Forgone Care among LGBTQ and Non-LGBTQ Americans during the COVID-19 Pandemic: The Role of Health, Social Support, and Pandemic-Related Stress

Objectives In this study, we explore the role of Coronavirus Disease 2019 pandemic-related stress, social support, and health on unmet healthcare needs during the Coronavirus Disease 2019 pandemic, particularly among lesbian, gay, bisexual, transgender, and queer plus (LGBTQ+) adults. Methods We collected data using a self-administered online survey of US adults. Using logistic regression, we modeled potential risk and protective factors for not receiving needed care during the pandemic (forgone care) among LGBTQ+ individuals (n = 121), cisgender and heterosexual-identifying women (n = 235), and cisgender and heterosexual-identifying men (n = 62). Limiting analyses to the LGBTQ+ subsample, we also assessed the unique role of LGBTQ+ discrimination and depressive symptoms. Results Logistic regression results suggested that social support was associated with lower odds of forgone care (odds ratio [OR] 0.95, P \u3c 0.01). Furthermore, better self-rated health and higher levels of income were associated with lower odds of forgone care (OR 0.56, P \u3c 0.001, and OR 0.92, P \u3c 0.05, respectively). Finally, LGBTQ+ individuals experienced uniquely high levels of forgone care, and LGBTQ+ discrimination (OR 1.03, P \u3c 0.05) and depressive symptoms (OR 1.09, P \u3c 0.01) were associated with higher odds of forgone care among LGBTQ+ participants. Conclusions Future research should examine the unique factors shaping the access to health care of LGBTQ+ adults in the United States, and healthcare practitioners should consider strategies to screen for discrimination and leverage the protective benefits of social support