Rural/Urban Differences in Health and Health Care Access for LGBT Adults
Despite gains in recent years in marriage equality and access to health insurance for lesbian, gay, bisexual, and transgender (LGBT) adults, long-standing health disparities by sexual orientation and gender identity persist. These were exacerbated by transphobic policies at the state and federal levels in recent years (e.g., "bathroom bills" and policies targeting transgender youth in sports and adults in the military). In addition to discriminatory policy, health disparities for LGBT adults are made worse by stigma, bigotry, and hate crimes leading to higher exposure to chronic stress and increased allostatic load. These disparities matter for current health equity, as well as for longer-term planning for future health care needs. Yet, there is limited information on rural/urban differences in health and health care access by sexual orientation and gender identity, despite heightened risk factors for poor health and reduced access to care in rural settings. This project will address that gap by identifying differences in health and health care access (e.g., usual provider, delayed/forgone care, health insurance status) by sexual orientation and gender identity for rural and urban adults, and by identifying examples of best practices in supporting LGBT health and wellbeing in rural areas.