School of Health Sciences, University of Brighton, Brighton, UK.
Centre for Transforming Sexuality and Gender, University of Brighton, Brighton, UK.
Eur J Public Health. 2019 Oct 1;29(5):974-980. doi: 10.1093/eurpub/cky226.
BACKGROUND: Lesbian, gay, bisexual, trans and intersex (LGBTI) people experience significant health inequalities. Located within a European Commission funded pilot project, this paper presents a review of the health inequalities faced by LGBTI people and the barriers health professionals encounter when providing care. METHODS: A narrative synthesis of 57 papers including systematic reviews, narrative reviews, meta-analyses and primary research. Literature was searched in Cochrane, Campbell Collaboration, Web of Science, CINAHL, PsychINFO and Medline. The review was undertaken to promote understanding of the causes and range of inequalities, as well as how to reduce inequalities. RESULTS: LGBTI people are more likely to experience health inequalities due to heteronormativity or heterosexism, minority stress, experiences of victimization and discrimination, compounded by stigma. Inequalities pertaining to LGBTI health(care) vary depending on gender, age, income and disability as well as between LGBTI groupings. Gaps in the literature remain around how these factors intersect to influence health, with further large-scale research needed particularly regarding trans and intersex people. CONCLUSION: Health inequalities can be addressed via changes in policy, research and in practice through health services that accommodate the needs of LGBTI people. With improved training to address gaps in their knowledge of LGBTI health and healthcare, health professionals should work in collaboration with LGBTI people to address a range of barriers that prevent access to care. Through structural change combined with increased knowledge and understanding, services can potentially become more inclusive and equally accessible to all.
背景:女同性恋、男同性恋、双性恋、跨性别和间性人(LGBTI)群体经历着显著的健康不平等。本文是在欧盟委员会资助的试点项目中,对 LGBTI 群体面临的健康不平等问题以及卫生专业人员在提供护理时遇到的障碍进行的综述。
方法:对包括系统评价、叙述性综述、荟萃分析和原始研究在内的 57 篇论文进行了叙述性综合。文献检索于 Cochrane、 Campbell 协作、 Web of Science、 CINAHL、 PsychINFO 和 Medline。该综述旨在促进对不平等原因和范围的理解,以及如何减少不平等。
结果:由于异性恋规范或异性恋主义、少数群体压力、受害和歧视经历,再加上污名化,LGBTI 群体更有可能经历健康不平等。LGBTI 健康(护理)方面的不平等取决于性别、年龄、收入和残疾,以及 LGBTI 群体的不同。关于这些因素如何相互作用影响健康的文献仍存在差距,特别是需要对跨性别和间性人进行大规模研究。
结论:可以通过政策、研究和实践方面的改变来解决健康不平等问题,使卫生服务适应 LGBTI 人群的需求。通过改善对 LGBTI 健康和医疗保健知识的培训,卫生专业人员应与 LGBTI 人群合作,解决一系列阻碍获得护理的障碍。通过结构性变革和增加知识和理解,服务可以潜在地变得更加包容,让所有人都能平等地获得服务。
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