Translating the NORC Model to Address Health and Social Service Gaps for GLBT Senior Population Residing In and Around Capitol Hill Neighborhood, Denver, Colorado

Background: Gay, Lesbian, Bisexual, or Transgender (GLBT) persons, face social and institutionalized barriers to accessing healthcare and social services as they age. There are approximately 1 to 2.8 million GLBT seniors in the US, who are disproportionately more likely to live alone, are at higher risk of poverty, homelessness, social isolation and premature institutionalization. GLBT seniors are often childless or estranged from family, while providing care for same-sex partners without the legal benefits or social approval. Many social and health services sustain homophobic and heterosexist beliefs the provoke fear and anxiety.

Purpose: The objective of this study is to identify health services gaps and access barriers faced by GLBT elders in the Denver Capitol Hill in order to implement an evidence-informed integrated supportive services model called a NORC (naturally occurring retirement community) to serve the needs of this highly vulnerable and often hidden population.

Methods: Qualitative community based participatory (CBPR) action study with observations, unstructured concept-clarification interviews, and focus groups with health and social service providers and GLBT community members (n=20). Thematic analysis consisted of transcription, evaluation and process first cycle coding, and secondary axial coding. The partnership constructed for the CBPR includes participation from Jewish Family Service, The Center, Kaiser Permanente, and the University of Denver.

Results: With a strength-based focus, GLBT seniors' were recognized for their enthusiasm, activism, resiliency and ability to connect with limited resources. Several factors contributed to gaps in health and social services including, support and structural limitations. The insufficient political and government rights, non-traditional family dynamics, limited social support systems, and lack of safeguards to both personal identify and physical harm were identified as problematic themes. Discrimination and complexity of dual stigmatization, indicated by a lack of awareness and knowledge by professionals and historic mistrust were seen as barriers to care.

Conclusion: This research contributes the growing literature indicating the existence of extreme health disparities for GLBT elders. These findings will drive the development and pilot of a NORC model that will address the specific needs of the GLBT community.