Social and Behavioural Health Sciences Division, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
Faculty of Health Science, Simon Fraser University, Burnaby, Canada.
Health Promot Int. 2022 Feb 17;37(1). doi: 10.1093/heapro/daab057.
Two-spirit, lesbian, gay, bisexual and transgender (2SLGBTQ+) people are disproportionately represented among those experiencing poverty. Both 2SLGBTQ+ people and people experiencing poverty face poorer health outcomes and greater difficulty accessing healthcare. Evidence of intersectional impacts of 2SLGBTQ+ status and poverty on health can help to inform economic and health policy. The objective of this review is to determine what is known about the health of 2SLGBTQ+ people in Canada experiencing poverty. Following the PRISMA framework, we searched and summarized Canadian literature on 2SLGBTQ+ poverty indexed in Medline, Sociological Abstracts, PsycInfo and EconList (N = 33). 2SLGBTQ+ poverty-related literature remains sparse but is expanding as illustrated by the fact that most (31/33) studies were published in the past decade. Half the studies analysed poverty as a focal variable and half as a covariate. Intersectionality theory assists in understanding the three health-related themes identified-healthcare access, physical health and mental health and substance use-as these outcomes are shaped by intersecting social structures that result in unique forms of discrimination. Those at the intersection of poverty and 2SLGBTQ+ status face poorer health outcomes than other 2SLGBTQ+ people in Canada. Discrimination was an overarching finding that explained persistent associations between 2SLGBTQ+ status, poverty and health. Research that directly interrogated the experiences of 2SLGBTQ+ populations experiencing poverty was sparse. In particular, there is a need to conduct research on underrepresented 2SLGBTQ+ sub-groups who are disproportionately impacted by poverty, including transgender, bisexual and two-spirit populations.
双性恋、女同性恋、男同性恋、双性人和跨性别者(2SLGBTQ+)在贫困人群中所占比例不成比例。2SLGBTQ+人群和贫困人口的健康状况都较差,获得医疗保健的机会也较少。2SLGBTQ+状况和贫困对健康的交叉影响的证据可以帮助为经济和卫生政策提供信息。本综述的目的是确定在加拿大,了解处于贫困中的 2SLGBTQ+人群的健康状况。我们遵循 PRISMA 框架,在 Medline、Sociological Abstracts、PsycInfo 和 EconList 中搜索并总结了加拿大有关 2SLGBTQ+贫困问题的文献(N=33)。2SLGBTQ+贫困相关文献仍然很少,但正如大多数(31/33)研究是在过去十年中发表的这一事实所表明的那样,其正在不断扩展。一半的研究将贫困作为焦点变量进行分析,另一半则作为协变量进行分析。交叉性理论有助于理解确定的三个与健康相关的主题-医疗保健获取、身体健康和心理健康和物质使用-这些结果是由交叉的社会结构形成的,这些结构导致了独特形式的歧视。那些处于贫困和 2SLGBTQ+状态交叉点的人比加拿大其他 2SLGBTQ+人群的健康状况更差。歧视是一个普遍的发现,它解释了 2SLGBTQ+地位、贫困和健康之间持续存在的关联。直接询问处于贫困中的 2SLGBTQ+人群的经验的研究很少。特别是,需要对那些因贫困而受到不成比例影响的代表性不足的 2SLGBTQ+亚群体进行研究,包括跨性别者、双性恋者和双灵人。
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