The Public Health Management Corporation last week released a wide-ranging, first-of-its-kind report on the needs of local LGBT seniors. “Health and Service Needs of LGBT Older Adults in Philadelphia,” prepared by PHMC’s Research and Evaluation Group, was released April 3 and looks at everything from health-care access to social services, housing and other issues of concern for the LGBT older-adult population. The state-funded report is based on focus groups and interviews with 49 LGBTs 55 and older, as well as on in-depth surveys completed by more than 200 people. PHMC associate researcher Lee Carson said the agency undertook the study because there was a lack of information regarding the health and well-being of LGBT older adults, as well as about their access to health-promoting resources. Carson said findings showed that LGBTs experience some of the same concerns as older heterosexual adults; however, they do face many disparities involving access to health care and fear of discrimination. “The biggest disparities came from accessing services,” he said. “Being 60, 70, 80 years old, you can only imagine how that is going to impact their comfort level. Some of the people had their doctor for 15 years and said they never wanted to get rid of that doctor. As you get older, it is best to have a genealogist, but they were so afraid of possible discrimination.” Nearly 40 percent of participants reported at least one discriminatory experience in a health-care setting in their lifetime, which included 13 percent who were denied access to health care and 22 percent who said they had to hide their identity from a provider. About 11 percent said they experienced abusive language from a provider. The report found that 83 percent of participants did have health insurance and prescription coverage, but 55 percent did not have dental insurance. However, one in five older adults between 55-64 lacked health insurance and prescription coverage. “All older adults don’t have health insurance and, as we know, the Baby Boomer age is here and they are going to be accessing health services at a greater rate,” Carson said. “There is this perspective that LGBT folks have all this money and there are segments that do, but there are also lots of folks, particularly in Philadelphia, who are living in poverty. We want them to have the best quality of life as they can as they age.” More than half of the respondents were receiving appropriate health-screening exams at regular intervals. But nearly 20 percent delayed medial care because of the cost. Housing was also an issue for many older adults. About 13 percent of respondents reported that they live in a less-than-stable environment, including in a rented room, shelter or in a house or apartment where their name was not on the lease or deed. Forty-eight percent reported that it was difficult to afford their housing. About 35 percent of respondents live with a partner, but more than half live alone, a rate much higher than that of heterosexual older adults. About a third of the participants said they were dissatisfied with their social settings. About 29 percent experienced recent symptoms of depression and 17 percent said they were not able to receive care for their emotional health. Participants came from throughout the region, including from the suburbs. Fifty-nine percent were white and 30 percent were black. More than 60 percent held a bachelor’s degree or higher, but there was sharp contrast in the income levels — with 21 percent earning an annual salary of less than $10,000 and 15 percent earning more than $80,000. Sixty-nine percent self-identified as male, 25 percent as female and 20 percent of individuals as transgender/transsexual. More than half were between 55-64. Moving forward, the study made recommendations in the areas of health-care access, access to social services and housing and increased cultural competence. Specific recommendations included enhanced access to health-insurance coverage for screenings and surgery for transgender people; education among older adults about the social services available to them; expanded housing options for LGBT older adults; and increased training for older-adult service organizations on LGBT issues. Carson said this report would serve as a foundation for future exploration of the issues impacting the community. He said backers are also looking to circulate the report to policymakers. “There are no concrete plans, but we had conversations with the advisory board to make an effort to get it to City Council members, state representatives and folks who have influence on how things are funded.”
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