Who Says I Do: The Changing Context of Marriage and Health and Quality of Life for LGBT Older Adults

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Abstract

<div class="section"> <a class="named-anchor" id="d137692e203">  </a> <h5 class="section-title" id="d137692e204">Purpose of the Study:</h5> <p id="d137692e206">Until recently, lesbian, gay, bisexual, and transgender (LGBT) adults were excluded from full participation in civil marriage. The purpose of this study is to examine how legal marriage and relationship status are associated with health-promoting and at-risk factors, health, and quality of life of LGBT adults aged 50 and older. </p> </div><div class="section"> <a class="named-anchor" id="d137692e208">  </a> <h5 class="section-title" id="d137692e209">Design and Methods:</h5> <p id="d137692e211">We utilized weighted survey data from Aging with Pride: National Health, Aging, and Sexuality/Gender Study (NHAS) participants who resided in states with legalized same-sex marriage in 2014 ( <i>N</i> = 1,821). Multinomial logistic regression was conducted to examine differences by relationship status (legally married, unmarried partnered, single) in economic and social resources; LGBT contextual and identity factors; health; and quality of life. </p> </div><div class="section"> <a class="named-anchor" id="d137692e216">  </a> <h5 class="section-title" id="d137692e217">Results:</h5> <p id="d137692e219">We found 24% were legally married, and 26% unmarried partnered; one-half were single. Those legally married reported better quality of life and more economic and social resources than unmarried partnered; physical health indicators were similar between legally married and unmarried partnered. Those single reported poorer health and fewer resources than legally married and unmarried partnered. Among women, being legally married was associated with more LGBT microaggressions. </p> </div><div class="section"> <a class="named-anchor" id="d137692e221">  </a> <h5 class="section-title" id="d137692e222">Implications:</h5> <p id="d137692e224">LGBT older adults, and practitioners serving them, should become educated about how legal same-sex marriage interfaces with the context of LGBT older adults’ lives, and policies and protections related to age and sexual and gender identity. Longitudinal research is needed to understand factors contributing to decisions to marry, including short- and long-term economic, social, and health outcomes associated with legal marriage among LGBT older adults. </p> </div>

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Health disparities among lesbian, gay, and bisexual older adults: results from a population-based study.

Karen I Fredriksen-Goldsen, Hyun-Jun Kim, Susan E Barkan … (2013)

We investigated health disparities among lesbian, gay, and bisexual (LGB) adults aged 50 years and older. We analyzed data from the 2003-2010 Washington State Behavioral Risk Factor Surveillance System (n = 96 992) on health outcomes, chronic conditions, access to care, behaviors, and screening by gender and sexual orientation with adjusted logistic regressions. LGB older adults had higher risk of disability, poor mental health, smoking, and excessive drinking than did heterosexuals. Lesbians and bisexual women had higher risk of cardiovascular disease and obesity, and gay and bisexual men had higher risk of poor physical health and living alone than did heterosexuals. Lesbians reported a higher rate of excessive drinking than did bisexual women; bisexual men reported a higher rate of diabetes and a lower rate of being tested for HIV than did gay men. Conclusions. Tailored interventions are needed to address the health disparities and unique health needs of LGB older adults. Research across the life course is needed to better understand health disparities by sexual orientation and age, and to assess subgroup differences within these communities.

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The health equity promotion model: Reconceptualization of lesbian, gay, bisexual, and transgender (LGBT) health disparities.

Karen I Fredriksen-Goldsen, Jane Simoni, Hyun-Jun Kim … (2014)

National health initiatives emphasize the importance of eliminating health disparities among historically disadvantaged populations. Yet, few studies have examined the range of health outcomes among lesbian, gay, bisexual, and transgender (LGBT) people. To stimulate more inclusive research in the area, we present the Health Equity Promotion Model-a framework oriented toward LGBT people reaching their full mental and physical health potential that considers both positive and adverse health-related circumstances. The model highlights (a) heterogeneity and intersectionality within LGBT communities; (b) the influence of structural and environmental context; and (c) both health-promoting and adverse pathways that encompass behavioral, social, psychological, and biological processes. It also expands upon earlier conceptualizations of sexual minority health by integrating a life course development perspective within the health-promotion model. By explicating the important role of agency and resilience as well as the deleterious effect of social structures on health outcomes, it supports policy and social justice to advance health and well-being in these communities. Important directions for future research as well as implications for health-promotion interventions and policies are offered.

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The times they are a changin': marital status and health differentials from 1972 to 2003.

Hui Liu, Debra J. Umberson (2008)

Although the meanings and rates of being married, divorced, separated, never-married, and widowed have changed significantly over the past several decades, we know very little about historical trends in the relationship between marital status and health. Our analysis of pooled data from the National Health Interview Survey from 1972 to 2003 shows that the self-rated health of the never-married has improved over the past three decades. Moreover, the gap between the married and the never married has steadily converged over time for men but not for women. In contrast, the self-rated health of the widowed, divorced, and separated worsened over time relative to the married, and the adverse effects of marital dissolution have increased more for women than for men. Our findings highlight the importance of social change in shaping the impact of marital status on self-reported health and challenge long-held assumptions about gender, marital status, and health.