Eliciting patient past experiences of healthcare discrimination as a potential pathway to reduce health disparities: A qualitative study of primary care staff.

Objective: To understand whether and how primary care providers and staff elicit patients' past experiences of healthcare discrimination when providing care.

Data Sources/study Setting: Twenty qualitative semi-structured interviews were conducted with healthcare staff in primary care roles to inform future interventions to integrate data about past experiences of healthcare discrimination into clinical care.

Study Design: Qualitative study.

Aging in isolation: Sexual orientation differences in navigating cognitive decline.

Introduction: Subjective cognitive decline is a self-reported measure of worsening memory and day-to-day decision making. Cognitive decline may impair an individual's ability to complete instrumental activities of daily living (IADL) such as preparing meals or taking medication, ultimately limiting one's ability to live independently. People with IADL impairments typically rely on informal care from spouses or children.

Mental Health of Transgender Youth Following Gender Identity Milestones by Level of Family Support.

Importance: Transgender youth are at an elevated risk for adverse mental health outcomes compared with their cisgender peers. Identifying opportunities for intervention is a priority.

Objective: To estimate differences in the association between gender identity milestones and mental health outcomes among transgender youth, stratified by level of family support.

Adverse childhood experiences (ACEs) and mental health by gender identity in the United States, 2019-2021.

Objective: To estimate the prevalence of adverse childhood experiences (ACEs) and their association with mental health outcomes in adulthood by gender identity.

Methods: Data come from 2019 to 2021 US Centers for Disease Control and Prevention Behavioral Risk Factor Surveillance System, among 17 states collecting gender identity and ACEs. We estimated the prevalence of ACEs and used Poisson family regression to estimate the association between ACEs and mental health stratified by gender identity.

Sexual Orientation, High-Deductible Health Plans, And Financial Barriers To Care.

Among US adults in 2013-18, we found high-deductible health plan enrollment to be the lowest among heterosexual and gay/lesbian adults in families with incomes below 200 percent of the federal poverty level and the highest among bisexual adults in families with incomes at or above 400 percent of poverty. Gay/lesbian and bisexual adults in these plans experienced greater financial barriers to health care than heterosexual adults.

Health Disparities Among Lesbian, Gay, Bisexual, Transgender, and Queer Older Adults: A Structural Competency Approach.

Lesbian, gay, bisexual, transgender, and queer (LGBTQ+) older adults experience significant health disparities. Examining these disparities has become an international research priority, but gaps remain. In this review article, we summarize major contributions of and ongoing gaps in health disparities research among LGBTQ+ older adults, while focusing on four major content areas: (a) social determinants of health disparities, (b) mental, cognitive, and physical health disparities, (c) reproductive and sexual health disparities, and (d) seeking LGBTQ+-affirming and age-friendly care.

Association of Affirming Care with Chronic Disease and Preventive Care Outcomes among Lesbian, Gay, Bisexual, Transgender, and Queer Older Adults.

Introduction: Experiences of discrimination and bias in healthcare contribute to health disparities for lesbian, gay, bisexual, transgender, and queer populations. To avoid discrimination, many go to great lengths to find healthcare providers who they trust and who are knowledgeable about their health needs. This study examines whether access to an affirming provider improves health outcomes for lesbian, gay, bisexual, transgender, and queer populations across a range of preventive health and chronic disease management outcomes.

State Policies and Health Disparities between Transgender and Cisgender Adults: Considerations and Challenges Using Population-Based Survey Data.

Context: The authors examined the association between state-level policy protections and self-rated health disparities between transgender and cisgender adults.

Methods: They used data on transgender (n = 4,982) and cisgender (n = 1,168,859) adults from the 2014-2019 Behavioral Risk Factor Surveillance System. The authors estimated state-specific health disparities between transgender and cisgender adults, and they used multivariable logistic regression models to compare adjusted odds ratios between transgender and cisgender adults by state-level policy environments.

Adverse Childhood Experiences and Mental Distress Among US Adults by Sexual Orientation.

This cross-sectional study uses Behavioral Risk Factor Surveillance System data to characterize adverse childhood experiences and mental distress by sexual orientation.

Toward Nonbinary Nuance in Research and Care: Mapping Differences in Gender Affirmation and Transgender Congruence in an Online National U.S. Survey.

To close gaps in transgender health research, we mapped trends in gender affirmation processes (i.e., social, legal, and psychological transitions) that are unique among nonbinary (NB) transgender adults when compared with transgender women (TW) and transgender men (TM).

Understanding the Role of Past Health Care Discrimination in Help-Seeking and Shared Decision-Making for Depression Treatment Preferences.

As a part of a larger, mixed-methods research study, we conducted semi-structured interviews with 21 adults with depressive symptoms to understand the role that past health care discrimination plays in shaping help-seeking for depression treatment and receiving preferred treatment modalities. We recruited to achieve heterogeneity of racial/ethnic backgrounds and history of health care discrimination in our participant sample. Participants were Hispanic/Latino ( = 4), non-Hispanic/Latino Black ( = 8), or non-Hispanic/Latino White ( = 9).

Analyses of electronic health records utilization in a large community hospital.

Introduction: The Electronic Health Record (EHR) has become an integral component of healthcare delivery. Survey based studies have estimated that physicians spend 4-6 hours of their workday devoted to EHR. Our study was designed to use computer software to objectively obtain time spent on EHR.

Depression Treatment Expenditures for Adults in the USA: a Systematic Review.

Purpose Of Review: We review 2016-2019 peer-reviewed literature which summarizes the factors contributing to high expense of treating depression among adults in the USA, and interventions that have been conducted to decrease depression treatment expenditures.

Recent Findings: Treatment expenditures associated with depression are high and growing, driven in part by increased health care utilization and a shift toward increased insurance coverage of medications and therapies. The majority of identified articles describe the elevated financial burden associated with treating individuals with chronic medical conditions who also have a depression diagnosis.