Lanvell Blake

He/Him/His/Himself

995704@swansea.ac.uk

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School of Psychology,
Swansea University

Lead supervisor:
Dr Liadh Timmins

Other supervisor(s):

• Kate Ellis-Davies

Start date: October 2026 (Part time)

Award: General

Subject Pathway:
Health and Well-Being and Data Science

Thematic Cluster:
Society and Well-Being Cluster

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In partnership with:

Stigma as a risk factor: The role of discrimination, violence, and social exclusion in shaping non-communicable disease outcomes among LGBTQ+ Jamaicans

Non-communicable diseases (NCDs) are the leading cause of morbidity and mortality globally, accounting for approximately 74% of all deaths worldwide (World Health Organization [WHO], 2023). In Jamaica and across the wider Caribbean, the burden of chronic conditions, specifically cardiovascular disease, type 2 diabetes, cancers, and chronic respiratory illness is increasing rapidly, placing fiscal and operational strain on public healthcare systems and communities (Pan American Health Organization [PAHO], 2019; Ferguson et al., 2017). In response, national and regional public health frameworks have prioritised population-wide approaches to prevention and clinical management (Ministry of Health and Wellness Jamaica [MOHW], 2018). However, these strategies operate under an assumed universality that routinely fails to account for the unique vulnerabilities, structural barriers, and social realities of marginalised groups, leaving the health needs of socially excluded populations structurally unaddressed (Marmot et al., 2012).

Sexual and gender minorities (SGM), including individuals with diverse sexual orientations, gender identities, gender expressions, and bodily characteristics, experience disproportionate exposure to upstream social stressors, including institutional stigma, everyday discrimination, violence, and social exclusion (Hatzenbuehler, 2014; Meyer, 2003). Over two decades ago, Boehmer (2002) highlighted that public health research concerning SGM communities was overwhelmingly restricted in scope, focusing almost exclusively on HIV and sexually transmitted infections among men who have sex with men in the Global North. While research in high-income countries has since broadened to investigate wider health disparities, including cardiovascular and metabolic inequities (Caceres et al., 2017; Flentje et al., 2020), the evidence base across low- and middle-income countries remains sparse (Müller & Hughes, 2016). There is an urgent, unmet need to assess what is known regarding the disease burden in SGM populations and to generate empirical evidence on the non-biological and social determinants that drive chronic physical disease beyond the historical, HIV-centric lens (Boehmer, 2002; World Health Organization, 2022).

In Jamaica, this evidence gap is compounded by a punitive legal and sometimes hostile social climate. Same-sex intimacy remains criminalised under Sections 76, 77, and 79 of the British colonial-era 1864 Offences Against the Person Act, and anti-LGBTQ+ cultural and religious attitudes remain deeply entrenched (Human Rights Watch, 2014; West & Cowell, 2015). These structural conditions dictate everyday experiences of street-level harassment, acute psychosocial stress, and institutional exclusion (Logie et al., 2017). Yet, Jamaica's national NCD strategies, public health surveillance systems, and primary health clinics render LGBTQ+ populations largely invisible (MOHW, 2018). Because routine national health surveys fail to disaggregate data by sexual orientation and gender identity, the distinct barriers SGM individuals encounter, such as provider bias, fear of disclosure, and pervasive healthcare avoidance, remain unmeasured (Logie et al., 2021). Consequently, national policies aimed at achieving universal health coverage risk entrenching and exacerbating the very health inequities they seek to dismantle.

My doctoral research aims to addresses this important public health gap by examining how stigma, discrimination, and social exclusion function as upstream risk factors shaping the risk, management, and physical health outcomes of NCDs among LGBTQ+ Jamaicans. Rather than conceptualising LGBTQ+ identity as an inherent biological deficit, my research posits that historical and contemporary social structures make sexual orientation and gender identity the pathway through which structural violence is experienced and biologically incorporated (Crenshaw, 1991; Krieger, 2014). Situated within Jamaica’s postcolonial landscape, my research integrates Postcolonial Theory (Alexander, 2005; Fanon, 1952), Intersectionality (Bauer, 2014; Collins, 2000; Crenshaw, 1989), and Minority Stress Theory (Brooks, 1981; Meyer, 2003). It will theorise the concept of 'statutory weathering' to investigate how living under state-sanctioned criminalisation and religious moral policing translates into chronic physiological strain and accelerated allostatic load (Geronimus et al., 2006; McEwen, 1998). Crucially, my research aims to move beyond a pure trauma narrative to examine 'queer marronage' and 'strategic (in)visibility', exploring how chosen families, community mutual-aid networks, and tactical discretion serve as culturally rooted mechanisms that may actively buffer against chronic physical disease (Frost & Meyer, 2012; Glave, 2005; Roberts, 2015).

Research Impact

This research aims to bridge health data science, social epidemiology, and grassroots human rights to deliver impact:

• By expanding the health agenda beyond communicable diseases, my research aims to provide the Ministry of Health and Wellness (MOHW) in Jamaica and the Pan American Health Organization (PAHO) with empirical data to formally integrate sexual and gender minorities into national NCD prevention and clinical management strategies. Findings will aim to inform key national instruments in Jamaica, including future iterations of the Jamaica Health and Lifestyle Survey (JHLS), the National Strategic and Action Plan for the Prevention and Control of NCDs in Jamaica, and the Jamaica Moves campaign.

• Conducted in close operational partnership with the Equality for All Foundation (EFAF), Transwave Jamaica and WE-Change Jamaica, the research will provide empirical evidence demonstrating the tangible biological and physical harms of colonial-era anti-sodomy legislation (the 1864 Offences Against the Person Act). This objective epidemiological data will directly support ongoing constitutional challenges, legislative reform advocacy, and stigma-mitigation campaigns across the Anglophone Caribbean.

• The research will demonstrate how Respondent-Driven Sampling (RDS) paired with zero-knowledge, privacy-preserving data architectures can be safely deployed among stigmatised populations. This will establish an ethical and computational blueprint for conducting (high)-risk, rigorous population health research in resource-constrained, (high)-stigma settings.

• Findings will directly inform culturally competent healthcare training toolkits focused specifically on non-communicable disease management. Designed for (public) primary health centres, these toolkits will aim to address provider attitudes, reduce clinical discrimination, protect patient confidentiality, and eliminate the systemic fear that drives healthcare avoidance among vulnerable communities.

Bibliography

Biography

Lanvell is an ESRC-funded doctoral researcher in the Health, Wellbeing and Data Science pathway at Swansea University, supported by the Welsh Graduate School for the Social Sciences (WGSSS). Their interdisciplinary doctoral research is supervised by Dr Liadh Timmins (School of Psychology), Professor Michael Gravenor (Swansea University Medical School), and Dr Kate Ellis-Davies (School of Psychology).

Lanvell’s work operates at the intersection of population data science, social epidemiology, and postcolonial queer studies. They bring substantial professional and field experience to this research, having previously worked within the human rights sector in Jamaica with the Equality for All Foundation (EFAF). Their prior postgraduate research explored the implementation and uptake of HIV Pre-Exposure Prophylaxis (PrEP) among gay and bisexual men in Jamaica.