Primary Submission Category: LGBTQ+
Exploring Barriers to Healthcare for Sexual Minorities by Place of Residence
Authors: Kaylee Wilson Stephanie Hernandez
Presenting Author: Kaylee Wilson*
Background: Despite demonstrated benefits of sexual and gender minority (SGM) specific health care resources in cities throughout the United States, SGM specific resources exist in lower quantities in communities outside of urban centers. In addition to the lack of resources, SGM individuals are often exposed to harassment, discrimination, and abuse in healthcare settings leading to worse health outcomes for SGM individuals. This is exacerbated for sexual minorities living in suburban or rural communities compared to sexual minorities living in urban areas.
Objective: Given existing research on health disparities among sexual minorities living in non-urban areas, the objective of this research was to examine the association between place of residence and access to health care among sexual minorities.
Methods: Nationally representative data collected from the 2021 wave of the National Health Interview Survey was used to conduct descriptive and logistic regression analyses. Place of residence was operationalized as urban, suburban, or rural, according to U.S. metropolitan statistical areas and the total population in the respondent’s county. Respondents were categorized as either straight, lesbian/gay, or bisexual according to their self-reported sexual orientation. The dependent variables assessed access to care across various dimensions including usual place of care, whether the respondent delayed care due to cost, financial barriers to care (e.g., needing but not affording medical care, skipping medications to save money), and trouble paying medical bills. Additional covariates included race/ethnicity, age, education, income, employment, and health insurance.
Results: Preliminary results confirmed the hypothesis that sexual minorities living in suburban and rural areas had lower access to care compared to sexual minorities living in urban areas. Examining access to care can help further explain health disparities among sexual minorities living in non-urban areas.