Abstract
Purpose: To compare chronic health and mental health conditions between mid-to-older deaf lesbian, gay, bisexual, transgender, and queer (LGBTQ) and mid-to-older non-LGBTQ adults who are 45 years or older.Methods: Medical conditions and mental health disorders data were gathered from 981 mid-to-older deaf adults (178 LGBTQ and 803 non-LGBTQ) who took the Health Information National Trends Survey in American Sign Language between 2015 and 2019. Modified Poisson regression with robust standard errors was used to calculate relative risk estimates and 95% confidence intervals for all medical conditions and mental health disorders with self-reported LGBTQ status as the main predictor, adjusting for known health correlates.Results: Consistent with the LGBTQ health disparity in the general population, our study findings indicated health disparities for certain medical conditions (e.g., lung disease, arthritis, and comorbidity) and mental health disorders (e.g., depression and anxiety) among mid-to-older deaf LGBTQ compared with non-LGBTQ deaf adults.Conclusion: Like the LGBTQ counterparts in the general population, deaf LGBTQ adults may require more frequent and comprehensive health care services. Culturally and linguistically competent care by providers may be invaluable in reducing such health inequities, particularly when provider education and training is undertaken through an intersectional framework that considers the interaction and context of multiple patient and provider social identities.
Highlights
The U.S Healthy People initiative includes plans to reduce health disparities among lesbian, gay, bisexual, transgender, and queer (LGBTQ) individuals by the end of 2030.1 no research has examined health disparities among sexual and gender minority individuals within the deaf and hard of hearing community, there are reports of health disparity between LGBTQ and non-LGBTQ individuals in the general population.[2,3]
This study found that Deaf LGBTQ patients’ willingness or hesitation to disclose sexual orientation and/or gender identities (SOGIs) was significantly associated with their perceptions of providers’ patient–centered communication behavior
While no census data are available on the number of older Americans identifying as LGBTQ, estimates have suggested their number lies in the range of 1.75 to 4 million adults.[18]
Summary
The U.S Healthy People initiative includes plans to reduce health disparities among lesbian, gay, bisexual, transgender, and queer (LGBTQ) individuals by the end of 2030.1 no research has examined health disparities among sexual and gender minority individuals within the deaf and hard of hearing community (termed as ‘‘Deaf’’ to reflect a linguistic minority group), there are reports of health disparity between LGBTQ and non-LGBTQ individuals in the general population.[2,3]. Many Deaf adults who use American Sign Language (ASL) experience barriers to accessing health information and health care, which places them at health knowledge disparity compared with the predominantly hearing, primarily English-speaking population.[4,5,6,7] Nonconcordant patient–physician communication, inaccessible health information, and few qualified sign language interpreters in health care settings are among the barriers encountered by this medically underserved group. The authors attributed this racial disparity to the underdiagnosis of hypertension in African American Deaf patients due to possible nonconcordant patient–physician communication and mistrust between such patients and their providers
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