Collaborative Approach to Understanding Aging LGBTQ Populations’ Health in New England: Findings from Lived Experiences

Background and Purpose: Lesbian, Gay, Bisexual, Transgender, and Queer (LGBTQ) people aged 50 and older currently represent approximately three million people or 4.5% of the United States older adult population (The Williams Institute, 2023), with 20% being people of color and one-third have incomes 200% below the federal poverty line (Movement Advancement Project & SAGE, 2017). These LGBTQ older adults experience unique health disparities compared to their heterosexual, cisgender peers (Emlet, 2016; Fredriksen-Goldsen, 2015). Disparities in heath can be defined as having health outcomes that are greater or less than between populations, i.e race, ethnicity, sex, gender, sexual orientation, and income, which are largely impacted by social determinants (US Department of Health and Human Services, 2019). These health disparities are often rooted in systemic societal inequity, usually based on holding a marginalized identity status (National Academies Press, 2017) such being an LGBTQ elder. Research on the health determinants of this population is scarce (Fasullo et al., 2021), and due to this invisibility, the health needs of LGBTQ older people have been rarely discussed, even though these health disparities persist (Fredriksen-Goldsen et al., 2011). Due in part of these health disparities, negative health outcomes have been seen in this population, such as higher rates of chronic disease, disability, mental health disorders (McNeil et al., 2021), morbidly, and even premature death, making LGBTQ older adults ultimately an at-risk population (Fredriksen-Goldsen et al., 2011). These disparities necessitate a collaborative project with this population and the community agencies that serve them in order to: 1. Understand the factors that impact the health of LGBTQ elders, and 2. What specific solutions through research, policies, and/or interventions will help support a decrease in negative health outcomes?

Methods: An Interpretive Phenomenological Analysis (IPA) was used to understand the themes associated with the lived health experiences of LGBTQ older adults and the key community partner that serve them in the New England Region of the United States. A sample of key agency informants and LGBTQ older adults aged 50 and over were interviewed in focus groups and follow up interviews, asking what the felt impacted the health of this population as they age and what solutions would improve health and aging.

Results: Through IPA thematic analysis of interviews, this study found the factors that impact the health of LGBTQ+ adults as they age include social isolation, resiliency in positive connections, lack of health and aging supports that are truly LGBTQ+ aging friendly, early negative experiences impacting relationships ongoing, as well as ageism, transphobia, homophobia, minority stress, historical context of when they were born, and current political backsliding. Suggestions of solutions include more: training, research, program funding, cultural competency, community supports, intergenerational connections, public education, and larger systemic changes are needed.

Conclusions and Implications: Findings from this study point to LGBTQ+ adults being vulnerable and invisible in our current health care system due to many systemic challenges. Implications from these findings suggest that more partnered advocacy is needed on a larger scale to support better health and community connection.