Disparities in Preventive Healthcare Utilization & Outcomes Among Sexual Minority and Heterosexual Older Adults

TL;DR

Older sexual minority adults show differences in preventive healthcare use and health outcomes compared to heterosexual peers, suggesting a need for targeted interventions.

Contribution

This study identifies disparities in preventive healthcare and health outcomes among older sexual minority adults using nationally representative data.

Findings

SMA were less likely to receive shingles vaccines and more likely to miss flu shots compared to heterosexual older adults.

SMA had higher rates of poor self-rated health, hypertension, diabetes, and cancer but lower arthritis prevalence.

No significant differences were observed in chronic pain, osteoporosis, or glaucoma between the groups.

Abstract

Research on health disparities among older sexual minority adults (SMA) remains limited. Evidence suggests SMA may have lower preventive healthcare utilization and poorer health outcomes than heterosexual peers, partly due to discomfort in medical settings. However, comprehensive studies outside HIV/AIDS and mental health remain scarce.

This study examines differences in health outcomes and healthcare utilization between SMA and heterosexual older adults using Health and Retirement Study (HRS) data.

Data from the 2018–2022 HRS surveys were analyzed to compare self-reported health, chronic conditions, and preventive healthcare utilization (e.g., vaccinations). Descriptive statistics and Pearson’s t-tests assessed group differences, with adjusted models planned.

The sample includes 463 SMA and 8,755 heterosexual older adults (mean age: 70, 60.6% female). SMA were significantly less likely to receive a shingles vaccine and more likely to have missed a flu shot (p < 0.05), with no differences in COVID-19 or pneumonia vaccinations. SMA had higher rates of poor self-rated health, hypertension, diabetes, and cancer (p < 0.05) but lower arthritis prevalence (p < 0.05). No differences were found in chronic pain, osteoporosis, or glaucoma.

SMA experience disparities in some preventive healthcare measures and health outcomes, though patterns vary. These findings highlight the need for targeted interventions and further research to understand underlying factors.