A Population Study of Health Status Among Sexual Minority Older Adults in Select U.S. Geographic Regions

2019 ◽  
Vol 46 (3) ◽  
pp. 426-435 ◽  
Author(s):  
Hongying Dai ◽  
Ilan H. Meyer
Keyword(s):  
Older Adults ◽  
Substance Use ◽  
Health Disparities ◽  
Sexual Orientation ◽  
Health Behaviors ◽  
Health Outcomes ◽  
Sexual Minority ◽  
Preventive Health ◽  
Health Conditions ◽  
Preventive Health Behaviors

Objective. This study seeks to examine the health disparities of sexual minority older adults. Method. We used a probability sample of adults older than 50 years in select U.S. regions from the 2014, 2015, and 2016 Behavioral Risk Factor Surveillance System with administration of the sexual orientation question ( n = 350,778). Binary and multinomial logistic regression models were performed to examine health disparities in general health conditions, lifetime chronic health conditions, limitations in activities, substance use, access to care and preventive health behaviors by sexual minority status (straight, gay/lesbian, bisexual, other, and nonresponse), stratified by sex (male vs. female) and age group (50-64 vs. 65+ years). Results. Compared with their straight peers, sexual minority older adults had disparities in some health outcomes, including a higher prevalence of depressive disorder and substance use. However, the disparities were not uniform across gender and age groups. Both men and women sexual minorities had some advantages as well, related to preventive health behaviors (e.g., HIV testing), as compared with their straight peers. Nonrespondents in sexual orientation generally had better health outcomes than their straight peers. Conclusions. This study identifies health disparities among subgroups of lesbians, gay men, and bisexuals older adults and highlights the need to assess variability related to gender, sexual identity, and age of this high-risk population.

Older adults’ lay theories of abilities predict their willingness to engage in preventive health behaviors

2021 ◽  
Vol 93 ◽  
pp. 104291
Author(s):  
Manon Marquet ◽  
Jason E. Plaks ◽  
Laksmiina Balasubramaniam ◽  
Samantha Brunet ◽  
Alison L. Chasteen
Keyword(s):  
Older Adults ◽  
Health Behaviors ◽  
Preventive Health ◽  
Lay Theories ◽  
Preventive Health Behaviors ◽  
Willingness To Engage

scholarly journals Difference Between Users and Nonusers of a Patient Portal in Health Behaviors and Outcomes: Retrospective Cohort Study

10.2196/13146 ◽  
2019 ◽  
Vol 21 (10) ◽  
pp. e13146 ◽  
Author(s):  
Jing Huang ◽  
Yong Chen ◽  
J Richard Landis ◽  
Kevin B Mahoney
Keyword(s):  
Cohort Study ◽  
Health Behaviors ◽  
Health Outcomes ◽  
Preventive Health ◽  
Patient Portal ◽  
Communication Tool ◽  
Patient Portals ◽  
Chronic Health ◽  
Preventive Health Behaviors ◽  
The Impact

Background Patient portals are frequently used in modern health care systems as an engagement and communication tool. An increased focus on the potential value of these communication channels to improve health outcomes is warranted. Objective This paper aimed to quantify the impact of portal use on patients’ preventive health behavior and chronic health outcomes. Methods We conducted a retrospective, observational cohort study of 10,000 patients aged 50 years or older who were treated at the University of Pennsylvania Health System (UPHS) from September 1, 2014, to October 31, 2016. The data were sourced from the UPHS electronic health records. We investigated the association between patient portal use and patients’ preventive health behaviors or chronic health outcomes, controlling for confounders using a novel cardinality matching approach based on propensity scoring and a subsequent bootstrapping method to estimate the variance of association estimates. Results Patient-level characteristics differed substantially between portal users, comprising approximately 59.32% (5932/10000) of the cohort, and nonusers. On average, users were more likely to be younger (63.46 years for users vs 66.08 years for nonusers), white (72.77% [4317/5932] for users vs 52.58% [2139/4068] for nonusers), have commercial insurance (60.99% [3618/5932] for users vs 40.12% [1632/4068] for nonusers), and have higher annual incomes (US $74,172/year for users vs US $62,940/year for nonusers). Even after adjusting for these potential confounders, patient portal use had a positive and clinically meaningful impact on patients’ preventive health behaviors but not on chronic health outcomes. Conclusions This paper contributes to the understanding of the impact of patient portal use on health outcomes and is the first study to identify a meaningful subgroup of patients’ health behaviors that improved with portal use. These findings may encourage providers to promote portal use to improve patients’ preventive health behaviors.

scholarly journals Elevated Risk of Cognitive Impairment Among Older Sexual Minorities: Do Health Conditions, Health Behaviors, and Social Connections Matter?

2020 ◽  
Author(s):  
Ning Hsieh ◽  
Hui Liu ◽  
Wen-Hua Lai
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Depressive Symptoms ◽  
Sexual Orientation ◽  
Health Behaviors ◽  
Sexual Minority ◽  
Social Life ◽  
Sexual Minorities ◽  
Social Connections ◽  
Future Research

Abstract Background and Objectives Little research has examined cognitive health disparities between sexual minority and heterosexual populations. Further, most extant studies rely on subjective measures of cognitive functioning and non-probability samples. This study uses a performance-based cognitive screening tool and a nationally representative sample of older Americans to examine the disparity in cognitive impairment by sexual orientation and the potential mechanisms producing this disparity. Research Design and Methods Using data from the 2015–2016 National Social Life, Health, and Aging Project (N = 3,567), we analyzed respondents’ scores on the survey-adapted Montreal Cognitive Assessment. We estimated ordinal logit regressions to examine the relationship between sexual orientation and cognitive impairment and used the Karlson–Holm–Breen method to assess how mental and physical conditions, health behaviors, and social connections mediate this relationship. Results The prevalence of cognitive impairment is significantly higher among sexual minority older adults than among heterosexual older adults when sociodemographic factors are adjusted for. Depressive symptoms explain some of this prevalence gap. Although anxiety symptoms, physical comorbidity, health behaviors, and social connections may contribute to cognitive impairment, they do not explain the cognitive disparity by sexual orientation. Discussion and Implications The findings indicate that depressive symptoms are an important link between minority sexual orientation and cognitive impairment and highlight the importance of studying other potential mechanisms that we could not explore in this study. Future research should further investigate how minority stress processes may unfold to accelerate cognitive decline among sexual minorities over the life course.

scholarly journals Difference Between Users and Nonusers of a Patient Portal in Health Behaviors and Outcomes: Retrospective Cohort Study (Preprint)

2018 ◽  
Author(s):  
Jing Huang ◽  
Yong Chen ◽  
J Richard Landis ◽  
Kevin B Mahoney
Keyword(s):  
Cohort Study ◽  
Health Behaviors ◽  
Health Outcomes ◽  
Preventive Health ◽  
Patient Portal ◽  
Communication Tool ◽  
Patient Portals ◽  
Chronic Health ◽  
Preventive Health Behaviors ◽  
The Impact

BACKGROUND Patient portals are frequently used in modern health care systems as an engagement and communication tool. An increased focus on the potential value of these communication channels to improve health outcomes is warranted. OBJECTIVE This paper aimed to quantify the impact of portal use on patients’ preventive health behavior and chronic health outcomes. METHODS We conducted a retrospective, observational cohort study of 10,000 patients aged 50 years or older who were treated at the University of Pennsylvania Health System (UPHS) from September 1, 2014, to October 31, 2016. The data were sourced from the UPHS electronic health records. We investigated the association between patient portal use and patients’ preventive health behaviors or chronic health outcomes, controlling for confounders using a novel cardinality matching approach based on propensity scoring and a subsequent bootstrapping method to estimate the variance of association estimates. RESULTS Patient-level characteristics differed substantially between portal users, comprising approximately 59.32% (5932/10000) of the cohort, and nonusers. On average, users were more likely to be younger (63.46 years for users vs 66.08 years for nonusers), white (72.77% [4317/5932] for users vs 52.58% [2139/4068] for nonusers), have commercial insurance (60.99% [3618/5932] for users vs 40.12% [1632/4068] for nonusers), and have higher annual incomes (US $74,172/year for users vs US $62,940/year for nonusers). Even after adjusting for these potential confounders, patient portal use had a positive and clinically meaningful impact on patients’ preventive health behaviors but not on chronic health outcomes. CONCLUSIONS This paper contributes to the understanding of the impact of patient portal use on health outcomes and is the first study to identify a meaningful subgroup of patients’ health behaviors that improved with portal use. These findings may encourage providers to promote portal use to improve patients’ preventive health behaviors.

Gender and Reasons for Preventive Health Behaviors

2006 ◽  
Author(s):  
Ruby R. Brougham ◽  
Daniel Yoo ◽  
Christopher Saunders ◽  
Josie Driscoll ◽  
Richard John
Keyword(s):  
Health Behaviors ◽  
Preventive Health ◽  
Preventive Health Behaviors

Medical and Social Determinants of Brain Health and Dementia in a Multicultural Community Cohort of Older Adults

2021 ◽  
pp. 1-14
Author(s):  
James E. Galvin ◽  
Stephanie Chrisphonte ◽  
Lun-Ching Chang
Keyword(s):  
Older Adults ◽  
Health Disparities ◽  
African Americans ◽  
Health Outcomes ◽  
Sex Education ◽  
Screening Program ◽  
Healthcare Services ◽  
Social Dimension ◽  
Medical Comorbidities ◽  
Race Ethnicity

Background: Socioeconomic status (SES), race, ethnicity, and medical comorbidities may contribute to Alzheimer’s disease and related disorders (ADRD) health disparities. Objective: Analyze effects of social and medical determinants on cognition in 374 multicultural older adults participating in a community-based dementia screening program. Methods: We used the Montreal Cognitive Assessment (MoCA) and AD8 as measures of cognition, and a 3-way race/ethnicity variable (White, African American, Hispanic) and SES (Hollingshead index) as predictors. Potential contributors to health disparities included: age, sex, education, total medical comorbidities, health self-ratings, and depression. We applied K-means cluster analyses to study medical and social dimension effects on cognitive outcomes. Results: African Americans and Hispanics had lower SES status and cognitive performance compared with similarly aged Whites. We defined three clusters based on age and SES. Cluster #1 and #3 differed by SES but not age, while cluster #2 was younger with midlevel. Cluster #1 experienced the worse health outcomes while cluster #3 had the best health outcomes. Within each cluster, White participants had higher SES and better health outcomes, African Americans had the worst physical performance, and Hispanics had the most depressive symptoms. In cross-cluster comparisons, higher SES led to better health outcomes for all participants. Conclusion: SES may contribute to disparities in access to healthcare services, while race and ethnicity may contribute to disparities in the quality and extent of services received. Our study highlights the need to critically address potential interactions between race, ethnicity, and SES which may better explain disparities in ADRD health outcomes.

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