VDH Research Spotlight
This Great New Community Survey – A Statewide Survey of the Transgender and Gender Non-Conforming Population of Virginia
The TGNC survey was conducted by UVA April 2021 to March 2023 to update the quantitative results of the Virginia Transgender Health Initiative Study (THIS) conducted in 2005-2006. Participation was open to transgender and gender non-conforming/nonbinary residents of Virginia aged 18 or older, with participant recruitment through social networks, social media platforms, and palm cards distributed to TGNC-serving community, healthcare, and social service organizations. All participants completed online screening to determine final eligibility. After UVA and VDH IRB approvals and pilot testing, all participants were individually interviewed by phone by UVA staff and provided $50 incentive for their participation.
The survey examined housing, discrimination, restroom access, school experiences, social support, social networks, sexual behaviors and relationships, substance use, mental health, physical health, cancer screening, health insurance, access and barriers to general healthcare, gender-affirming care, reproductive healthcare, HIV, STI, HCV and HPV testing, prevention, education, and treatment, and Covid 19.
The final sample of 551 was composed of 62% TGNC persons assigned female at birth and 38% assigned male at birth. Participants were mostly white (81%) with a median age of 29 years, residing in 34 of the 35 Virginia Health Districts.
Contact Ted.heck@vdh.virginia.gov for additional information.
Impact of Pre-Pregnancy Care and Insurance on Maternal and Infant Health
David S. Gregory, MD, FAAFP, et al.
In the context of worsened maternal & infant outcomes in Virginia, rural hospitals closing “labor and delivery” units and changes in access to Medicaid, this project sought to assess whether healthcare and insurance access affected maternal and infant outcomes in Maternity Care Deserts (MCD’s).
All publicly available maternal and infant data for delivered pregnancies in Virginia from 2018-2022 were analyzed with risk factors and outcomes of pregnant individuals residing in counties/cities, accounting for rurality and MCD location. Higher rates of the following risk factors were seen in pregnant individuals residing in these MCD or rural localities:
- Teen Pregnancy
- Maternal Smoking
- Chronic Disease Burden
- Hypertension during pregnancy
Additionally, higher rates of adverse outcomes of preterm births and preterm births to individuals with 1 or more chronic health condition were seen in individuals in these same MCD or rural localities
However, with access to pre-pregnancy healthcare, pregnant individuals residing in MCD or rural localities, compared to those without pre-pregnancy healthcare access, had reduced rates of:
- Large for gestational age (>90th percentile) infants
- Depression during pregnancy
The preliminary analysis suggests that more study is needed to explore the causes of these associations in order to reduce associated adverse outcomes. For additional information please contact dgregory@carilionclinic.org.
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