able to pro-
vide additional funding for
communities that lacked the
infrastructure to execute an
appropriate program. As a
result, we were able to work
with the diversity of the popu-
lation and choose quality over
quantity.

The words ‘gay’ or
‘lesbian’ do not appear in
Vermont Best Practices to Cut
Smoking in Half by 2010, the
state’s road map for tobacco

control. DoH’s tobacco control L

program has made no grants to
gay community organizations
and the only gay-specific proj-
ect being funded is a video
being produced by Chittenden
Community Television.

Back to“!-IIV‘
Dr. Janis said, “I am also very
concerned about youth, gay and
lesbian youth. My understand-
ing is that it’s a very significant
risk factor for alcohol and drug
use, perhaps more so than other
populations. We know alcohol
and drugs leads to risky behav-
ior which gets us back to STDs
and HIV.”

Nationally, more sex-
ual minorities are dealing with
depression or some other form
of mental illness than with
HIV. The leading causes of
death for adult sexual minori- «
ties are not AIDS, but heart dis- _ .
ease and stroke. Gay youth are ‘
much more likely to become
addicted to alcohol or drugs
than become HIV positive.

When pressed on the . _ ‘
issue, Dr. Jarris could not pro-
vide an example of something
DoH was doing for sexual
minorities outside the AIDS
program.

“There’s a lot we do
for the population in >>
Vermont based on risk