title: The physical and mental health of lesbian, gay male, and bisexual (LGB) older adults: the role of key health indicators and risk and protective factors.
abstract: OBJECTIVE
  Based on resilience theory, this paper investigates the influence of key health indicators and risk and protective factors on health outcomes (including general health, disability, and depression) among lesbian, gay male, and bisexual (LGB) older adults.
  
  
  METHODS
  A cross-sectional survey was conducted with LGB older adults, aged 50 and older (N = 2,439). Logistic regressions were conducted to examine the contributions of key health indicators (access to health care and health behaviors), risk factors (lifetime victimization, internalized stigma, and sexual identity concealment), and protective factors (social support and social network size) to health outcomes, when controlling for background characteristics.
  
  
  RESULTS
  The findings revealed that lifetime victimization, financial barriers to health care, obesity, and limited physical activity independently and significantly accounted for poor general health, disability, and depression among LGB older adults. Internalized stigma was also a significant predictor of disability and depression. Social support and social network size served as protective factors, decreasing the odds of poor general health, disability, and depression. Some distinct differences by gender and sexual orientation were also observed.
  
  
  CONCLUSIONS
  High levels of poor general health, disability, and depression among LGB older adults are of major concern. These findings highlight the important role of key risk and protective factors, which significantly influences health outcomes among LGB older adults. Tailored interventions must be developed to address the distinct health issues facing this historically disadvantaged population.
authors.affiliation: School of Social Work, University of Washington, Seattle, WA 98105, USA. fredrikk@u.washington.edu
authors.forename: Karen I
authors.initials: KI
authors.lastname: Fredriksen-Goldsen
authors.forename: Charles A
authors.initials: CA
authors.lastname: Emlet
authors.forename: Hyun-Jun
authors.initials: HJ
authors.lastname: Kim
authors.forename: Anna
authors.initials: A
authors.lastname: Muraco
authors.forename: Elena A
authors.initials: EA
authors.lastname: Erosheva
authors.forename: Jayn
authors.initials: J
authors.lastname: Goldsen
authors.forename: Charles P
authors.initials: CP
authors.lastname: Hoy-Ellis
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001727:Bisexuality / Q000523:psychology / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D003863:Depression / Q000523:psychology; D005260:Female; D015438:Health Behavior; D006297:Health Services Accessibility; D006304:Health Status; D006305:Health Status Indicators; D018452:Homosexuality, Female / Q000523:psychology / Q000706:statistics & numerical data*; D018451:Homosexuality, Male / Q000523:psychology / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D054525:Minority Health; D011788:Quality of Life; D055500:Resilience, Psychological; D012307:Risk Factors; D057545:Social Stigma; D012944:Social Support; D012959:Socioeconomic Factors