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美国50岁及以上女同性恋、男同性恋、双性恋、跨性别者和非二元性别成年人中的健康差异。

Health Disparities Among Lesbian, Gay, Bisexual, Transgender, and Nonbinary Adults 50 Years Old and Older in the United States.

作者信息

Pharr Jennifer R

机构信息

Department of Environmental and Occupational Health, School of Public Health, University of Nevada, Las Vegas, Las Vegas, Nevada, USA.

出版信息

LGBT Health. 2021 Oct;8(7):473-485. doi: 10.1089/lgbt.2021.0009. Epub 2021 Sep 17.

Abstract

The purpose of this study was to examine health disparities among LGBT and nonbinary adult subgroups of those 50 years old and older. This was a cross-sectional analysis of data from the 2019 Behavioral Risk Factor Surveillance System survey. Access to health care, disabilities, health risk and healthy behaviors, and general health and chronic diseases and conditions were compared between gay men, bisexual men, lesbian/gay women, bisexual women, transgender women, transgender men, and nonbinary adults 50 years old and older. Rao-Scott corrected chi-square tests were utilized to determine significant differences between subgroups using weighted data. Multiple comparisons adjusted values (Bonferroni) analyses were conducted when chi-square tests were significant. Health disparities were identified among subgroups of LGBT and nonbinary older adults, with those who identified as nonbinary or as transgender women being the most vulnerable. Older nonbinary adults, transgender women, and bisexual men were more likely to not have a personal doctor or to not have had a medical checkup in the past 2 years, and nonbinary older adults were more likely to report disabilities, poor mental and physical health, depression, and asthma. Public health professionals and health care providers can use this information to target interventions to specific groups. Subgroup analyses of LGBT and nonbinary adults who are 50 years old and older need to continue with a focus on the most vulnerable groups. In addition, more research is needed that disaggregates transgender and nonbinary older adults to identify the unique health concerns of each group.

摘要

本研究的目的是调查50岁及以上的女同性恋、男同性恋、双性恋和非二元性别成年亚组之间的健康差异。这是对2019年行为风险因素监测系统调查数据的横断面分析。比较了50岁及以上的男同性恋者、双性恋男性、女同性恋/男同性恋女性、双性恋女性、跨性别女性、跨性别男性和非二元性别成年人在获得医疗保健、残疾情况、健康风险和健康行为以及总体健康状况和慢性病及疾病方面的差异。使用加权数据,采用Rao-Scott校正卡方检验来确定亚组之间的显著差异。当卡方检验显著时,进行多重比较调整值(Bonferroni)分析。在女同性恋、男同性恋、双性恋和非二元性别老年亚组中发现了健康差异,其中那些被认定为非二元性别或跨性别女性的人最为脆弱。年龄较大的非二元性别成年人、跨性别女性和双性恋男性更有可能没有私人医生或在过去两年内没有进行过体检,并且年龄较大的非二元性别成年人更有可能报告有残疾、身心健康状况不佳、抑郁和哮喘。公共卫生专业人员和医疗保健提供者可以利用这些信息针对特定群体开展干预措施。需要继续对50岁及以上的女同性恋、男同性恋、双性恋和非二元性别成年人进行亚组分析,重点关注最脆弱的群体。此外,还需要更多研究对跨性别和非二元性别老年人进行分类,以确定每个群体独特的健康问题。

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