Department of Health Research, Lancaster University, Lancashire LA1 4YW, UK.
The National LGB&T Partnership, Exeter EX4 6NA, UK.
Int J Environ Res Public Health. 2021 Jan 19;18(2):826. doi: 10.3390/ijerph18020826.
This scoping review of UK evidence aimed to describe what is known about Lesbian, Gay, Bisexual, and Trans (LGBT+) health inequalities in relation to cancer, mental health, and palliative care to inform research, policy and public health interventions. Using a scoping review methodology, we identified studies from database searches, citation tracking, and expert consultation. The in/exclusion criteria was based on the PICOS framework. The data were charted and then summarised to map the theoretical approaches and the main types of evidence and identify knowledge gaps. In total, 279 articles were screened and 83 were included in the final review. We found that there is limited UK research examining LGBT+ health inequality in cancer, mental health and palliative care. We would argue that this thin evidence base is partly due to national policy discussions of LGBT+ health inequality that are framed within a depoliticised 'it's getting better' narrative, and an unwillingness to adequately acknowledge the unjust social and economic relations that produce LGBT+ health inequality. In addition, LGBT+ health inequality is depoliticised by existing public health explanatory theories, models and frameworks that exclude sexual orientation and gender diversity as dimensions of power that interlock with those of socio-economic, race and ethnicity. This is a barrier to developing public health interventions that can successfully tackle LGBT+ health inequality.
本范围性综述旨在描述英国有关同性恋、双性恋、跨性别者（LGBT+）的癌症、心理健康和姑息治疗方面健康不平等的现有证据，以为研究、政策和公共卫生干预提供信息。我们使用范围性综述方法，从数据库搜索、引文追踪和专家咨询中确定了研究。纳入和排除标准基于 PICOS 框架。对数据进行图表分析，然后进行总结，以绘制理论方法和主要证据类型图，并确定知识空白。总共筛选了 279 篇文章，其中 83 篇被纳入最终综述。我们发现，英国在癌症、心理健康和姑息治疗方面针对 LGBT+健康不平等的研究有限。我们认为，这一薄弱的证据基础部分归因于全国性政策讨论将 LGBT+健康不平等问题框定为一种“情况正在改善”的非政治化叙事，以及不愿充分承认造成 LGBT+健康不平等的不公正社会和经济关系。此外，现有的公共卫生解释理论、模型和框架将性取向和性别多样性排除在权力维度之外，这些维度与社会经济、种族和族裔的权力维度相互交织，从而使 LGBT+健康不平等问题政治化。这是制定能够成功解决 LGBT+健康不平等问题的公共卫生干预措施的障碍。
