Health Disparities Among Lesbian, Gay, Bisexual, Transgender, and Queer Older Adults: A Structural Competency Approach.

Lesbian, gay, bisexual, transgender, and queer (LGBTQ+) older adults experience significant health disparities. Examining these disparities has become an international research priority, but gaps remain. In this review article, we summarize major contributions of and ongoing gaps in health disparities research among LGBTQ+ older adults, while focusing on four major content areas: (a) social determinants of health disparities, (b) mental, cognitive, and physical health disparities, (c) reproductive and sexual health disparities, and (d) seeking LGBTQ+-affirming and age-friendly care. Using a structural competency approach, we develop a four-part agenda for this research area that enhances our understanding of how macro-level systems, institutions, and structures drive health disparities among aging LGBTQ+ communities. We also outline future research on structural competency in LGBTQ+ older adult health, while providing recommendations for researchers and clinicians. These recommendations illuminate potential best practices for bettering the health and quality of life of LGBTQ+ older populations.

女同性恋、男同性恋、双性恋、跨性别和酷儿（LGBTQ +）老年人存在显著的健康差异。研究这些差异已成为国际研究的重点，但差距仍然存在。在这篇综述文章中，我们总结了LGBTQ +老年人健康差异研究的主要贡献以及仍然存在的差距，同时关注四个主要内容领域：（a）健康差异的社会决定因素，（b）心理、认知和身体健康差异，（c）生殖和性健康差异，（d）寻求对LGBTQ +友好且适合老年人的医疗服务。运用结构能力方法，我们为该研究领域制定了一个由四部分组成的议程，以增进我们对宏观层面的系统、机构和结构如何导致LGBTQ +老年群体健康差异的理解。我们还概述了LGBTQ +老年人健康方面结构能力的未来研究，并为研究人员和临床医生提供了建议。这些建议阐明了改善LGBTQ +老年人群健康和生活质量的潜在最佳实践。