Identity Stress and Health in Three Cohorts of LGB individuals

三组 LGB 个体的身份压力和健康状况

• 批准号: 9105270
• 负责人: ILAN H MEYER
• 金额: $ 6.41万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-09-04 至 2019-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9105270
• 关键词: Adult; Affect; Age; Aging; Arizona; Asians; California; Communities; Data; Data Sources; Development; Discrimination; Equation; Event; Exposure to; Family; Friends; Gays; Generations; Goals; Health; Health Services; Health behavior; Heterosexuals; Individual; Influentials; Institution; Knowledge; Latino; Lesbian Gay Bisexual; Lesbian Gay Bisexual Transgender; Life; Life Cycle Stages; Longevity; Longitudinal Studies; Mental Health; Methods; Minority; Minority Groups; Modeling; New York; Outcome; Pathway interactions; Pattern; Personal Satisfaction; Persons; Population; Prejudice; Probability Samples; Procedures; Process; Public Health; Recruitment Activity; Resources; Respondent; Rural; Sampling; Services; Sex Orientation; Social Change; Social Conditions; Social Environment; Social Health Services; Social support; Societies; Staging; Stress; Structure; Study models; Subgroup; Surveys; United States Public Health Service; Violence; Youth; aged; cohort; coping; design; experience; follow-up; health care delivery; health care service utilization; health disparity; improved; innovation; insight; interest; life history; member; model development; peer; physical conditioning; public health intervention; service intervention; social stigma; stress resilience; theories

DESCRIPTION (provided by applicant): Lesbian, gay, and bisexual (LGB) youth and adults suffer disparities in health outcomes compared with their heterosexual peers. Minority stress theory suggests that because of prejudice and stigma in the social environment, LGB people experience excess stress that leads to poor health outcomes and health disparities. Because of its focus on the social environment, minority stress theory leads us to predict that the character of stress processes affecting LGBs shift along with improvement in the social environment. Similarly shifting are notions of LGB identity, connection with the community, and the types of social and health services LGB people seek. If we are to achieve the U.S. Public Health Services' goal of reducing health disparities related to sexual orientation, we need to understand the impact of changes in identity and minority stress on LGB health and, using this knowledge, inform public health interventions across the lifespan. To gain this knowledge, we propose a longitudinal study using a probability sample of diverse LGBs representative of LGBs in the U.S. population. We seek to compare 3 cohorts of LGB individuals-aged 18 - 25, 34 - 42, and 48 - 55 years old-who are distinct in that they were exposed to significantly different social environments when they came of age. We are interested in ways that identity and minority stress predict health across the cohorts. We will use a mixed method design that allows us to gain knowledge from both qualitative and survey data. We use an innovative 2-stage procedure to recruit a sample of 676 LGB individuals representative of U.S. Black, Latino, and White LGB populations. We assess respondents baseline and annually for 3 years thereafter. In a qualitative study, we use a narrative life history to assess a diverse group of Black, Latino, White, and Asian LGB individuals in urban and rural regions of New York, California, and Arizona. We hypothesize that: 1. Despite readily acknowledging an LGB identity and coming out at a younger age than did older cohorts, the younger cohorts differ from older cohorts in that their LGB identity is less central, they are less strongly identified with the LGB community, and have different meanings of sexual orientation and identity. 2. Compared with older, the younger cohort experience less minority stress related to their own acceptance of a gay identity and coming out, but more external stress, including prejudice-related stressful life events, antigay violence, and everyday forms of discrimination. 3. Members of younger LGB cohorts utilize fewer LGB-identified social and health services than do members of older LGB cohorts. 4. In structural equations, the minority stress model functions equally well in predicting health outcomes in the younger and older cohorts, but patterns of stress, resilience, and health outcomes differ among the cohorts in accordance with findings in Aims 1 and 2.

描述（由申请人提供）：与异性恋同龄人相比，女同性恋、男同性恋和双性恋 (LGB) 青少年和成年人的健康状况存在差异。少数群体压力理论认为，由于社会环境中的偏见和耻辱，男女同性恋、双性恋和变性者承受着过度的压力，导致健康结果不佳和健康差异。由于少数人压力理论关注社会环境，因此我们预测，影响LGB的压力过程的特征会随着社会环境的改善而发生变化。同样的转变还有 LGB 身份、与社区的联系以及 LGB 人们寻求的社会和医疗服务类型的观念。如果我们要实现美国公共卫生服务部门减少与性取向相关的健康差异的目标，我们需要了解身份变化和少数群体压力对 LGB 健康的影响，并利用这些知识为整个生命周期的公共卫生干预措施提供信息。为了获得这些知识，我们提出了一项纵向研究，使用代表美国人口中 LGB 的不同 LGB 的概率样本。我们试图比较 3 组 LGB 个体，年龄分别为 18 - 25 岁、34 - 42 岁和 48 - 55 岁，他们的不同之处在于，他们在成年时所接触的社会环境截然不同。我们对身份和少数族裔压力预测人群健康状况的方式感兴趣。我们将使用混合方法设计，使我们能够从定性数据和调查数据中获取知识。我们采用创新的两阶段程序来招募代表美国黑人、拉丁裔和白人 LGB 群体的 676 名 LGB 个体样本。我们评估受访者的基线，并在此后 3 年内每年进行一次评估。在一项定性研究中，我们使用叙事生活史来评估纽约、加利福尼亚和亚利桑那州城乡地区的黑人、拉丁裔、白人和亚裔 LGB 个体的多元化群体。我们假设： 1. 尽管较年长的群体更容易承认 LGB 身份，并且出柜年龄更小，但年轻群体与年长群体的不同之处在于，他们的 LGB 身份不太重要，他们对 LGB 群体的认同程度较低，并且对性取向和身份具有不同的含义。 2. 与年长者相比，年轻群体因接受同性恋身份和出柜而承受的少数群体压力较小，但外部压力较多，包括与偏见相关的压力生活事件、反同性恋暴力和日常形式的歧视。 3. 较年轻的 LGB 群体成员使用的 LGB 确定的社会和健康服务少于老年 LGB 群体的成员。 4. 在结构方程中，少数群体压力模型在预测年轻和年长人群的健康结果方面同样有效，但根据目标 1 和 2 中的发现，不同人群的压力、复原力和健康结果模式有所不同。