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

摘要 老年性少数和性别少数（SGM）人口在以下方面存在显著差异： 发病率和残疾与异性恋和顺性别的同行相比。有 关于为什么身体健康、心理健康和残疾结果可能 与年长的异性恋和顺性成年人相比，年长的SGM成年人的差异：1） 少数人的压力经历对一生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人的支持存在差异。本研究 开发和测试一个新的概念模型，将这两个不同的研究领域结合起来 通过应用多层次的方法来理解少数压力过程是如何工作的。我们 认为社交网络调节了少数民族压力和健康之间的关系。社会 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， 社会价值观和结构。或者，社交网络可以缓冲负面影响， SGM成人的生活经历，他们的网络包括对SGM的更积极的评价 身份为了测试这个模型，我们将收集三波以自我为中心的网络数据 来自800名年龄在50至70岁之间的SGM成年人，居住在以下大都市统计区： 美国南部的三个中型城市：田纳西州的纳什维尔、阿拉巴马州的伯明翰和北卡罗来纳州的罗利。 参与者将被招募使用多个面对面，社区和有针对性的在线 方法，以确保包括更多孤立的个人或个人谁是较少 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层面而开发的工具， 身心健康，以及少数民族的压力经历。

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.