Recent estimates indicate that 11.3 million adults in the United States identify as sexual and/or gender minorities (SGMs) and of these 2.3 million are aged 50 and older. Demographic estimates also indicate that the proportion of the U.S. populous identifying as older sexual and gender minorities will exponentially grow by 2030, with projections indicating roughly 6.0 million adults aged 50 and older will identify as sexual and gender minorities. Cigarette smoking represents one of the most deleterious health behaviors that shapes a multitude of health disease processes, including dementias, neurodegenerative cognitive functioning, and overall increasing mortality that jeopardizes longevity and quality of life for aging populations. Across the adult lifespan, sexual minorities exhibit elevated rates of smoking compared to their heterosexual counterparts, with neighborhood contexts increasingly shaping smoking behaviors. Inconclusive evidence suggests concentrations of older SMs in residential neighborhoods may boost social networks enhancing resiliency, conversely buffering against experiences of discrimination. Yet, most research on SGM older populations has not thoroughly considered neighborhood contexts in shaping smoking behaviors across the adult lifespan; particular racial/ethnic variations. This project fills this gap with three aims.
The first aim will focus on constructing a novel measure of age-specific patterns of residential segregation among sexual minority populations, residing in a gayborhood or not, using Census data and social demographic techniques. This will help identify racial/ethnic variations among sexual minorities across the adult lifespan with respect to residential configurations in urban centers.
The second aim will focus on documenting cohort-specific racial/ethnic variations, among sexual minorities, in neighborhood disadvantage drawing upon Census data.
The third aim will combine contextual data with individual-level health data form two national samples of adult sexual minorities (aged 18-90) to employ inventive intersectional multilevel analysis of individual heterogeneity and discriminatory accuracy (MAIHDA). Evidence derived from this study is necessary to identify key stages across the adult lifespan to minimize smoking behaviors among persons with multiple stigmatized identities; evidence to inform optimizing clinical and/or population-level interventions aimed at eliminating the deleterious impacts of cigarette smoking. Building upon strong training in aging health-related research, enhancing feasibility, the proposed study will contribute knowledge on populations understudied in aging focused disparities research. Moreover, the novel measure of residential segregation will appeal to the cadre of investigators interested in assessing the mediating influence of neighborhood contexts in compromising healthy aging trajectories.

Public Health Relevance

NIA R36 Project Narrative: Neighborhoods, Sexual Orientation, Race/Ethnicity & Smoking Across the Lifespan: A Multilevel Intersectional Assessment Smoking is linked to multiple diseases that compromise healthy aging, with sexual minority populations exhibiting higher rates of smoking across the lifespan than their heterosexual counterparts; although when assessing racial/ethnic differences among sexual minorities, trends mirror that in the general population. Increasingly evidence suggests that neighborhood contexts are an important social determinant in shaping healthy aging and deleterious behaviors like smoking; though very few aging-focused disparities research has explored these dynamics. The proposed study will fill these gaps by constructing a disseminable novel measure of neighborhood contexts (gayborhoods), to evaluate racial/ethnic differences in smoking among sexual minorities and the intervening influence of neighborhood contexts across the lifespan.

National Institute of Health (NIH)
National Institute on Aging (NIA)
Dissertation Award (R36)
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Neuroscience of Aging Review Committee (NIA)
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Bandiera, Frank
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University of New Mexico Health Sciences Center
Sch Allied Health Professions
United States
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