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Association of Affirming Care with Chronic Disease and Preventative Care Outcomes among Lesbian, Gay, Bisexual, Transgender, and Queer Older Adults

  • Tara McKay
    Correspondence
    Address correspondence to: Tara McKay, PhD, Department of Medicine, Health, and Society, Vanderbilt University, 2301 Vanderbilt Place, PMB 351665, Nashville TN 37235-1665.
    Affiliations
    Department of Medicine, Health, and Society, Vanderbilt University, Nashville, Tennessee

    Department of Health Policy, Vanderbilt University, Nashville, Tennessee

    Vanderbilt LGBT+ Policy Lab, Vanderbilt University, Nashville, Tennessee.
    Search for articles by this author
  • Nathaniel M. Tran
    Affiliations
    Department of Health Policy, Vanderbilt University, Nashville, Tennessee

    Vanderbilt LGBT+ Policy Lab, Vanderbilt University, Nashville, Tennessee.
    Search for articles by this author
  • Harry Barbee
    Affiliations
    Department of Medicine, Health, and Society, Vanderbilt University, Nashville, Tennessee

    Vanderbilt LGBT+ Policy Lab, Vanderbilt University, Nashville, Tennessee.
    Search for articles by this author
  • Judy K. Min
    Affiliations
    Department of Medicine, Health, and Society, Vanderbilt University, Nashville, Tennessee
    Search for articles by this author
Published:November 29, 2022DOI:https://doi.org/10.1016/j.amepre.2022.09.025

      Introduction

      Experiences of discrimination and bias in healthcare contribute to health disparities for lesbian, gay, bisexual, transgender, and queer populations. To avoid discrimination, many go to great lengths to find healthcare providers who they trust and who are knowledgeable about their health needs. This study examines whether access to an affirming provider improves health outcomes for lesbian, gay, bisexual, transgender, and queer populations across a range of preventive health and chronic disease management outcomes.

      Methods

      This cross-sectional study uses Poisson regression models to examine original survey data (n=1,120) from Wave 1 of the Vanderbilt University Social Networks, Aging, and Policy Study, a panel study examining older (aged 50–76 years) lesbian, gay, bisexual, transgender, and queer adults’ health and aging, collected between April 2020 and September 2021.

      Results

      Overall, access to an affirming provider is associated with greater uptake of preventive health screenings and improved management of mental health conditions. Participants with an affirming provider are more likely to have ever and recently received several types of preventive care than participants reporting a usual source of care that is not affirming, including past year provider visit, influenza vaccination, colorectal cancer screening, and HIV test. Access to an affirming provider is also associated with better management of mental health conditions.

      Conclusions

      Inclusive care is essential for reducing health disparities among lesbian, gay, bisexual, transgender, and queer populations. Health systems can reduce disparities by expanding continuing education opportunities; adopting nondiscrimination policies for patients and employees; and ensuring that necessary care is covered by health insurance.
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