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Primary sources of health care among LGBTQ+ veterans: Findings from the Behavioral Risk Factor Surveillance System |
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| Authors: | Hunter Hahn PhD Kelly H. Burkitt PhD Michael R. Kauth PhD Jillian C. Shipherd PhD John R. Blosnich PhD MPH |
| Affiliation: | 1. Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, USA;2. Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, HSR&D Center of Innovation, Houston, Texas, USA Lesbian, Gay, Bisexual, Transgender and Queer (LGBTQ+) Health Program, Office of Patient Care Services, Veterans Health Administration, Washington, DC, USA Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas, USA;3. Lesbian, Gay, Bisexual, Transgender and Queer (LGBTQ+) Health Program, Office of Patient Care Services, Veterans Health Administration, Washington, DC, USA Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts, USA National Center for PTSD, VA Boston Healthcare System, Boston, Massachusetts, USA |
| Abstract: | ObjectiveThis study examined the primary source of health care between veterans with lesbian, gay, bisexual, queer and similar identities (LGBTQ+) and non-LGBTQ+ veterans.Data Sources and Study SettingVeterans (N = 20,497) from 17 states who completed the CDC's Behavioral Risk Factor Surveillance System from 2016 to 2020, including the Sexual Orientation and Gender Identity and Health Care Access modules.Study DesignWe used survey-weighted multiple logistic regression to estimate average marginal effects of the prevalence of utilization of Veteran's Health Administration (VHA)/military health care reported between LGBTQ+ and non-LGBTQ+ veterans. Prevalence estimates were adjusted for age group, sex, race and ethnicity, marital status, educational attainment, employment status, survey year, and US state.Data Collection MethodsStudy data were gathered via computer-assisted telephone interviews with probability-based samples of adults aged 18 and over. Data are publicly available.Principal FindingsOverall, there was not a statistically significant difference in estimated adjusted prevalence of primary use of VHA/military health care between LGBTQ+ and non-LGBTQ+ veterans (20% vs. 23%, respectively, p = 0.13). When examined by age group, LGBTQ+ veterans aged 34 and younger were significantly less likely to report primary use of VHA/military health care compared to non-LGBTQ+ veterans (25% vs. 44%, respectively; p = 0.009). Similarly, in sex-stratified analyses, fewer female LGBTQ+ veterans than female non-LGBTQ+ veterans reported VHA/military health care as their primary source of care (13% vs. 29%, respectively, p = 0.003). Implications and limitations to these findings are discussed.ConclusionsFemale and younger LGBTQ+ veterans appear far less likely to use VHA/military for health care compared to their cisgender, heterosexual peers; however, because of small sample sizes, estimates may be imprecise. Future research should corroborate these findings and identify potential reasons for these disparities. |
| Keywords: | health care health disparities LGBTQ veterans Veterans Health Administration |