Background: Medical mistrust and trust significantly impact a variety of health behaviors and outcomes, widening health inequities among minoritized populations. While medical mistrust has been extensively studied, particularly among Black men, less is known about medical mistrust among sexual minority men (SMM). Additionally, research on medical trust is limited as most studies examine medical mistrust.This dissertation examines medical mistrust and trust in a sample of racially and ethnically diverse young sexual minority men (SMM; e.g., gay, queer, bisexual, and other men who have sex with men) in three ways: 1) to validate a scale commonly used to measure mistrust (Group-Based Medical Mistrust [GBMMS] and Group-Based Medical Mistrust-Sexual Orientation and Gender Minority [GBMMS-SGM]), 2) to examine medical mistrust within SMM by racial and ethnic group, 3) to validate Trust in Physician Scale (TIPS) among SMM. As such, this dissertation contains three articles.Methods: The GBMMS, GBMMS-SGM, and TIPS scales' factor structure were evaluated using Principal Axis Factoring (PAF) with a promax (oblique) rotation. To assess and compare medical mistrust among SMM, a one-way multivariate analysis of variance (MANOVA) was conducted to examine variations in race-based medical mistrust (GBMMS scores) and medical mistrust attributed to sexual/gender minority group status (GBMMS-SGM scores) by race (Black, Latinx, White, 0́−Other0́+). One-way ANOVAs were conducted separately for each scale to examine pair-wise differences in GBMMS and GBMMS-SGM scores between race and ethnic groups. Results: The GBMMS, GBMMS-SGM, and TIPS scales are valid and reliable measures for evaluating medical mistrust among this population. Additionally, this study found significant differences in race-based medical mistrust by race and that there may be meaningful differences in medical mistrust attributed to sexual/gender minority status by race. Conclusion: This dissertation provides the first validation of mistrust and trust-related scales among SMM. This study also demonstrates the need for more research examining the many facets of medical mistrust and trust among SMM. These findings can be used to develop culturally sensitive and appropriate programs and interventions that focus on addressing barriers to healthcare utilization for SMM and other minorized populations.

In the United States, some populations suffer from far greater disparities in health than others. Those disparities are caused not only by fundamental differences in health status across segments of the population, but also because of inequities in factors that impact health status, so-called determinants of health. Only part of an individual's health status depends on his or her behavior and choice; community-wide problems like poverty, unemployment, poor education, inadequate housing, poor public transportation, interpersonal violence, and decaying neighborhoods also contribute to health inequities, as well as the historic and ongoing interplay of structures, policies, and norms that shape lives. When these factors are not optimal in a community, it does not mean they are intractable: such inequities can be mitigated by social policies that can shape health in powerful ways. Communities in Action: Pathways to Health Equity seeks to delineate the causes of and the solutions to health inequities in the United States. This report focuses on what communities can do to promote health equity, what actions are needed by the many and varied stakeholders that are part of communities or support them, as well as the root causes and structural barriers that need to be overcome.

This volume of Advances in Medical Sociology showcases rich theoretical and empirical contributions on SGM health and wellbeing. The chapters address a variety of topics, drawing from classic and contemporary sociological frameworks and constructs, and reflecting intersecting interdisciplinary approaches to SGM health.

Most public health students, academicians, and practitioners recognize the association between racial/ethnic minority status and the disproportionate burden of preventable disease in the United States. Much less attention has been directed, however, toward health disparities that affect gay and bisexual men. These disparities affect the lives of an estimated 5.3-7.4 million American men, and are an important concern for public health. Until very recently, the relative invisibility of this group and a paucity of empirical data have hampered attempts to identify health disparities experienced by gay and bisexual men. This book proposes to review and synthesize evidence of health disparities among gay and bisexual men, identify individual and community factors that contribute to these disparities, and articulate strategies for public health efforts to eliminate disparities. To date, these disparities have been largely discussed in isolation in the research literature in a manner that does not permit a comprehensive examination of these problems, their underlying causes, and potential solutions. Thus, a primary emphasis of the book will be to document health disparities among gay and bisexual men while also describing public health solutions to these challenges.

Ten years in public health 2007-2017 chronicles the evolution of global public health over the decade that Margaret Chan served as Director-General at the World Health Organization. This series of chapters evaluates successes setbacks and enduring challenges during the decade. They show what needs to be done when progress stalls or new threats emerge. The chapters show how WHO technical leadership can get multiple partners working together in tandem under coherent strategies. The importance of country leadership and community engagement is stressed repeatedly throughout the chapters. Together we have made tremendous progress. Health and life expectancy have improved nearly everywhere. Millions of lives have been saved. The number of people dying from malaria and HIV has been cut in half. WHO efforts to stop TB saved 49 million lives since the start of this century. In 2015 the number of child deaths dropped below 6 million for the first time a 50% decrease in annual deaths since 1990. Every day 19 000 fewer children die. We are able to count these numbers because of the culture of measurement and accountability instilled in WHO. These chapters tell a powerful story of global challenges and how they have been overcome. In a world facing considerable uncertainty international health development is a unifying – and uplifting – force for the good of humanity.