Fredriksen-Goldsen Karen I, Bryan Amanda E B, Jen Sarah, Goldsen Jayn, Kim Hyun-Jun, Muraco Anna
School of Social Work, University of Washington, Seattle.
Department of Sociology, Loyola Marymount University, Los Angeles, California.
Gerontologist. 2017 Feb;57(suppl 1):S15-S29. doi: 10.1093/geront/gnw185.
Life events are associated with the health and well-being of older adults. Using the Health Equity Promotion Model, this article explores historical and environmental context as it frames life experiences and adaptation of lesbian, gay, bisexual, and transgender (LGBT) older adults.
This was the largest study to date of LGBT older adults to identify life events related to identity development, work, and kin relationships and their associations with health and quality of life (QOL). Using latent profile analysis (LPA), clusters of life events were identified and associations between life event clusters were tested.
On average, LGBT older adults first disclosed their identities in their 20s; many experienced job-related discrimination. More had been in opposite-sex marriage than in same-sex marriage. Four clusters emerged: "Retired Survivors" were the oldest and one of the most prevalent groups; "Midlife Bloomers" first disclosed their LGBT identities in mid-40s, on average; "Beleaguered At-Risk" had high rates of job-related discrimination and few social resources; and "Visibly Resourced" had a high degree of identity visibility and were socially and economically advantaged. Clusters differed significantly in mental and physical health and QOL, with the Visibly Resourced faring best and Beleaguered At-Risk faring worst on most indicators; Retired Survivors and Midlife Bloomers showed similar health and QOL.
Historical and environmental contexts frame normative and non-normative life events. Future research will benefit from the use of longitudinal data and an assessment of timing and sequencing of key life events in the lives of LGBT older adults.
生活事件与老年人的健康和幸福相关。本文运用健康公平促进模型,探讨历史和环境背景如何塑造女同性恋、男同性恋、双性恋和跨性别(LGBT)老年人的生活经历及适应情况。
这是迄今为止关于LGBT老年人的最大规模研究,旨在确定与身份发展、工作和亲属关系相关的生活事件及其与健康和生活质量(QOL)的关联。使用潜在剖面分析(LPA)确定生活事件簇,并测试生活事件簇之间的关联。
LGBT老年人平均在20多岁时首次公开自己的身份;许多人经历过与工作相关的歧视。异性婚姻的人数多于同性婚姻。出现了四个簇:“退休幸存者”是年龄最大且最普遍的群体之一;“中年绽放者”平均在40多岁时首次公开其LGBT身份;“困境高危者”与工作相关的歧视率高且社会资源少;“资源丰富显见者”具有高度的身份可见性,在社会和经济上具有优势。各簇在心理健康、身体健康和生活质量方面存在显著差异,在大多数指标上,资源丰富显见者情况最好,困境高危者情况最差;退休幸存者和中年绽放者的健康和生活质量相似。
历史和环境背景塑造了规范和非规范的生活事件。未来的研究将受益于纵向数据的使用以及对LGBT老年人生活中关键生活事件的时间和顺序的评估。