Department of Social and Behavioral Health Program, School of Public Health, University of Nevada, Las Vegas, Nevada, USA.
Department of Gerontology, University of Massachusetts, Boston, Massachusetts, USA.
Gerontologist. 2023 May 9;63(4):741-750. doi: 10.1093/geront/gnac137.
Research suggests lesbian, gay, bisexual, and transgender (LGBT) populations have unique health care challenges. The purpose of this study was to understand contextual factors, including minority stress and social resources, associated with the health care utilization of LGBT middle-aged and older adults.
Using data from the Caring and Aging With Pride: National Health, Aging, and Sexuality/Gender Study (N = 2,560), multiple logistic regression investigated associations between minority stress (i.e., internalized stigma and LGBT identity disclosure) and health care utilization (i.e., health screenings, emergency room use, routine checkups, and regular provider). We also examined the moderating effect of social resources (i.e., social network size, social support, and LGBT community belonging) in these associations.
Internalized stigma was negatively associated with having a routine checkup in the previous year. LGBT identity disclosure was positively associated with having a health screening within the past 3 years. Social support moderated the association between LGBT identity disclosure and health screenings.
Health and human service professionals and their clients should be educated about the ways that LGBT identity disclosure can affect health care utilization. Providers should consistently assess the social support of their aging LGBT clients and inform them about the potential risk of low social support in health care utilization.
研究表明,女同性恋、男同性恋、双性恋和跨性别者(LGBT)群体在医疗保健方面面临独特的挑战。本研究的目的是了解与 LGBT 中年和老年群体医疗保健利用相关的背景因素,包括少数群体压力和社会资源。
本研究使用了来自“自豪地关怀与衰老:全国健康、衰老和性/性别研究”(N = 2560)的数据,采用多项逻辑回归分析了少数群体压力(即内化的耻辱感和 LGBT 身份披露)与医疗保健利用(即健康筛查、急诊室使用、常规检查和定期就诊)之间的关联。我们还研究了社会资源(即社交网络规模、社会支持和 LGBT 社区归属感)在这些关联中的调节作用。
内化的耻辱感与过去一年定期体检呈负相关。LGBT 身份披露与过去 3 年内进行健康筛查呈正相关。社会支持调节了 LGBT 身份披露与健康筛查之间的关联。
医疗保健专业人员及其客户应该接受有关 LGBT 身份披露如何影响医疗保健利用的教育。提供者应定期评估其老年 LGBT 客户的社会支持情况,并告知他们社会支持低可能会对医疗保健利用产生的潜在风险。