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Kristi Westphaln PNP

Human Rights, Pride, and the Russian Divide

By Editorial Staff

July 27, 2017

By Sarah Lobo

Edited by Kristi Westphaln


June and July have hosted many fantastic events across the United States in celebration and support of the LGBTQ+ (lesbian, gay, bisexual, transgender, queer, plus) community. As these events draw to a close, it remains important to keep human rights on the forefront of policy discussions. While many people promote and accept the LGBTQ+ community, oppression and discrimination represent significant challenges.


Russian law hosts some of the strongest discrimination towards the LGBTQ+ community. Homosexuality was classified as a mental illness until 1999 and gay rights forums were banned in Moscow until 2006. This past year at the Women’s March in Moscow, young people displaying rainbow flags were arrested due to “promoting” the LGBTQ+ community. Russia’s current view on LGBTQ+ issues has caused the government to continuously ban Moscow Pride since its original launch date in May 2006. Additionally, it remains illegal to distribute any LGBTQ+ related materials to minors.


In 2014, Russia passed an Anti-Gay Propaganda Bill that prevented LGBTQ+ children from accessing support groups and information by a 436-0 vote. This bill attempted to sever access to support resources for LGBTQ+ teenagers, including Children-404 and Children-404 helps by creating online forums for LGBTQ+ teenagers. They publish real, anonymous letters from Russian who share their lives, interactions, and experiences. strives to assist the Russian LGBTQ+ community via initiating events and marches to raise awareness for the LGBTQ+ population. has attempted to organize Moscow Pride marches, however this has been outlawed and deemed punishable via physical torture by the Russian government.’s motto, “Gay Equality, No Compromise,” perfectly shows their message and mission. These organizations are two of the many that demand change. They need help. Only the people of the world can bring about change. This issue cannot go unchecked and needs to be fixed NOW. If you aren’t convinced, go to Children-404’s website and read a few of their letters:


“Parents, when did you disavow your child? Why did you betray your determination to be there for them, to protect and support? Who are you to your child now, when you found out he’s different: a chastener, a ruthless judge, a detached boring preacher? You promised to love your child ALWAYS, WHATEVER HAPPENS, probably BEFORE HE WAS EVEN BORN, so why did you break your promise? Why do you demand from your child to be responsible for something you cannot change without causing harm? Are you sure you can change the sexuality of your grown-up children? Are you sure your life priorities are placed in the right order?”Anonymous Letter, January 16, 2015, Children 404


World humanitarian rights are typically championed by the United Nations. Currently, the United Nations allows member countries to individually ratify its edicts, including the one concerning LGBTQ+ rights. This contributes to the sluggish passage of humanitarian rights in many countries.  Additionally, many countries avoid passing certain edicts due to concerns regarding accountability for previous actions. Once a country passes a law or definition agreed upon by the United Nations, they are bound to acknowledge and respond accordingly. That action may require reparations, a formal apology, or sometimes more drastic measures as was the case when Germany formally accepted the UN’s definition of genocide after the Holocaust.


Russia is not alone. Just today, President Trump announced plans to ban transgender individuals from serving in the United States military. I am not proud that human rights are not always a first priority in many countries throughout the world. However, I’m hopeful that equity and equality will prevail when human rights are made the priority and love becomes the ultimate agenda.


This blog is authored bySarah Lobo, high school student, human rights advocate, and Healthcetera intern. Sarah and her friend, Parker Russ, have created a video depicting the challenges of Russian LGBTQ+ youth. Please check it out here:


Editorial Staff

Repealing the ACA: Response from the Field

By Diana J. Mason

January 26, 2017


Donald Trump and the Republican Congress have promised to repeal the Affordable Care Act (ACA, also known as Obamacare) and, perhaps, replace it with something else.  After taking office, Trump signed an executive order directing his executive administration to take any steps available to repeal and replace the ACA “to minimize the unwarranted economic and regulatory burdens of the Act, and prepare to afford the States more flexibility and control to create a more free and open healthcare market.”  What this produces is not clear.

Greater clarity on what the new administration and Congress will do was not obvious during the hearings to confirm Tom Price, MD, nominee for Secretary of Health and Human Services, who was vague about what pieces will go and what will replace these. He repeatedly said that they would take actions to provide the American people with more choices and offered approaches such as high risk pools at the state level, catastrophic insurance that he said would be more affordable than what people are getting on the insurance exchanges, and moving Medicaid into a block grant to states. But an editorial in the January 25th New York Times, challenges some of these assertions that new approaches would be better for the American people.

What we know is that the Republicans will repeal parts of the ACA that have budgetary implications through the budget reconciliation process that will occur over the coming months. It is expected that they will undo the individual mandate for everyone to have insurance or pay a penalty. This is one leg of a stool for universal coverage: the individual mandate forces people into the insurance pool who are healthy and are unlikely to use many health care resources, making coverage more affordable for those with health problems. We all are likely to become ill or experience trauma that requires significant health care resources at some point in our lives, so sharing risk all along one’s life is key to keeping coverage affordable and the stool upright. Repealing the individual mandate destablizes the stool.

The Republicans also say they will keep the highly popular requirements that insurers cover people with pre-existing conditions–unless the person has a break in coverage, which can occur when people with limited resources are forced to choose between paying for insurance or paying the rent.

Turning Medicaid into a state block grant is highly likely and will reduce the funds going to states that bought into the expansion of Medicaid coverage to single men and families with higher income levels. It is likely to result in eliminating some people from Medicaid coverage or forcing states to curtail the services Medicaid covers.

These are but a few of the concerns about what will happen to access to health care with the promises to repeal and replace the ACA. The uncertainty surrounding what will happen has increased the levels of stress and anxiety among the vulnerable populations served by HealthCetera co-producer Kristi Westphaln, MSN, PNP, a pediatric nurse practitioner who works in a clinic in Southern California. Kristi shares with HealthCetera producer Diana Mason, PhD, RN, some of the concerns of the families she serves and how she responds to them.

The interview took place on January 17th in San Diego. It airs on Thursday, January 26, 2017, at 1:00 on WBAI, 99.5-FM in New York City. You can listen to the interview anytime by clicking here:

HealthCetera is sponsored by the Center for Health, Media & Policy.



Diana J. Mason
Diana is a founder of the Center for Health, Media & Policy, and HealthCetera Radio. She is the President of the American Academy of Nursing, the Rudin Professor of Nursing at Hunter-Bellevue School of Nursing, and a health policy expert and leader. Diana tweets @djmasonrn.

Bringing health literacy home for the holidays

By Kristi Westphaln

November 23, 2016

Krisit Westphaln & Eileen Fry-Bowers
Krisit Westphaln & Eileen Fry-Bowers

Data from the US Department of Health and Human Services National Assessment of Adult Literacy estimates that approximately 77 million Americans are currently at risk for low health literacy.


From a refugee family who arrives to a health care visit with minimal English speaking skills to an English speaking family attempting to understand a multi-medication asthma regimen for a loved one, navigating the jargon and technology within the health care system can be both challenging and frustrating for families.


A lacking of health literacy, or understanding about one’s health, can lead to potentially devastating effects including but not limited to poor access to health care, prolonged uncomfortable symptoms, delayed diagnoses, and unanticipated hospital readmissions. Additionally, low health literacy affects people of all ages and all stages of life.


When was the last time that you sat down with your loved ones and talked about health literacy, literally? Skills such as reading a pamphlet or calculating a medication dose aren’t always easy. Feelings such as fear or sadness can also impact health care actions and decisions. Communication and comprehension represent key components in promoting health and wellness.


Tune into Healthcetera Radio on Thursday, November 24th as Senior Fellow Kristi Westphaln interviews health literacy scholar and health policy expert, Dr. Eileen Fry-Bowers. Among her many accomplishments, Dr. Fry-Bowers holds a degree in law from Whittier Law School, a PhD from the UCLA School of Nursing, and she currently serves as faculty at the Hahn school of Nursing and Health Science at the University of San Diego.


The holidays are right around the corner. Take a few minutes to learn how you can bring tidings of health literacy to your friends and family. Dr. Fry-Bowers demystifies health literacy as she defines it, provides strategies for enhancing health literacy, and explains the important Ask Me 3 questions that you should ask your health care provider at every check up.


Give the gift of health this year by boosting your family health literacy and tune into Healthcetera radio.

You can listen to the interview here on iTunes


Kristi Westphaln
Kristi Westphaln, RN MSN PNP-PC is a San Diego based Nurse Practitioner with a passion for pediatric clinical practice, child advocacy, and nursing education. She has over a decade of experience in pediatric emergency care, with a focus on trauma and abuse. She is pursuing a PhD, and as a senior fellow, produces frequent HealthCetera Radio segments.