Social determinants of health in lesbian, gay, bisexual, transgender, queer, and other sexual and gender minority (LGBTQ+) older adults: Impact of socioeconomic disadvantage on inpatient hospitalizations.

Little is known about the impact of socioeconomic disadvantage on lesbian, gay, bisexual, transgender, queer, and other sexual and gender minority (LGBTQ+) older adults (≥50 years). The aim of this study is to determine whether the distribution of LGBTQ+ inpatient hospitalizations are related to structural socioeconomic factors.A secondary analysis of retrospective electronic health record data for LGBTQ+ older adults hospitalized from 2018 to 2022 was conducted at one large health system. The average county area deprivation index where the patient resided was calculated.The analysis included 2270 LGBTQ+ older adult inpatient hospitalizations, with 1508 (66.4%) from low socioeconomic disadvantage, 595 (26.3%) from moderate socioeconomic disadvantage; and 17 (7.4%) from high socioeconomic disadvantage counties (p < .0001). LGBTQ+ older adults who resided in moderate and high socioeconomic disadvantaged counties had a significant proportion of patients identifying as asexual (a posteriori contrasts, p < .05) compared to the low socioeconomic disadvantaged group. Those from moderate socioeconomic disadvantaged counties had a significantly higher proportion of patients identifying as bisexual (a posteriori contrasts, p < .05) compared to the high socioeconomic disadvantaged group.This analysis highlights socioeconomic disadvantage of LGBTQ+ older adults who utilized one large health system. More work needs to be done to understand use of the hospital system by LGBTQ+ older adults in moderate to high socioeconomic disadvantaged areas.

Duke Scholars

Author Devon Noonan School of Nursing

Author Susan Gray Silva School of Nursing