Sexual minority middle-aged and older adults are at high risk for having multiple chronic diseases

Older lesbian, gay, and bisexual (LGB) adults are an underserved and understudied population that experience specific health disparities. A study just published in BMC Public Health finds that gay men and bisexual women age 50 and older are at particularly high risk for having co-occurring conditions. Authors Joseph Palamar and Benjamin Han tell us more about their research findings.

Aging is a major risk factor for the majority of chronic diseases, which include diseases like cardiovascular disease, hypertension, and arthritis. More than half of older adults in the US have three or more chronic diseases. Having multiple chronic diseases can increase the chances for disability, hospitalization, and death.

Lesbian, gay, and bisexual (LGB) adults are an under-served population that experience health disparities often related to a lifetime of stressors such as stigma, discrimination, and oppression. As such, this is a population with many barriers to receiving patient-centered health care. With aging, middle-aged and older LGB adults are therefore likely to be at risk not only for medical diseases, but also other chronic conditions.

We found that gay men and bisexual women in particular, were at high risk for having two or more conditions.

To examine chronic diseases in this population, we used data from the US National Survey of Drug Use and Health to determine the extent of three chronic conditions: mental illness, unhealthy substance use, and having two or more medical diseases. We then looked at the presence of having more than one of these conditions among LGB adults age 50 and older. We found that gay men and bisexual women in particular, were at high risk for having two or more conditions.

These results highlight the complex health needs of this population. It is important to recognize that while medical and public health interventions usually focus on one condition, this is often not appropriate for older adults with multiple chronic diseases. A patient-centered coordinated approach is needed that considers how each condition is interrelated with other coexisting diseases. Unhealthy substance use and mental illness for example can complicate the management of chronic medical diseases and lead to poorer health outcomes.

The care of older adults, especially for communities that are under-served, such as sexual minority populations, needs to involve patient-centered care that considers all chronic diseases and how they may be related. For older LGB adults we also need a greater awareness of all possible forms of stigma related to people such as older individuals and those of sexual minority status, and we must understand how this may impact health.

The goal of our research is to not further stigmatize but to draw attention to the needs of older adults from communities who have been neglected and under-served so that they can receive better care through improved awareness of the multiple factors that affect health and well-being.


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