Understanding the Role of Housing in the Health of Sexual and Gender Minority Older Adults

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Degree type
Doctor of Philosophy (PhD)
Graduate group
Nursing
Discipline
Nursing
Subject
Gerontology
Health equity
Housing
LGBTQ aging
LGBTQ health
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Copyright date
01/01/2024
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Author
Foley, Kierra, A
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Abstract

Sexual and gender minority (SGM) adults aged 60 and older are presently one of the fastest growing demographics in the United States. This rapidly growing demographic suffers significantly poorer health outcomes than heterosexual and cisgender older adults. The inequitable distribution of health protective resources to stigmatized groups such as SGM people likely drives these adverse health outcomes, especially for older adults who have survived such stigma throughout the entire life course. Research examining the relationships between SGM older adults’ physical and social environments and their health is needed to inform innovative interventions to address these disparities. SGM older adults face greater rates of housing insecurity than demographically matched heterosexual and cisgender older adults, but the specific ways that housing disparities inform health disparities are not yet understood. This dissertation seeks to address this gap, examining the association between SGM older adults’ overall health and housing. This multi-methods dissertation first includes an integrative review synthesizing the current literature examining SGM older adults’ housing, specifically drawing out factors associated with housing security and insecurity. We found that homophobic and transphobic harassment/discrimination as well as heterosexism and social isolation in senior congregate living are key drivers of housing insecurity for SGM older adults. Significant burden in meeting mortgage/rent costs was also correlated with housing insecurity. We then performed a secondary quantitative analysis to model the relationship between SGM older adults’ housing and health. We found significant relationships between inadequate/substandard housing and poorer self-rated health. We also found a significant relationship between experiencing concerns about homelessness and poorer self-rated health. We qualitatively explored the relationship between housing and well-being for SGM older adults using in-depth, semi-structured interviews that we then analyzed using thematic analysis. We found five major themes; SGM older adults felt their housing contributed to or harmed their wellbeing depending on their experiences with neighborhood safety, housing prices, neighborly social support, community with other SGM people, and accessibility of their homes. These findings may be translated into policy recommendations: increased funding/protections for SGM older adults’ housing is needed to improve health.

Advisor
Bauermeister, José, A.
Date of degree
2024
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