Effects of Social Networks and Policy Context on Health among Older Sexual and Gender Minorities in the US South

摘要 老年性和性别少数 (SGM) 人群在以下方面存在显着差异 与异性恋和顺性别者相比的发病率和残疾率。有 关于为什么身体健康、心理健康和残疾结果可能会出现的两个主要解释 老年 SGM 成年人与老年异性恋和顺性别成年人的不同之处：1) 少数群体的压力经历对生命历程中的健康产生负面影响，以及 2) 社交网络的种类和质量以及老年支持方面的差异。在这项研究中我们 开发并测试整合这两个不同研究领域的新概念模型 通过应用多层次的方法来了解少数人的压力过程是如何运作的。我们 认为社交网络调节少数群体压力与健康之间的关系。社交 网络效应可能是负面的，加剧了负面生活经历的影响 通过强化相对于主导地位的消极边缘感来进行歧视或暴力 社会价值观和结构。或者，社交网络可以缓冲负面影响 SGM成年人的生活经历，其网络包括对SGM更积极的评价 身份。为了测试这个模型，我们将通过三个波浪收集深入的以自我为中心的网络数据 800 名年龄在 50 岁至 70 岁之间且居住在以下城市统计区的 SGM 成年人 美国南部的三个中型城市：田纳西州纳什维尔；阿拉巴马州伯明翰；和北卡罗来纳州罗利。 将通过多种面对面、社区和有针对性的在线方式招募参与者 方法，以确保纳入更多孤立的个人或较少的个人 参与社区组织。调查将使用基于网络的 专门为评估个人网络的多维方面而开发的工具， 身心健康以及少数民族压力的经历。

ABSTRACT Older sexual and gender minority (SGM) populations experience significant disparities in morbidity and disability compared with their heterosexual and cisgender counterparts. There are two primary explanations as to why physical health, mental health, and disability outcomes may differ for older SGM adults compared to older heterosexual and cisgender adults: 1) experiences of minority stress that negatively affect health over the life course, and 2) differences in the kind and quality of social networks and support in older age. In this study we develop and test a new conceptual model that integrates these two disparate areas of research by applying a multilevel approach to understanding how minority stress processes work. We contend that social networks mediate the relationship between minority stress and health. Social network effects may be negative, exacerbating the effects of negative life experiences of discrimination or violence by reinforcing feelings of negative marginality relative to dominant societal values and structures. Alternatively, social networks may buffer the effects of negative life experiences among SGM adults whose networks include more positive valuations of SGM identities. To test this model, we will collect in-depth ego-centric network data over three waves from 800 SGM adults aged 50 to 70 years and residing in the metropolitan statistical areas of three midsize cities in the US South: Nashville, TN; Birmingham, AL; and Raleigh, NC. Participants will be recruited using multiple face-to-face, community and targeted online methods in order to ensure inclusion of more isolated individuals or individuals who are less involved with community organizations. Surveys will be administered using a web-based instrument developed specifically for assessing multidimensional aspects of personal networks, physical and mental health, and experiences of minority stress.