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LGBT+ Health and wellbeing

Calendar icon Health and Care, Inequalities

Folder icon Mar 2023 - Ongoing

Public health has long investigated health inequalities between social groups. However, examination of the social determinants of the health of lesbian, gay, bisexual, transgender and other identity (LGBT+) groups, in comparison to the wider population, has occupied a lower status within public health research and policy agendas.

This omission is in part explained by a lack of routine data on the LGBT+ population in the UK but may also be underpinned by the prevailing heteronormative culture that exists within scientific, medical, and public health professions.

objectives icon Project objectives

The overall aim of this project is to examine the contemporary social determinants of LGBT+ health and wellbeing. Key objectives are:   

  1. To identify the types of available evidence concerning the social determinants of LGBT+ health and unmet public health needs experienced by members of the LGBT+ community.
  2. To clarify key themes, concepts, and definitions in the literature.
  3. To examine how research is conducted which investigates the health and wellbeing of the LGBT+ community, and how inequalities and unmet needs are determined and evidenced.
  4. To identify and analyse knowledge gaps within the current evidence base.
  5. To provide insight which may guide future research on this topic, including a systematic review.

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involved icon What is involved

This project involved a scoping review of the findings of almost 200, UK studies, primarily published over the past five years. The fundamental drivers of health inequalities among LGBT+ groups are examined within the UK, where possible, with some limited reference to studies out with the UK in order to illustrate specific issues or gaps in UK evidence. Consideration is given to individual groups within the LGBT+ community and the ways in which unmet public health needs are manifest at different life stages.

The scoping review groups and presents the evidence relating to LGBT+ health inequalities under seven interwoven themes. These are:

  1. Data inadequacies
  2. Life course discrimination, intolerance and microaggressions
  3. Mental health and wellbeing
  4. Adolescence and mental health
  5. Physical health and risk factors
  6. Healthcare access and experiences
  7. Health in older age.

The review then develops key policy recommendations based on the evidenced social determinants of LGBT+ health and the identified unmet health needs within the population. These evidence-based policy recommendations recognise the social determinants of LGBT+ health and wellbeing and aim to redress the priority health inequalities evident. Recommendations for future research are also made based upon the scope, nature, and gaps within the evidence reviewed.

findings icon Findings & outcomes

The studies reviewed demonstrate that LGBT+ groups experience mental and physical health inequalities and life course discrimination, microaggressions and minority stress.

Five priority unmet health needs are identified from the evidence. These are:

  • inadequate public health surveillance of LGBT+ health, wellbeing, and inequalities
  • discrimination against transgender individuals and mental health impacts
  • discrimination against LGBT+ adolescents and young people and mental health impacts
  • LGBT+ populations’ higher rates of chronic disease, and risk factors
  • LGBT+ older people’s physical and mental health inequalities

Policy recommendations include improving public health surveillance of LGBT+ health and inequalities; development of national public education campaigns highlighting these inequalities and discrimination; continuation of and further development of preventative mental health support specifically targeting LGBT+ adolescents, LGBT+ older people and transgender people; embedding adequate, regular, up-to-date training on LGBT+ health inequalities and barriers to accessing services across public services.

Understanding the unmet health needs of LGBT+ communities

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