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LGBT – Health Disparities Impacting LTC

Many LGBT individuals experience health disparities throughout their lives. While health issues in anyone’s younger years may lead to the need for long-term care later in life, limited research shows that health disparities can have a major impact on some LGBT individuals, and this should be taken into account in planning for future long-term care needs. Below are categories of disparities and our current understanding of how they impact LGBT individuals.

Barriers to Health Care Access

LGBT Adults are:

  • Less likely to have health insurance coverage
  • More likely to delay or not seek medical care
  • Facing barriers to access as older adults due to isolation and a lack of culturally competent providers. One study found 13% of older LGBT adults were denied or provided inferior health care.
  • More likely to delay or not get needed prescription medications
  • More likely to receive health care services in emergency rooms
  • Fail to receive screenings, diagnoses and treatment for important medical problems. 22% of LGBT older adults do not reveal sexual orientation to physicians. In some states health care providers can decline to treat or provide certain necessary treatments to individuals based on their sexual orientation or gender identity.
  • Particularly distressed in nursing homes. One study indicates elderly LGBT adults face distress from potentially hostile staff and fellow residents, denial of visits from partners and family of choice, and refusal to allow same-sex partners to room together

Negative Impact on Physical and Mental Health and Well-Being

Societal biases are taking a toll on LGBT adults. They are:

  • Less likely to report having good health than their heterosexual counterparts
  • More likely to have cancer
  • More likely to suffer psychological distress
  • More likely to require medication for emotional health issues
  • Lesbian and bisexual women are less likely to receive mammograms and are more likely to be overweight or obese.
  • 41% of LGBT adults age 50 + have a disability
  • Transgender adults are much more likely to have suicide ideation

More Likely to Engage in Risky Behavior

  • LGBT adults are more likely to have problems with alcoholism
  • Older lesbians are significantly more likely to engage in heavy drinking
  • LGBT adults are more likely to smoke cigarettes
  • Gay men are at higher risk of HIV and other STDs, especially among communities of color

Research also indicates that if you live alone, you’re more likely to need paid care than if you’re married or single and living with a partner. Important implication for LGBT individuals:  data shows that people living alone are more likely to need paid long-term assistance. Planning is particularly important for such individuals.