May Jennifer T, Noonan Devon, Silva Susan G
Department of Biobehavioral Health & Nursing Science, College of Nursing, University of South Carolina, Columbia, South Carolina, United States of America.
School of Nursing, Duke University, Durham, North Carolina, United States of America.
PLoS One. 2025 Sep 3;20(9):e0330612. doi: 10.1371/journal.pone.0330612. eCollection 2025.
Little is known about the impact of socioeconomic disadvantage on lesbian, gay, bisexual, transgender, queer, and other sexual and gender minority (LGBTQ+) older adults (≥50 years). The aim of this study is to determine whether the distribution of LGBTQ+ inpatient hospitalizations are related to structural socioeconomic factors.
A secondary analysis of retrospective electronic health record data for LGBTQ+ older adults hospitalized from 2018 to 2022 was conducted at one large health system. The average county area deprivation index where the patient resided was calculated.
The analysis included 2270 LGBTQ+ older adult inpatient hospitalizations, with 1508 (66.4%) from low socioeconomic disadvantage, 595 (26.3%) from moderate socioeconomic disadvantage; and 17 (7.4%) from high socioeconomic disadvantage counties (p < .0001). LGBTQ+ older adults who resided in moderate and high socioeconomic disadvantaged counties had a significant proportion of patients identifying as asexual (a posteriori contrasts, p < .05) compared to the low socioeconomic disadvantaged group. Those from moderate socioeconomic disadvantaged counties had a significantly higher proportion of patients identifying as bisexual (a posteriori contrasts, p < .05) compared to the high socioeconomic disadvantaged group.
This analysis highlights socioeconomic disadvantage of LGBTQ+ older adults who utilized one large health system. More work needs to be done to understand use of the hospital system by LGBTQ+ older adults in moderate to high socioeconomic disadvantaged areas.
关于社会经济劣势对女同性恋、男同性恋、双性恋、跨性别者、酷儿及其他性取向和性别少数群体（LGBTQ+）的老年人（≥50岁）的影响，我们知之甚少。本研究的目的是确定LGBTQ+住院患者的分布是否与结构性社会经济因素有关。
在一个大型医疗系统中，对2018年至2022年住院的LGBTQ+老年人的回顾性电子健康记录数据进行了二次分析。计算了患者居住县的平均地区贫困指数。
分析包括2270例LGBTQ+老年住院患者，其中1508例（66.4%）来自社会经济劣势低的地区，595例（26.3%）来自社会经济劣势中等的地区；17例（7.4%）来自社会经济劣势高的县（p <.0001）。与社会经济劣势低的群体相比，居住在社会经济劣势中等和高的县的LGBTQ+老年人中，有很大比例的患者认定为无性恋（事后对比，p <.05）。与社会经济劣势高的群体相比，来自社会经济劣势中等县的患者中认定为双性恋的比例显著更高（事后对比，p <.05）。
该分析突出了使用一个大型医疗系统的LGBTQ+老年人的社会经济劣势。需要开展更多工作来了解社会经济劣势中等至高的地区的LGBTQ+老年人对医院系统的使用情况。
