Diversity, its growth and complexity, are defining features of the dramatic aging of the world-wide population. Research demonstrates that older adults from disadvantaged populations are at elevated risk of poor health, disability and premature death. The National Institutes of Health are committed to reducing and eliminating health disparities. The Centers for Disease Control and Prevention state that health disparities related to sexual orientation are one of the main gaps in health disparities research. Existing evidence demonstrates that lesbian, gay and bisexual (LGB) older adults are an at-risk, under-investigated and under-served health disparate population. This study will examine the determinants of health impacting LGB older adults to assess change in health and quality of life (QOL) over time. Based on an innovative resilience conceptual framework, the pro- posed longitudinal research will obtain data from 2,000 LGB older adults who participated in the original study in order to allow us to understand the inter-relationships between risk and protective factors as well as cohort effects as they impact health and QOL of LGB older adults over time. This multidisciplinary collaboration of University of Washington researchers and community-based collaborators addresses a critical gap by identifying modifiable mechanisms impacting health and QOL over time. The primary goals of the project are as follows: 1) Investigate how lifetime victimization, everyday discrimination, stress (perceived stress and physiological response to stress) and health behavior change affects health and QOL of LGB older adults over time;2) Evaluate how social relations (time-varying) and sexual identity management (time-varying) affect the associations among everyday discrimination, stress, health and QOL over time;and, 3) Test whether there is cohort heterogeneity in overall levels and age growth trajectories of health and QOL, and to what extent the differences in experiences within a historical context (e.g., time of sexual identity disclosure, lifetime victimization) between Baby Boom and Silent Generation LGB older adults account for these cohort effects. As the population ages, the health care costs associated with health disparities will continue to rise. To respond to this growing public health challenge it is imperative to identfy groups at high risk of disparities and to determine the modifiable mechanisms impacting their health and QOL as they age. The findings from this project will generate needed information to directly inform and guide the development of tailored interventions that can be effectively delivered within community-based agency settings to improve the health and QOL of demographically diverse older adults.

Public Health Relevance

As the population ages, the health care costs associated with health disparities continue to rise. To reduce health disparities it is imperative to identify grous at risk of disparities and to determine the modifiable factors impacting their health and quality o life. Lesbian, gay, and bisexual (LGB) older adults have been identified as an at-risk, under-investigated, and under-served health disparate population. This longitudinal research will identify risk and protective mechanisms impacting the health and quality of life of LGB older adults, which will directly contribute to the development of tailored interventions to improve the health of demographically diverse older adults.

Agency
National Institute of Health (NIH)
Institute
National Institute on Aging (NIA)
Type
Research Project (R01)
Project #
2R01AG026526-03A1
Application #
8576314
Study Section
Social Psychology, Personality and Interpersonal Processes Study Section (SPIP)
Program Officer
Patmios, Georgeanne E
Project Start
2005-07-01
Project End
2018-06-30
Budget Start
2013-07-15
Budget End
2014-06-30
Support Year
3
Fiscal Year
2013
Total Cost
$625,473
Indirect Cost
$211,729
Name
University of Washington
Department
None
Type
Schools of Social Work
DUNS #
605799469
City
Seattle
State
WA
Country
United States
Zip Code
98195
Fredriksen-Goldsen, Karen I (2014) Despite disparities, most LGBT elders are aging well. Aging Today 35:
Fredriksen-Goldsen, Karen I; Hoy-Ellis, Charles P; Goldsen, Jayn et al. (2014) Creating a vision for the future: key competencies and strategies for culturally competent practice with lesbian, gay, bisexual, and transgender (LGBT) older adults in the health and human services. J Gerontol Soc Work 57:80-107
Fredriksen-Goldsen, Karen I; Kim, Hyun-Jun; Barkan, Susan E et al. (2013) Health disparities among lesbian, gay, and bisexual older adults: results from a population-based study. Am J Public Health 103:1802-9
Kim, Hyun-Jun; Fredriksen-Goldsen, Karen I (2013) Nonresponse to a question on self-identified sexual orientation in a public health survey and its relationship to race and ethnicity. Am J Public Health 103:67-9
Fredriksen-Goldsen, Karen I; Emlet, Charles A; Kim, Hyun-Jun et al. (2013) The physical and mental health of lesbian, gay male, and bisexual (LGB) older adults: the role of key health indicators and risk and protective factors. Gerontologist 53:664-75
Emlet, Charles A; Fredriksen-Goldsen, Karen I; Kim, Hyun-Jun (2013) Risk and protective factors associated with health-related quality of life among older gay and bisexual men living with HIV disease. Gerontologist 53:963-72
Fredriksen-Goldsen, Karen I; Kim, Hyun-Jun; Barkan, Susan E (2012) Disability among lesbian, gay, and bisexual adults: disparities in prevalence and risk. Am J Public Health 102:e16-21