Barriers to healthcare more common for lesbians, gays

People who are lesbian, gay or bisexual (LGB) are more likely to run into obstacles when trying to get healthcare than their straight peers, according to a number of new studies.

"I think we know or at least we’ve suspected that LGBT people have had trouble reaching healthcare broadly," said Dr. Mitchell Lunn of the University of California, San Francisco, an expert on sexual and gender minority health who was not involved with the new studies.

Investigators from the U.S. Centers for Disease Control and Prevention (CDC) write in the American Journal of Public Health that researchers have in the past that significant barriers made it hard for LGB people to get healthcare. Those barriers include lack of insurance coverage and few culturally competent providers.

For one of the new studies released this week, James Dahlhamer of the CDC and colleagues analyzed data from the 2013 National Health Interview Survey, collected from 521 gay or lesbian people, 215 bisexual people and 25,149 straight people.

Compared to their straight counterparts, LGB people were more likely to delay or not receive care due to costs. Bisexual people were also more likely to delay care for reasons other than costs. Gay and bisexual men were more likely than their straight peers to report trouble finding healthcare providers.

Also, bisexual women were more likely than gay and lesbian women to report three of the five barriers to care the researchers asked about on the survey.

Based on their findings, the researchers call for "sustained research on health care access among LGB adults."

In a separate report in the same journal, researchers from Sweden say health disparities between LGB people and their straight peers may be a result of unequal distribution of health-protective resources like knowledge, prestige, power and supportive social connections.

Richard Branstrom of the Karolinska Institute in Stockholm and colleagues examined Swedish illness data collected from 2001 to 2011 on 66,604 straight people and 1,654 LGB people.

They compared illnesses in LGB people and their straight counterparts in relation to how preventable the diseases were. For example, high-preventable diseases included pneumonia, flu, accidents and liver disease. Low-preventable diseases included pancreatic cancer, heart muscle disease, and multiple sclerosis.

Overall, there was no difference between LGB and straight people when it came to low-preventable diseases.

However, gay and bisexual men were 48 percent more likely than straight men to have a high-preventable illness. Similarly, lesbian and bisexual women were 64 percent more likely than straight women to have highly preventable illnesses.

The researchers say their findings support the "fundamental cause theory," which says disparities between advantaged and disadvantaged groups will be greater for preventable conditions than non-preventable conditions.

Overcoming healthcare barriers for LGB and transgender people will take a multipronged approach that includes educating healthcare providers and everyone involved with the healthcare system, said Lunn. Also important, he said, is better data collection from the LGBT community.

"I think that information will help us develop some targeted public health interventions to help change access," Lunn said. "A lot of people focus on disease for public health approaches, but hopefully we can improve access to healthcare."