Community Leaders: The LGB&T Public Health Outcomes Framework Companion

The Public Health Outcomes Framework (PHOF) published by Public Health England is based on national data collected through NHS monitoring and national surveys.

Because sexual orientation and gender identity are not routinely monitored, the PHOF does not contain data related to LGB&T communities and so their health needs are not recognised in the document.

However, there is a substantial body of evidence demonstrating that LGB&T people experience significant health inequalities, which impact both on their health outcomes and their experiences of the healthcare system.

What Is The LGB&T PHOF Companion Document?

The LGB&T PHOF Companion Document has been developed by a group of volunteer experts from across the LGB&T community working with the Department of Health, to increase understanding of LGB&T health and make sure that the public health system tackles inequality related to sexual orientation and gender identity and promotes equality for everybody.

The working group was formed following an LGB&T consultation event held by the Department of Health and Public Health England in October 2012, and has been co-ordinated by The Lesbian & Gay Foundation.

The document is intended primarily for Health and Wellbeing Boards and public health teams, as well as local authorities, the NHS, and voluntary and community organisations that commission and provide services, as a resource to improve the health and wellbeing of the diverse LGB&T communities they serve.

The document follows the structure of the PHOF, providing data and evidence on LGB&T communities for each indicator and domain. It makes recommendations for actions to address inequalities in outcomes for LGB&T people and communities.

Reference documents highlight best practice case studies and resources to support organisations in implementing these recommendations, as well as the evidence relating to minority groups within LGB&T.

The LGB&T PHOF Companion Document covers the following key areas:

Improving the wider determinants of Health

LGB&T individuals often experience discrimination and marginalisation that impacts on wider factors such as education, housing and perceptions and experiences of crime and violence, meaning that these groups experience specific health inequalities as a result.

Health Improvement

Local and national research and needs assessments of LGB&T communities have repeatedly demonstrated higher levels of health risk behaviours, such as smoking and drug and alcohol use, as well as higher levels of self-harm.

LGB&T people are less likely to engage with health interventions and screening programmes, and gender-specific screening can present particular challenges for Trans and non-gendered individuals.

LGB&T communities therefore have higher levels of need for intervention and targeted support related to these indicators.

Health Protection

These indicators focus on protecting the population’s health from major incidents, and other threats, while reducing health inequalities there are some areas which particularly affect LGB&T people.

There is a lack of evidence on LGB&T communities in relation to many of the indicators in this domain, yet the available evidence indicates that LGB&T people may be experiencing health inequalities in relation to health protection.

Healthcare public health preventing premature mortality

Evidence indicates that LGB&T communities are more likely to be experiencing health inequalities in relation to public health areas and preventing premature mortality.

The higher prevalence of smoking, alcohol use and drug use, and lower uptake of screening programmes, are likely to contribute to increased risk of preventable ill health. There is also a significant body of evidence demonstrating high rates of suicide attempts.

How to access

The LGB&T PHOF Companion Document is freely available via the Policy & Research Section of The Lesbian & Gay Foundation’s Website:

Supporting Documents also available include:

  • Case Studies
  • Resource Directory
  • Minorities within Minorities - the evidence base relating to minority groups within the LGB&T community