While many LGBT older people engage in health behaviors that promote good health, research also shows that many LGBT older people engage disproportionately in behaviors that put them at risk, such as smoking, excessive drinking and non-prescribed drug use. In addition, many LGBT elders delay care out of fear of discrimination from health providers, which means that illnesses go undetected until crisis hits. And more broadly, a general lack of data collection and research on LGBT elder health issues has left the field without the information they need to develop effective interventions that address LGBT older people's unique health realities.
Health disparities among LGBT older people. According to a 2011 national study on LGBT older adults, high percentages of LGBT older people struggle with health conditions such as obesity, high blood pressure, cholesterol, arthritis, cataracts, asthma, cardiovascular disease, diabetes and more. Nineteen percent of LGBT elders reported having had at least one type of cancer. Read the full report. ▶
LGBT elders also deal disproportionately with mental health concerns, which is a primary risk factor for social isolation. According to a 2011 national health study, more than half of the respondents have been told by a doctor that they have depression; 39 percent have seriously thought of suicide; and 53 percent feel isolated from others.
Research shows that LGBT elders engage in health behaviors that both promote good health and put them at risk. According to The Aging and Health Report: "The majority of LGBT older adults in the project are sexually active and most engage in moderate exercise, wellness activities, and participate in health screenings. Yet, some report high-risk health behaviors such as smoking, excessive drinking and non-prescribed drug use. Especially at high risk are those age 50 – 64. Their rates of smoking, excessive drinking, non-prescribed drug use, and HIV risk behaviors are significantly higher than those age 65 and older." Read SAGE's resources on diabetes, falls prevention, heart disease and HIV/AIDS.
A lack of cultural competence regarding transgender people and their health needs, as well as bias and outright discrimination by providers, create serious barriers. These barriers, together with financial barriers, mean that many transgender older adults often avoid or delay seeking care. In addition, medically necessary care related to gender transition is often arbitrarily excluded from public and private insurance. Inability to access this care can contribute to declining health, and these exclusions are often also used to deny coverage for preventive and other medical care transgender older adults need. Read more on transgender health issues. ▶
Improving data collection in both federal surveys and patient intake processes helps further our knowledge about health disparities among LGBT older people. The federal government advises health providers to collect information on sexual orientation and gender identity/transgender status to improve care for LGBT clients, as well as to further our understanding on the nature of health disparities among LGBT people across the age span. According to Healthy People 2020, a comprehensive, national 10-year health plan from the US Department of Health and Human Services (HHS), one of the noteworthy efforts to improve LGBT health is "[a]ppropriately inquiring about and being supportive of a patient's sexual orientation to enhance the patient-provider interaction and regular use of care." Additionally, HHS has begun taking steps to collect this information, as encouraged by Section 4302 of the Affordable Care Act, while the Institute of Medicine's 2011 report on the state of LGBT health firmly recommends that such data be collected in federally funded surveys and in electronic health records.
To learn more about SAGE's work on health and health care issues please contact Aaron Tax, Director of Federal Government Relations, SAGE, at 212-741-2247 or at firstname.lastname@example.org.