Over the Rainbow: Addressing Health Disparities Among LGBT Older Adults and Their Caregivers

Purpose Health disparities are of critical societal importance. Despite advancements in health for many Americans, historically disadvantaged communities continue to bear higher levels of illness. Sexual minority status seems to influence health outcomes, although such communities are most often neglected in health research. In this presentation, we will discuss findings from the first national study of health and health disparities among lesbian, gay, bisexual, and transgender (LGBT) older adults and their caregivers. Such research provides important insights into the health and risk and protective factors experienced by LGBT older adults and their informal caregivers.

Methods An anonymous self-administered mail and on-line survey was conducted among LGBT older adults and caregivers, served by community based aging agencies in New York, Boston, Chicago, Milwaukee, Los Angeles, San Francisco, and Seattle. The respondents were at least 50 years of age and self-identified as gay, lesbian, bisexual, or transgender. Key outcome measures included were physical and mental health status and health-related quality of life. Both risk and protective factors were considered as potential predictors of health outcomes. Risk factors included the following: internalized stigma, discrimination, risky health behaviors, and lack of access to health care. Protective factors included social support, a caregiving relationship, exercise, and community integration. We conducted descriptive statistics to examine the health status and quality of life among LGBT older adults and multivariate analyses to further examine the relationship between the outcome variables and risk and protective factors, while controlling for confounders, such as socio-demographic and background characteristics. In addition, we examined subgroup differences among LGBT older adults.

Results The findings indicate that sexual orientation is a significant social indicator of health among LGBT older adults. For LGBT older adults, risk factors, such as discrimination, victimization, and loneliness, negatively impacted their physical and mental health. We also found that LGBT older adults demonstrated resilience and developed their own strategies to maintain health and quality of life through such mechanisms as social support and caregiving relationships. The findings also indicate that there are important subgroup differences in health within LGBT communities.

Implications The social context has important implications for health among historically disadvantaged and marginalized communities. The findings from this first national federally-funded project suggest that significant health disparities exist among culturally diverse LGBT older adults and their caregivers. The research demonstrates the importance of building the capacity and sustainability of interdisciplinary research teams to assess health disparities and illustrates how social work research can be utilized to address health disparities in LGBT communities. The limitations and constraints of utilizing agency-based data will be discussed and next steps will be outlined to address health among LGBT older adults and their caregivers. Public policies are needed to sensitively address the needs in these community and better support diverse sexualities and families.