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

Abstract

Introduction 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. Methods 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. Results 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. Discussion 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.