Online Program

Healthcare Coverage, Access, and Utilization among a Community Sample of LGBT Young Adults

Wednesday, November 4, 2015 : 10:50 a.m. - 11:10 a.m.

George J. Greene, PhD, Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
Kathryn Macapagal, Ph.D., Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
Ramona Bhatia, MD, Chicago Department of Public Health, Chicago, IL
Brian Mustanski, PhD, Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
Objective.  Healthcare under-utilization may contribute to health disparities in lesbian, gay, bisexual, and transgender (LGBT) youth, yet utilization patterns in this vulnerable group are not well understood. This study addresses gaps in health services research for these underserved young adults.

Methods.  Data were collected from 206 participants enrolled in Project Q2 (55% female-born; 10% transgender; 56% Black, 18% multiracial, 14% White, 12% Latino/a; mean age = 23 years), a longitudinal cohort study of LGBT youth in the Chicagoland area.  At the 8th follow-up, participants completed psychiatric interviews and self-report measures of health, healthcare coverage, access, and utilization.

Results. Overall, 56% reported substance abuse, 31% met criteria for recent major depressive disorder or post-traumatic stress disorder, and 8% were HIV positive. Significant Chi-squared results indicated: 1) Black participants were less likely to have private insurance (24% vs 50%) and more likely to be uninsured (49% vs 32%) compared to non-Blacks; 2) male participants reported easier access to healthcare than females (79% vs 61%); 3) HIV-positive participants were more likely to have received a checkup in the last year compared to HIV-negative participants (94% vs 66%); and 4) transgender participants (32%) were more likely than male  (7%) or female (5%) participants to delay care due to perceived gender identity or sexual orientation discrimination from healthcare providers.

Conclusions. Healthcare coverage, access, and utilization varied by race, sex, and gender identity in this community sample of LGBT young adults. Additional research using nationally-representative samples is needed to inform policy and practice changes that can reduce LGBT health disparities.

Learning Areas:

Diversity and culture

Learning Objectives:
Describe factors contributing to healthcare disparities for LGBT young adults. Explain group difference in relation to healthcare coverage, access, and utilization. Identify negative healthcare experiences reported by LGBT young adults.

Keyword(s): Health Care Access, Lesbian, Gay, Bisexual and Transgender (LGBT)

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: In addition to holding a doctorate in Community Psychology, I have also been lead or co-investigator on federally funded grants on LGBT health topics, including mental health, substance use, and HIV prevention. I have worked over the last 15 years to develop, implement, and evaluate HIV-preventive interventions community, clinic, and academic settings.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.