Inequalities in health and care among Lesbian, Gay and Bisexual people aged 50 and over in the United Kingdom: A systematic review and meta-analysis of sources of individual participant data

OBJECTIVES: Modelling the health and care trajectories of lesbian, gay and bisexual (LGB) is essential to identify inequalities and support needs, yet because of the small sample of LGB people in any one survey, current evidence relies on studies that have poor generalisability and low power. This study assesses the magnitude of health inequalities among older LGB people across ten outcomes, informed by evidence on the health trajectories and distinct LGB history of the United Kingdom (UK). METHODS: A systematic review was conducted of representative data sources on older LGB and heterosexual people's health and care status in the UK. Individual Participant Data (IPD) meta-analysis was employed to synthesise data from up to 25 different sources. To account for the intricacies of individual datasets, the analysis employed a two-stage approach where an odds ratio (OR) and standard error was calculated for each dataset individually, before being meta-analysed through DerSimonian and Laird random effects models. RESULTS: Among men aged 50+, being gay, bisexual or having another non-heterosexual orientation is associated with an increased risk of reporting long-term illness and health-related limitations. Indicators of mental health also suggest that gay and bisexual men are more likely to report low life satisfaction and to have attempted suicide over their life time. Among women, differences are apparent with regards to self-rated health as well as with engagement with risky health behaviours. DISCUSSION: The findings corroborate the minority stress theory, but they also generate new questions for researchers around when and how these inequalities emerge