Abstract
BackgroundOlder lesbian, gay, and bisexual (LGB) adults are an underserved and understudied population that experience specific health disparities. The intersection of aging and chronic medical disease with a higher risk for substance use and mental illness may place older LGB adults at risk for co-occurring conditions and resulting comorbidity. Understanding multimorbidity among older LGB adults may help inform interventions to reduce disparities in health outcomes.MethodsData come from the 2015 to 2017 National Surveys on Drug Use and Health (n = 25,880). We first determined whether sexual orientation was associated with reporting: past-year drug use, mental illness, and/or 2 or more chronic medical diseases. We then determined whether sexual orientation was associated with reporting co-occurrence of these conditions. This was done using multivariable logistic regression. Analyses were stratified by gender.ResultsCompared to heterosexual men, gay men were at increased odds for reporting 2 or more chronic medical diseases (adjusted odds ratio [aOR] = 2.18, 95% confidence interval [CI] = 1.48, 3.21), and gay (aOR = 1.79, 95% CI = 1.09, 2.93) and bisexual men (aOR = 3.53, 95% CI = 2.03, 6.14) were at increased odds for reporting mental illness. Gay men (aOR = 2.95, 95CI = 1.60, 5.49) and bisexual men (aOR = 2.84, 95% CI = 1.58, 5.08) were at increased odds of reporting co-occurring conditions. Compared to heterosexual women, bisexual women were at increased odds for past-year drug use (aOR = 4.20, 95% CI = 2.55, 6.93), reporting mental illness (aOR = 1.94, 95% CI = 1.03, 3.67), and reporting co-occurring conditions (aOR = 3.25, 95% = 1.60, 6.62).ConclusionsMiddle-aged and older LGB adults in the United States are at high risk for experiencing co-occurring drug use, mental illness, and/or medical multimorbidity. Interventions for older sexual minority populations are needed to reduce disparities.
Highlights
Older lesbian, gay, and bisexual (LGB) adults are an underserved and understudied population that experience specific health disparities
One study examining data from the 2013–2014 National Health Interview Survey (NHIS) found that among adults age ≥ 50 who identify as lesbian, gay, or bisexual (LGB), older lesbian or bisexual women were more likely to have more chronic diseases while older gay or bisexual men were more likely to have angina pectoris or cancer, and disability was higher among LGB older adults for both identities compared to older heterosexuals [3]
We considered past-year selfreported use of cannabis, any other illegal drug use, and misuse of prescription pain-relievers and tranquilizers
Summary
Gay, and bisexual (LGB) adults are an underserved and understudied population that experience specific health disparities. The intersection of aging and chronic medical disease with a higher risk for substance use and mental illness may place older LGB adults at risk for co-occurring conditions and resulting comorbidity. Existing research demonstrates sexual minority disparities in mental illness, drug use (including substance use disorders [SUDs]), chronic health conditions, and healthrelated behaviors among adults [1,2,3,4,5,6]. Other studies have shown higher rates of anxiety, depression, illicit opioid use, prescription tranquilizer misuse, and SUDs among middle-aged and older LGBT adults [9, 11, 12]
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