Comparative Health Status and Characteristics of Respondents of the 2019–2020 National Survey on Health and Disability by Sexual and Gender Minority Status

Streed, Carl G.; Hall, Jean P.; Boyd, Brian A.; Batza, Katie; Kurth, Noelle K.

doi:10.1089/lgbt.2021.0075

Cited by 7 publications

(3 citation statements)

References 17 publications

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“…A fourth limitation is the collapsed racial category, the lack of information about sexual identities, and the exclusion of gender-expansive groups. The intersectionality of disability, gender, and sexual identity remains an understudied topic, but several reports have suggested that sexual and gender minority groups with disabilities are more affected by disability and barriers to care compared with heterosexual and/or cisgender adults . Fifth, the COVID-19 pandemic disrupted in-person recruitment to the AmeriSpeak panel.…”

Section: Discussionmentioning

confidence: 99%

“…The intersectionality of disability, gender, and sexual identity remains an understudied topic, but several reports have suggested that sexual and gender minority groups with disabilities are more affected by disability and barriers to care compared with heterosexual and/or cisgender adults. 46 , 47 , 48 , 49 , 50 Fifth, the COVID-19 pandemic disrupted in-person recruitment to the AmeriSpeak panel. However, a representative sample was achieved for the MCSIC survey, and participants were unaware of an analytic interest in disability at the time of survey recruitment and completion.…”

Section: Discussionmentioning

confidence: 99%

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Impairment and Disability Identity and Perceptions of Trust, Respect, and Fairness

Salinger,

Feltz,

Chan

et al. 2023

JAMA Health Forum

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ImportanceMost studies use impaired functioning alone to specify populations with disabilities. However, some people with functional impairments do not identify as disabled. With functional status-based definitions, studies have shown disparate care quality for people with disabilities.ObjectiveTo examine whether impairment and disability identity have different associations with perceived health care experiences and explore factors associated with disability identification.Design, Setting, and ParticipantsThis cross-sectional study used a nationally representative survey of US adults conducted from April 20 through May 31, 2021, and analyzed between June 1 and August 31, 2022. Survey participants were 1822 English- or Spanish-speaking adults responding either online or via telephone.ExposuresUsing 8 survey questions, participants were grouped according to presence of impairment and disability identity.Main Outcomes and MeasuresLikert scale measures of trust, respect, and fairness (henceforth, procedural justice measures) were dichotomized. Sociodemographic characteristics and rates of procedural justice responses were compared across groups. Multivariable logistic regressions adjusting for baseline characteristics were performed to (1) estimate associations of impairment and disability identity with perceptions of procedural justice and (2) explore factors associated with disability identification. Analyses applied survey weights.ResultsOf 6126 individuals invited to participate, 1854 (30.3%) completed the survey. Thirty-two were excluded due to unreportable gender, for a final analytic sample of 1822 participants. Participants with impairments (n = 816; mean [SD] age, 48.1 [17.0] years; 51.2% women, 48.8% men) had worse perceptions on 7 of 10 procedural justice measures (crude) compared with those without impairments (n = 1006; mean [SD] age, 49.6 [18.1] years, 55.1% female, 44.9% male). Among respondents with impairments, those who did (n = 340) vs did not (n = 476) identify as disabled gave better ratings for clinician communication efforts (a lot of effort, 38.8% vs 31.0%) and having health goals understood (understood very or fairly well, 77.2% vs 70.1%) but gave worse ratings for respect (almost never felt inferior or talked down to, 66.1% vs 59.1%). Disability identification was associated with more reports of unfair treatment (31.0% vs 22.4%; adjusted odds ratio, 1.65; 95% CI, 1.12-2.42) and of being unafraid to ask questions or disagree (50.5% vs 40.1%; adjusted odds ratio, 1.51; 95% CI, 1.04-20.19). Income and employment were associated with disability identification.Conclusions and RelevanceIn this cross-sectional survey study of US adults, health care perceptions differed between groups defined by impairment status and disability identity. These findings suggest that, alongside functional measures, health systems should capture disability identity to better address disparities for people with impairments.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Impairment and Disability Identity and Perceptions of Trust, Respect, and Fairness

Salinger,

Feltz,

Chan

et al. 2023

JAMA Health Forum

View full text Add to dashboard Cite

show abstract

“…For example, in the Nemoto study on Black transgender women in California, healthcare services needs included sexually transmitted diseases screening, emergency room use, alternative healthcare, and a category called “other health services” [ 13 ]. From another study using the NSHD, sexual and gender minority persons with disabilities with and without health insurance reported numerous unmet healthcare needs [ 83 ]. Thus, it is important to highlight unmet needs by specific type of healthcare services, as the type of service measured can affect rates of unmet need.…”

Section: Discussionmentioning

confidence: 99%

Gender Identity, Disability, and Unmet Healthcare Needs among Disabled People Living in the Community in the United States

Mulcahy

Streed

Wallisch

et al. 2022

IJERPH

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Disabled adults and transgender people in the United States face multiple compounding and marginalizing forces that result in unmet healthcare needs. Yet, gender identity among disabled people has not been explored, especially beyond binary categories of gender. Using cross-sectional survey data, we explored the rates of disability types and the odds of unmet healthcare needs among transgender people with disabilities compared to cisgender people with disabilities. The rates of disability type were similar between transgender and cisgender participants with two significant differences. Fewer transgender participants identified physical or mobility disability as their main disability compared to cisgender participants (12.31%/8 vs. 27.68/581, p < 0.01), and more transgender participants selected developmental disability as their main disability compared to cisgender participants (13.85%/9 vs. 3.67%/77, p < 0.001). After adjusting for sociodemographic characteristics, the odds of disabled transgender participants reporting an unmet need were higher for every unmet need except for preventative services.

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Experiences of patients with disabilities and sexual or gender minority status during healthcare interactions

Mulcahy,

Batza,

Goddard

et al. 2023

J Public Health (Berl.)

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Comparative Health Status and Characteristics of Respondents of the 2019–2020 National Survey on Health and Disability by Sexual and Gender Minority Status

Cited by 7 publications

References 17 publications

Impairment and Disability Identity and Perceptions of Trust, Respect, and Fairness

Impairment and Disability Identity and Perceptions of Trust, Respect, and Fairness

Gender Identity, Disability, and Unmet Healthcare Needs among Disabled People Living in the Community in the United States

Experiences of patients with disabilities and sexual or gender minority status during healthcare interactions

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