By: Monica Kao
The existence of health disparities in certain vulnerable populations–as identified by race/ethnicity, age, gender, disability status, geography, and socioeconomic status, among others–is well-documented in the United States; however, the health inequities affecting those who identify as being gay, lesbian, or bisexual are often overlooked. A research study conducted by the UCLA Center for Health Policy Research was recently highlighted in the New York Times [Disparities: Illness More Prevalent Among Older Gay Adults] and places a special emphasis on the aging gay population. The findings of the study reveal that aging LGB adults exhibit higher rates of chronic physical and mental health conditions than their heterosexual counterparts, of hypertension, diabetes, physical disability, and poor mental health. They are also more likely to report psychological stress and to assess their own health status as being fair or poor. And although the people who make up the aging LGB community are more likely to be male, less likely to be members of a racial/ethnic minority, more likely to have received a higher education, and more likely to earn a higher income (in other words, they possess more characteristics that typically have been associated with better health status) than those making up the aging heterosexual population, they are no more likely to be insured.
The research suggests that, as is the case with other minorities, LGB adults face unique challenges that impact their health. Gay/bisexual men and women are less likely to be married and/or living with a partner than their heterosexual counterparts. As individuals age, support from biological kin or other family members becomes increasingly important for maintaining independence and health, and without the additional family structure afforded by having a partner and children, gay/bisexual men and women may be more prone to poor health. Furthermore, same-sex partnerships are generally not recognized by the Medicaid and Social Security programs, disqualifying many LGB adults from receiving full benefits and therefore restricting their access to medical care. Prior studies have also shown that the lesbian, gay and bisexual populations are subject to greater social stresses, oftentimes rooted in discrimination and social stigma. This, especially in combination with the differences in family structure, has contributed to higher rates of mental health distress in LGB adults relative to the general population.
The number of aging gay, lesbian and bisexual adults in the United States is expected to continue to rise in the coming years, and it will become increasingly important for policymakers to acknowledge the accompanying surge in chronic conditions and to decide how best to prepare. What will be the strategy to reduce health disparities in minority populations, even as their numbers increase? What are the specific factors contributing to poor health in certain populations and how might those be remediated? What social structures are in place to help close the gap? How might greater sensitivity and cultural competency be introduced so as to improve the quality of care for LGB adults? Policymakers would be wise to consider such questions and to anticipate the unique needs of the gay, lesbian and bisexual populations when reflecting upon the future health status of the United STates.