EPPI-Centre, UCL Institute of Education, University College London, UK.
School of Medicine, Cardiff University, UK.
J Gerontol B Psychol Sci Soc Sci. 2020 Sep 14;75(8):1758-1771. doi: 10.1093/geronb/gbaa071.
Modeling the health and care trajectories of lesbian, gay, and bisexual (LGB) is essential to identify inequalities and support needs, yet because of the small sample of LGB people in any one survey, current evidence relies on studies that have poor generalizability and low power. This study assesses the magnitude of health inequalities among older LGB people across 10 outcomes, informed by evidence on the health trajectories and distinct LGB history of the United Kingdom.
A systematic review was conducted of representative data sources on older LGB and heterosexual people's health and care status in the United Kingdom. Individual Participant Data (IPD) meta-analysis was employed to synthesize data from up to 25 different sources. To account for the intricacies of individual data sets, the analysis employed a two-stage approach where an odds ratio and standard error was calculated for each data set individually, before being meta-analyzed through DerSimonian and Laird random effects models.
Among men aged 50+, being gay, bisexual, or having another nonheterosexual orientation is associated with an increased risk of reporting long-term illness and health-related limitations. Indicators of mental health also suggest that gay and bisexual men are more likely to report low life satisfaction and to have attempted suicide over their life time. Among women, differences are apparent with regards to self-rated health as well as with engagement with risky health behaviors.
The findings corroborate the minority stress theory, but they also generate new questions for researchers around when and how these inequalities emerge.
对女同性恋、男同性恋和双性恋（LGB）的健康和护理轨迹进行建模，对于确定不平等和支持需求至关重要，但由于任何一项调查中 LGB 人群的样本量都很小，因此目前的证据依赖于那些通用性差、效力低的研究。本研究评估了 10 项结果中，英国 LGB 老年人健康不平等的程度，这些结果是基于 LGB 人群健康轨迹和独特历史的证据。
对英国 LGB 和异性恋老年人健康和护理状况的代表性数据来源进行了系统回顾。采用个体参与者数据（IPD）荟萃分析来综合多达 25 个不同来源的数据。为了说明个体数据集的复杂性，该分析采用了两阶段方法，首先为每个数据集单独计算比值比和标准误差，然后通过 DerSimonian 和 Laird 随机效应模型进行荟萃分析。
在 50 岁以上的男性中，同性恋、双性恋或其他非异性恋倾向与报告长期患病和与健康相关的限制的风险增加有关。心理健康指标还表明，男同性恋和双性恋男性更有可能报告生活满意度低，并在其一生中试图自杀。对于女性，在自我报告的健康状况以及参与危险健康行为方面，存在差异。
这些发现证实了少数群体应激理论，但也为研究人员提出了新的问题，即这些不平等现象何时以及如何出现。
