Who Are the Remaining Uninsured Sexual Minority Adults Under the Affordable Care Act?

Gonzales, Gilbert; Driscoll, Ryan; Quinones, Nicole

doi:10.1089/lgbt.2019.0007

Cited by 8 publications

(4 citation statements)

References 9 publications

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“…This is likely a reflection of the barriers that SM persons of any race face when seeking mental health care, which may include limited availability of affirming providers, transportation challenges, and inability to afford health care, particularly related to a lack of health insurance. 9,[26][27][28] Additionally, there were a number of reasons for postponing/avoiding care that did not evidence Black-White differences where, based on the literature, we might expect them to exist. For example, there is extensive literature about the stigma of mental health issues and PMHC utilization in Black communities.…”

Section: Discussionmentioning

confidence: 99%

Black Sexual Minority Adults’ Avoidance of Professional Mental Health Care

Williams

Turpin

Boekeloo

et al. 2024

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Objective: To determine if Black sexual minority (SM) individuals are more likely than White SM people to postpone/avoid professional mental health care and, if so, to identify differences in the reasons for postponing/avoiding care.Methods: Analyses were conducted using subsample of Black (n = 78) and White SM (n = 398) individuals from a larger survey of U.S. adults administered via MTurk in 2020 (n = 1,012).Logistic regression models identify Black-White differences in overall postponement/avoidance of care as well as Black-White differences in each of nine reasons for postponing/avoiding care.Results: Black SM individuals were more likely than their White counterparts to report ever postponing/avoiding professional mental health care (average marginal effect [AME] = 13.67 percentage points [pp]; 95% confidence interval [CI]: 5.42, 21.92). Black SM people were more likely than White SM people to cite beliefs that they should work out their problems on their own (AME = 13.09 pp; 95% CI: 1.24, 24.94) or with family and friends (AME = 17.53 pp; 95% CI: 5.95, 29.11), as well as providers refusing to treat them (AME = 17.37 pp; 95% CI: 7.64, 27.11), as reasons for postponing/avoiding care. Conclusions.Study results indicate that personal beliefs about managing mental health, as well as provider refusal, influence Black SM individuals' willingness or ability to seek professional mental health care at rates similar to their White SM counterparts.

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Section: Discussionmentioning

confidence: 99%

Black Sexual Minority Adults’ Avoidance of Professional Mental Health Care

Williams

Turpin

Boekeloo

et al. 2024

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“…Still, gay men maintained the largest positive trends in health care access over time, even after adjusting for these factors. Overall, socioeconomic factors do not completely explain the changes in health care access for any of the groups; there have been a number of studies that address how marriage equality has led to gains in insurance coverage, but less into how this policy ruling might have affected actual health-seeking behaviors, and other barriers to care that are not directly related to socioeconomic status [12,17]. In the context of developing policy to address health care access among sexual minority populations, our findings highlight both the relevance of socioeconomic factors, as well as the importance of addressing factors beyond just socioeconomics, such as health literacy, medical mistrust, and cultural competency of providers regarding LGBTQ+ populations [23].…”

Section: Discussionmentioning

confidence: 99%

“…Compared to their heterosexual peers, sexual minority adults are more likely to report unmet medical needs and less likely to receive routine medical care [10,11]. The disparity in health insurance coverage is a commonly cited factor in issues of health care access; sexual minority adults are less likely to report health insurance coverage compared to their heterosexual peers [12,13]. Cost is another common barrier to receiving health care, even among insured sexual minorities [14,15] Studies often find that sexual minorities delay or forgo care due to, in part, affordability [16,17].…”

Section: Introductionmentioning

confidence: 99%

Trends in Health Care Access/Experiences: Differential Gains across Sexuality and Sex Intersections before and after Marriage Equality

Turpin

Williams

Akré

et al. 2022

IJERPH

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Background: Sexual minority adults experience several health care access inequities compared to their heterosexual peers; such inequities may be affected by LGBTQ+ legislation, such as the 2015 national marriage equality ruling. Methods: Using population-based data (n = 28,463) from the Association of American Medical Colleges biannual Consumer Survey of Health Care Access, we calculated trend ratios (TR) for indicators of health care access (e.g., insurance coverage, delaying or forgoing care due to cost) and satisfaction (e.g., general satisfaction, being mistreated due to sexual orientation) from 2013 to 2018 across sexuality and sex. We also tested for changes in trends related to the 2015 marriage equality ruling using interrupted time series trend interactions (TRInt). Results: The largest increases in access were observed in gay men (TR = 2.42, 95% CI 1.28, 4.57). Bisexual men had decreases in access over this period (TR = 0.47, 95% CI 0.22, 0.99). Only gay men had a significant increase in the health care access trend after U.S. national marriage equality (TRInt = 5.59, 95% CI 2.00, 9.18), while other sexual minority groups did not. Conclusions: We found that trends in health care access and satisfaction varied significantly across sexualities and sex. Our findings highlight important disparities in how federal marriage equality has benefited sexual minority groups.

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“…Although not found to be significant in the logistic regression, some demographic characteristics and notable life eventsfoundto be significant at the bivariate level provide additional guidance on how to tailor interventionsand increase access to culturally competent healthcare for opioid-using SGM persons. Compared to participants not using opioids, more participants reporting opioid misuse lacked health insurance; decreasing access to routine medical care, emergency services, and substance use detoxification, treatment, and recovery services [53][54][55][56][57][58]. This lack of health insurance is more concerning in a non-Medicaid expansion state, like Texas, where uninsured persons might face additional financial barriers to accessing healthcare.…”

Section: Discussionmentioning

confidence: 99%

Opioid Misuse Among Sexual and Gender Minorities in Texas: The Most Vulnerable Populations

Jm¹

2021

J Addict & Prev

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Background: Increasing opioid-related mortality is especially concerning in Sexual and Gender Minority (SGM) persons who are more likely than cis-gender heterosexual persons to have substance use disorders. These analyses identified variables associated with opioid (heroin and prescription pain medication) use by SGM Texans. Method: Analyses were conducted on 1273 SGM Texans who completed an online cross-sectional survey. Variables including demographic characteristics, substance use, and notable life experiences. Variables found to be significant in bivariate analyses were entered into logistic regression models. Results: 128 (10.0%) of participants reported opioid use within the 12 months prior. Those who reported opioid use were more likely to use another substance or engage in hazardous drinking. Those who reported injection drug use and having a non-monosexual private identity were more likely to report opioid use. Although age was not found to be a significant predictor of opioid use, those under 19 year of age accounted for 57.0% of those who reported opioid use. Discussion: Opioid use is a concern among SGM persons, especially those who have a non-monosexual identity. Organizations serving SGM persons provide services to youth should consider implementing a screening, intervention, treatment, and harm reductionfor opioids, alcohol, and other substances. The minority stress theory proposes that various environmental factors which are less supportive of an individual's identity leads to stress producing circumstances including rejection and internalization contribute to negative mental health and behavioral health outcomes including substance use [24-26]. The individual identities and factors that are included in the theory include: sexual identity, gender, and race/ethnicity, general stressors, discrimination, and prejudice based

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Who Are the Remaining Uninsured Sexual Minority Adults Under the Affordable Care Act?

Cited by 8 publications

References 9 publications

Black Sexual Minority Adults’ Avoidance of Professional Mental Health Care

Black Sexual Minority Adults’ Avoidance of Professional Mental Health Care

Trends in Health Care Access/Experiences: Differential Gains across Sexuality and Sex Intersections before and after Marriage Equality

Opioid Misuse Among Sexual and Gender Minorities in Texas: The Most Vulnerable Populations

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