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Journal of Urban Health

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23.06.2023 | Original Article

The Social Determinants of Health Among Lesbian, Gay, Bisexual, and Transgender (LGBT) Adults in Nashville, Tennessee

verfasst von: Gilbert Gonzales, Frances Lavey

Erschienen in: Journal of Urban Health | Ausgabe 3/2023

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Abstract

Lesbian, gay, bisexual, and transgender (LGBT) populations experience widespread disparities in health outcomes, health behaviors, and access to care compared to their non-LGBT counterparts. Moreover, very few studies have either studied the social determinants of health (SDoH) of LGBT populations or LGBT health in large cities located in the US South. This study uses novel, community-informed, and representative data to study the SDoH of LGBT adults in Nashville and Davidson County, Tennessee. Compared to non-LGBT adults (n = 1583), LGBT adults (n = 128) in Nashville, Tennessee, were more likely to report being dissatisfied with life and feeling emotionally upset or physical symptoms as a result of how they were treated based on their race/ethnicity compared to non-LGBT adults. LGBT adults in Nashville were also less likely to keep a firearm in the home than their non-LGBT peers. This study documents new disparities in the SDoH for LGBT adults living in one of the largest and fastest growing cities in the southeastern US. More research on LGBT populations in urban centers located in the US South is critically needed. Meanwhile, locally based community organizations and public health leaders may consider developing and testing innovative solutions to enhance social networks and social supports among LGBT populations. Addressing the SDoH among LGBT adults in southern cities will be essential for achieving health equity for all LGBT populations in the USA.

Institute of Medicine. The health of lesbian, gay, bisexual, and transgender people: building a foundation for better understanding. The National Academies Press, Washington, DC; 2011.

Patterson CJ, Sepulveda MJ, White J. Understanding the well-being of LGBTQI+ populations. Understanding the Well-Being of LGBTQI+ Populations. Published online October 21, 2020:1–436. https://doi.org/10.17226/25877

Dahlhamer JM, Galinsky AM, Joestl SS, Ward BW. Barriers to health care among adults identifying as sexual minorities: a US national study. Am J Public Health. 2016;106(6):1116–22. https://doi.org/10.2105/AJPH.2016.303049.CrossRefPubMedPubMedCentral

Gonzales G, Henning-Smith C. Barriers to care among transgender and gender nonconforming adults. Milbank Q. 2017;95(4). https://doi.org/10.1111/1468-0009.12297

Gonzales G, Przedworski J, Henning-Smith C. Comparison of health and health risk factors between lesbian, gay, and bisexual adults and heterosexual adults in the United States. JAMA Intern Med. 2016;176(9):1344–51. https://doi.org/10.1001/jamainternmed.2016.3432.CrossRefPubMed

Gonzales G, Henning-Smith C. Health disparities by sexual orientation: results and implications from the Behavioral Risk Factor Surveillance System. J Community Health. 2017. https://doi.org/10.1007/s10900-017-0366-z.CrossRefPubMed

Meyer IH. Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: conceptual issues and research evidence. Psychol Bull. 2003;129(5):674–97. https://doi.org/10.1037/0033-2909.129.5.674.CrossRefPubMedPubMedCentral

Hacker K, Houry D. Social needs and social determinants: the role of the centers for disease control and prevention and public health. Public Health Rep. 2022;137(6):1049–52. https://doi.org/10.1177/00333549221120244.CrossRefPubMedPubMedCentral

Braveman P, Gottlieb L. The social determinants of health: it’s time to consider the causes of the causes. 2014;129(Suppl. 2):19–31. https://doi.org/10.1177/00333549141291S206

10.

Martinez-Velez JJ, Melin K, Rodriguez-Diaz CE. A preliminary assessment of selected social determinants of health in a sample of transgender and gender nonconforming individuals in Puerto Rico. Transgend Health. 2019;4(1):9–17. https://doi.org/10.1089/trgh.2018.0045.CrossRefPubMedPubMedCentral

11.

Redden M, Gahagan J, Kia H, et al. Housing as a determinant of health for older LGBT Canadians: focus group findings from a national housing study. Hous Soc. 2021;00(00):1–25. https://doi.org/10.1080/08882746.2021.1905996.CrossRef

12.

Downing JM, Rosenthal E. Prevalence of social determinants of health among sexual minority women and men in 2017. Am J Prev Med. 2020;59(1):118–22. https://doi.org/10.1016/j.amepre.2020.01.007.CrossRefPubMed

13.

Schuler MS, Prince DM, Collins RL. Disparities in social and economic determinants of health by sexual identity, gender, and age: results from the 2015–2018 National Survey on Drug Use and Health. LGBT Health. 2021;8(5):330–9. https://doi.org/10.1089/lgbt.2020.0390.CrossRefPubMedPubMedCentral

14.

Migdon B. Tennessee enacts nation’s first law restricting drag shows, bans gender-affirming care for youth. The Hill, Published 2023. https://thehill.com/homenews/state-watch/3881688-tennessee-enacts-nations-first-law-restricting-drag-shows-bans-gender-affirming-care-for-youth/. Accessed 4 May 2023.

15.

Sasani A; Tennessee’s rejection of federal funds to curb HIV alarms prevention groups. The New York Times. Published 2023; https://www.nytimes.com/2023/03/24/us/tennessee-hiv-funding.html. Accessed 4 May 2023.

16.

Hasenbush A, Flores A, Kastanis A, Sears B, Gates GJ; The LGBT divide: a data portrait of LGBT people in the Midwest, Mountain, and Southern States. The Williams Institute. Published 2023. https://williamsinstitute.law.ucla.edu/lgbtdivide/#/introduction. Accessed 10 January 2023.

17.

Stone AL. The geography of research on LGBTQ life: why sociologists should study the South, rural queers, and ordinary cities. Sociol Compass. 2018;12(11):e12638. https://doi.org/10.1111/SOC4.12638.CrossRef

18.

NashvilleHealth. The nashville community health and well-being survey; 2020. https://www.nashville.gov/Health-Department/Data-and-Publications/Community-Health-Survey.aspx. Accessed 2 August 2020.

19.

NashvilleHealth. About NashvilleHealth. https://nashvillehealth.org/about/#overview. Accessed 12 September 2020.

20.

Office of the US Surgeon General. Our epidemic of loneliness and isolation: The US surgeon general’s advisory on the healing effects of social connection and community. Department of Health and Human Services; Washington, DC; 2023.

21.

Blumberg S. National center for health statistics meeting of the NCHS board of scientific counselors measuring discrimination in NCHS surveys. Published online 2022. https://www.cdc.gov/nchs/data/bsc/bsc‐pres‐stephen‐blumberg‐2‐10‐2022.pdf. Accessed 20 June 2023

22.

Gramlich J. What the data says about gun deaths in the U.S. pew research center. Published 2023. https://www.pewresearch.org/short-reads/2023/04/26/what-the-data-says-about-gun-deaths-in-the-u-s/. Accessed 5 May 2023.

23.

De Lange J, Baams L, Van Bergen DD, Bos HMW, Bosker RJ. Minority stress and suicidal ideation and suicide attempts among LGBT adolescents and young adults: a meta-analysis. LGBT Health. 2022;9(4):222–37. https://doi.org/10.1089/LGBT.2021.0106/SUPPL_FILE/SUPP_FIGS10.TIF.CrossRefPubMed

24.

Clark KA, Mays VM, Arah OA, Kheifets LI, Cochran SD. Sexual orientation differences in lethal methods used in suicide: findings from the National Violent Death Reporting System. Arch Suicide Res. 2022;26(2):548. https://doi.org/10.1080/13811118.2020.1811181.CrossRefPubMed

25.

Tasigiorgos S, Economopoulos KP, Winfield RD, Sakran JV. Firearm injury in the United States: an overview of an evolving public health problem. J Am Coll Surg. 2015;221(6):1005–14. https://doi.org/10.1016/J.JAMCOLLSURG.2015.08.430.CrossRefPubMed

26.

Gavulic KA, Gonzales G. Did the Orlando shooting at Pulse Nightclub affect sexual minority mental health? Results and challenges using population-based data. 2020;25(3):252–264. https://doi.org/10.1080/19359705.2020.1819501

27.

Slevin C. Colorado gay club shooting suspect charged with hate crimes. Associated Press. Published 2022. https://apnews.com/article/crime-shootings-colorado-hate-crimes-springs-b9be567920a55986c57af59535ac9f61. Accessed 5 May 2023.

28.

Weeks WB, Cao SY, Lester CM, Weinstein JN, Morden NE. Use of Z-codes to record social determinants of health among fee-for-service medicare beneficiaries in 2017. J Gen Intern Med. 2020;35(3):952–5. https://doi.org/10.1007/s11606-019-05199-w.CrossRefPubMed

29.

Truong HP, Luke AA, Hammond G, Wadhera RK, Reidhead M, Joynt Maddox KE. Utilization of social determinants of health ICD-10 Z-codes among hospitalized patients in the United States, 2016–2017. Med Care. 2020;58(12):1037–43. https://doi.org/10.1097/MLR.0000000000001418.CrossRefPubMedPubMedCentral

30.

Centers for Medicare & Medicaid Services. ICD-10. https://www.cms.gov/Medicare/Coding/ICD10. Accessed 3 January 2023.

31.

Sears B, Mallory C, Flores AR, Conron KJ. LGBT people’s experiences of workplace discrimination and harassment. The williams institute. Published September 2021. https://williamsinstitute.law.ucla.edu/wp-content/uploads/Workplace-Discrimination-Sep-2021.pdf. Accessed 12, January 2023.

32.

Panchal N, Kamal R, Cox C, Garfield R. The implications of COVID-19 for mental health and substance use. Kaiser Family Foundation. Published 2021. https://www.kff.org/coronavirus-covid-19/issue-brief/the-implications-of-covid-19-for-mental-health-and-substance-use/. Accessed 12 January 2023.

33.

Maskut JL, Hodge CJ, Van CD, Razmi A, Khau MT Utilization of z codes for social determinants of health among Medicare fee-for-service beneficiaries, 2019;2019. www.ccwdata.org. Accessed 21 May 2023.

34.

Tabler J, Schmitz RM, Charak R, Propst A. Forgone care among LGBTQ and non-LGBTQ Americans during the COVID-19 pandemic: the role of health, social support, and pandemic-related stress. South Med J. 2022;115(10):752. https://doi.org/10.14423/SMJ.0000000000001456.

Titel: The Social Determinants of Health Among Lesbian, Gay, Bisexual, and Transgender (LGBT) Adults in Nashville, Tennessee
verfasst von: Gilbert Gonzales
Frances Lavey
Publikationsdatum: 23.06.2023
Verlag: Springer US
Erschienen in: Journal of Urban Health / Ausgabe 3/2023
Print ISSN: 1099-3460
Elektronische ISSN: 1468-2869
DOI: https://doi.org/10.1007/s11524-023-00745-8

Springer Medizin

Abstract

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