Co-occurring mental illness, drug use, and medical multimorbidity among lesbian, gay, and bisexual middle-aged and older adults in the United States: a nationally representative study

BMC Public Health

Dustin T. Duncan¹  Benjamin H. Han²  Joseph J. Palamar²  Mauricio Arcila-Mesa³ 

[1] Department of Epidemiology, Mailman School of Public Health, Columbia University;Department of Population Health, New York University School of Medicine;Division of Geriatric Medicine and Palliative Care, Department of Medicine, New York University School of Medicine;

关键词: Chronic disease;    Multimorbidity;    Geriatrics;    Sexual minorities;   

DOI  :  10.1186/s12889-020-09210-6

来源: DOAJ

【 摘 要 】

Abstract Background Older lesbian, gay, and bisexual (LGB) adults are an underserved and understudied population that experience specific health disparities. The intersection of aging and chronic medical disease with a higher risk for substance use and mental illness may place older LGB adults at risk for co-occurring conditions and resulting comorbidity. Understanding multimorbidity among older LGB adults may help inform interventions to reduce disparities in health outcomes. Methods Data come from the 2015 to 2017 National Surveys on Drug Use and Health (n = 25,880). We first determined whether sexual orientation was associated with reporting: past-year drug use, mental illness, and/or 2 or more chronic medical diseases. We then determined whether sexual orientation was associated with reporting co-occurrence of these conditions. This was done using multivariable logistic regression. Analyses were stratified by gender. Results Compared to heterosexual men, gay men were at increased odds for reporting 2 or more chronic medical diseases (adjusted odds ratio [aOR] = 2.18, 95% confidence interval [CI] = 1.48, 3.21), and gay (aOR = 1.79, 95% CI = 1.09, 2.93) and bisexual men (aOR = 3.53, 95% CI = 2.03, 6.14) were at increased odds for reporting mental illness. Gay men (aOR = 2.95, 95CI = 1.60, 5.49) and bisexual men (aOR = 2.84, 95% CI = 1.58, 5.08) were at increased odds of reporting co-occurring conditions. Compared to heterosexual women, bisexual women were at increased odds for past-year drug use (aOR = 4.20, 95% CI = 2.55, 6.93), reporting mental illness (aOR = 1.94, 95% CI = 1.03, 3.67), and reporting co-occurring conditions (aOR = 3.25, 95% = 1.60, 6.62). Conclusions Middle-aged and older LGB adults in the United States are at high risk for experiencing co-occurring drug use, mental illness, and/or medical multimorbidity. Interventions for older sexual minority populations are needed to reduce disparities.

【 授权许可】

Unknown