Long-term conditions among sexual minority adults in England: evidence from a cross-sectional analysis of responses to the English GP Patient Survey

Saunders, Catherine L.; MacCarthy, Sarah; Meads, Catherine; Massou, Efthalia; Mant, Jonathan; Saunders, Alison M; Elliott, Marc N.

doi:10.3399/bjgpo.2021.0067

Cited by 15 publications

(17 citation statements)

References 26 publications

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“…Fifth, the analyses were performed separately based on the indicated sex, but information on sexual orientation was missing. However, multimorbidity was found to be increased among sexual minorities [122,123], and respective effects could not be considered in the present study. Finally, this study focused on the comorbidity of two conditions, although multimorbidity is a common phenomenon for many patients.…”

Section: Limitationscontrasting

confidence: 65%

Sex Differences in Comorbidity Combinations in the Swedish Population

et al. 2022

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High comorbidity rates, especially mental–physical comorbidity, constitute an increasing health care burden, with women and men being differentially affected. To gain an overview of comorbidity rates stratified by sex across a range of different conditions, this study examines comorbidity patterns within and between cardiovascular, pulmonary, skin, endocrine, digestive, urogenital, musculoskeletal, neurological diseases, and psychiatric conditions. Self-report data from the LifeGene cohort of 31,825 participants from the general Swedish population (62.5% female, 18–84 years) were analyzed. Pairwise comorbidity rates of 54 self-reported conditions in women and men and adjusted odds ratios (ORs) for their comparison were calculated. Overall, the rate of pairwise disease combinations with significant comorbidity was higher in women than men (14.36% vs. 9.40%). Among psychiatric conditions, this rate was considerably high, with 41.76% in women and 39.01% in men. The highest percentages of elevated mental–physical comorbidity in women were found for musculoskeletal diseases (21.43%), digestive diseases (20.71%), and skin diseases (13.39%); in men, for musculoskeletal diseases (14.29%), neurological diseases (11.22%), and digestive diseases (10%). Implications include the need for integrating mental and physical health care services and a shift from a disease-centered to an individualized, patient-centered focus in clinical care.

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Section: Limitationscontrasting

confidence: 65%

Sex Differences in Comorbidity Combinations in the Swedish Population

et al. 2022

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“…It is interesting to note that this variation in age-related patterns between long-term health conditions is not seen when considering inequalities in longterm health conditions by socioeconomic deprivation, for which inequalities consistently increase with age, 18 nor by sexual orientation, where disparities across almost all long-term health conditions are greatest at younger ages and decrease at older ages. 19 For trans and non-binary adults, the drivers of differences are likely to be more condition specific. These patterns are likely, among other possible mechanisms, to be the result of complex interactions between minority stress, behavioural risk factors and biological effects of exogenous hormones, as well as sexual orientation, socioeconomic status and healthcare access.…”

Section: Discussionmentioning

confidence: 99%

“…The four different age-related patterns for long-term conditions point to heterogeneous and potentially intersecting factors driving some of the differences seen. It is interesting to note that this variation in age-related patterns between long-term health conditions is not seen when considering inequalities in long-term health conditions by socioeconomic deprivation, for which inequalities consistently increase with age,18 nor by sexual orientation, where disparities across almost all long-term health conditions are greatest at younger ages and decrease at older ages 19. For trans and non-binary adults, the drivers of differences are likely to be more condition specific.…”

Section: Discussionmentioning

confidence: 99%

Demographic characteristics, long-term health conditions and healthcare experiences of 6333 trans and non-binary adults in England: nationally representative evidence from the 2021 GP Patient Survey

et al. 2023

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ObjectiveIn order to address the lack of data on the health and healthcare needs of trans and non-binary adults, NHS England includes questions asking about both gender and trans status in its surveys to support quality improvement programmes.We used self-reported data from the GP Patient Survey to answer the research question: what are the demographic characteristics, health conditions and healthcare experiences of trans and non-binary adults in England?Design/settingNationally representative, population-based cross-sectional survey in England with survey data collection from January to March 2021.Participants840 691 survey respondents including 6333 trans and non-binary adults.OutcomesWe calculated weighted descriptive statistics, and using logistic regression explored 15 long-term physical and mental health conditions, and 18 patient experience items, covering overall experience, access, communication and continuity.ResultsTrans and non-binary adults were younger, more likely to be from Asian, black, mixed or other ethnic groups and more likely to live in more deprived parts of the country. Age-specific patterns of long-term conditions were broadly similar among trans and non-binary adults compared with all other survey respondents, with some variation by condition. Overall, inequalities in long-term health conditions were largest for autism: OR (95% CI), 5.8 (5.0 to 6.6), dementia: 3.1 (2.5 to 3.9), learning disabilities: 2.8 (2.4 to 3.2) and mental health: 2.0 (1.9 to 2.2), with variation by age. In healthcare experience, disparities are much greater for interpersonal communication (OR for reporting a positive experience, range 0.4 to 0.7 across items) than access (OR range 0.8 to 1.2). Additionally, trans and non-binary adults report much higher preference for continuity 1.7 (1.6 to 1.8), with no evidence of any differences in being able to see or speak to a preferred general practitioner.ConclusionThis research adds up to date evidence about population demographics, health and healthcare needs to support healthcare improvement for trans and non-binary adults.

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“…Sexuality is measured from self-reported sexual orientation, with a sample size of approximately 2.92% of individuals identifying as LGB [20]. Previous studies have used the GPPS to examine how frequently LGB individuals access GPs compared with heterosexual individuals, and to look at inequalities in long-term health conditions between sexual minority groups compared with their heterosexual counterparts [26,27]. The inclusion of smoking by asking individuals if they are never smokers, former, occasional or regular smokers can allow for analysis on smoking status across sexuality groups.…”

Section: Health Surveysmentioning

confidence: 99%

Navigating the LGB Data Landscape: A Review of Appropriate Secondary Data Sources for Sexuality and Substance Use Research in the UK

Davies¹,

Moon

Sabel

2022

IJERPH

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Research has found that sexual minority individuals are more likely to experience health inequalities and have higher rates of substance use compared with their heterosexual counterparts. This association between sexuality and health outcomes is increasingly being explored using quantitative methodologies within the context of public health, psychology and health geography. Much of this research, however, has relied on primary data, despite the wide availability of secondary sources, mainly survey data, collecting information on sexuality and different types of health outcomes and health risk behaviours, such as substance use. This study reviewed recent surveys in the UK that are appropriate for exploring topics related to LGB populations and substance use behaviours. We carried out a narrative review of secondary data sources in the UK to assess the accessibility and suitability of secondary sources for sexuality and substance use research. We identified eight cross-sectional and two longitudinal surveys that contained both sexuality and substance use data. We summarised the possible applications of each survey and the scope of questions within sexuality and substance use research that could be addressed by each survey. The identification of appropriate surveys in this review can allow researchers to extend the use of secondary data sources in the UK to examine substance use inequalities between sexuality groups, further advancing this key topic.

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Long-term conditions among sexual minority adults in England: evidence from a cross-sectional analysis of responses to the English GP Patient Survey

Cited by 15 publications

References 26 publications

Sex Differences in Comorbidity Combinations in the Swedish Population

Sex Differences in Comorbidity Combinations in the Swedish Population

Demographic characteristics, long-term health conditions and healthcare experiences of 6333 trans and non-binary adults in England: nationally representative evidence from the 2021 GP Patient Survey

Navigating the LGB Data Landscape: A Review of Appropriate Secondary Data Sources for Sexuality and Substance Use Research in the UK

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