By Mark Brennan-Ing, PhD (Director for Research and Evaluation at ACRIA, Center on HIV and Aging )
When we talk about fully including lesbian, gay, bisexual and transgender (LGBT) individuals in society, marriage equality and broader civil rights protections dominate our discourse. However, equally important are the numerous health disparities they experience in later life compared to heterosexuals. Older LGBT adults are not a small population. In 2015, the U.S. Administration for Community Living estimated that there were 1.8 to 4.0 million LGBT adults age 60 and older. A number that will grow to 7 million by 2030.
Healthy People 2020, a report by the Institute of Medicine (IOM, 2011) and the National Institutes of Health (NIH), identified addressing the health status of LGBT individuals, including older adults, as a priority. Healthy People 2020 and the IOM both note that the lack of representative, population-based data to inform policy and programs targeted at older LGBT adults hampers this goal. Most available evidence derives from studies using convenience samples, so the true extent of health disparities among this community is unknown.
With this caveat in mind, here is what existing research tells us about health disparities among older LGBT adults compared to heterosexuals:
Older gay and bisexual men and transgender women are disproportionately affected by HIV, accounting for the majority of people over age 50 with HIV/AIDS (CDC, 2013)
Higher rates of tobacco use, disability and poorer self-reported health are reported by older LGBT individuals (Fredriksen-Goldsen et al., 2011; Wallace et al., 2011)
There are higher obesity rates for older lesbian and bisexual women (Fredriksen-Goldsen et al., 2011)
Older LGBT adults report increased levels of depressive symptoms, alcohol consumption, and use of other substances (Fredriksen-Goldsen et al., 2011)To address this knowledge gap, the National Institute on Aging, part of NIH, approved funding to Dr. Karen Fredriksen-Goldsen at the University of Washington in 2015 to study health disparities in older LGBT adults. Her multiyear study is entitled, “Aging with Pride: The National Health, Aging, Sexuality and Gender Study.” This community participatory and integrated project is also being supported by NIH supplement awards, along with foundation, private and other governmental support.
To address this knowledge gap, the National Institute on Aging, part of NIH, approved funding to Dr. Karen Fredriksen-Goldsen at the University of Washington in 2015 to study health disparities in older LGBT adults. Her multiyear study is entitled, “Aging with Pride: The National Health, Aging, Sexuality and Gender Study.” This community participatory and integrated project is also being supported by NIH supplement awards, along with foundation, private and other governmental support.
This research builds and extends upon Fredriksen-Goldsen’s earlier seminal study, “Caring and Aging with Pride (CAP)” (2011), one of the first large-scale studies of older LGBT aging and health. With a 96% retention rate from the original CAP study, the new effort will follow 2,450 LGBT adults, ages 50 and older, to assess aging and health trajectories over time, and the sample is stratified by age cohort, gender and race/ethnicity. [Disclaimer: I was/am a research participant in both of these studies]. Total funding for the study amounts to approximately $3,062,530.
Fredriksen-Goldsen’s study will also examine barriers to health care in the special context of LGBT aging. It is understandable that after facing a lifetime of discrimination and marginalization that many LGBT older adults distrust the mainstream institutions and service providers that most heterosexual older adults count on as resources for growing older. The vital data that Fredriksen-Goldsen and colleagues produce will be an important tool for reducing health disparities in older LGBT adults, by helping them to lead fuller and healthier lives and achieve greater equality in our society.
Fredriksen-Goldsen, K. I., Kim, H. J., Emlet, C. A., Muraco, A., & Erosheva, E. (2011). The aging and health report: Disparities and resilience among lesbian, gay, bisexual, and transgender older adults. Seattle: Institutional for Multigenerational Health.
Wallace, S. P., Cochran, S. D., Durazo, E. M., & Ford, C. L. (2011). The health of aging lesbian, gay and bisexual adults in California. Los Angeles, CA: UCLA Center for Health Policy Research.
Mark Brennan-Ing, PhD is the Director for Research and Evaluation at ACRIA, Center on HIV and Aging and an Adjunct Assistant Professor at the New York University College of Nursing. He is the 2016 Chair of the APA Committee on Sexual Orientation and Gender Diversity.
For more on this topic, check out APA’s resource page on LGBT Aging.
Image source: Flickr user Jose Antonio Navas via Creative Commons