title: The health equity promotion model: Reconceptualization of lesbian, gay, bisexual, and transgender (LGBT) health disparities.
abstract: National health initiatives emphasize the importance of eliminating health disparities among historically disadvantaged populations. Yet, few studies have examined the range of health outcomes among lesbian, gay, bisexual, and transgender (LGBT) people. To stimulate more inclusive research in the area, we present the Health Equity Promotion Model-a framework oriented toward LGBT people reaching their full mental and physical health potential that considers both positive and adverse health-related circumstances. The model highlights (a) heterogeneity and intersectionality within LGBT communities; (b) the influence of structural and environmental context; and (c) both health-promoting and adverse pathways that encompass behavioral, social, psychological, and biological processes. It also expands upon earlier conceptualizations of sexual minority health by integrating a life course development perspective within the health-promotion model. By explicating the important role of agency and resilience as well as the deleterious effect of social structures on health outcomes, it supports policy and social justice to advance health and well-being in these communities. Important directions for future research as well as implications for health-promotion interventions and policies are offered.
authors.affiliation: School of Social Work, University of Washington.
authors.forename: Karen I
authors.initials: KI
authors.lastname: Fredriksen-Goldsen
authors.affiliation: Department of Psychology, University of Washington.
authors.forename: Jane M
authors.initials: JM
authors.lastname: Simoni
authors.affiliation: School of Social Work, University of Washington.
authors.forename: Hyun-Jun
authors.initials: HJ
authors.lastname: Kim
authors.affiliation: MIRECC Postdoctoral Fellow, VA Puget Sound Health Care System.
authors.forename: Keren
authors.initials: K
authors.lastname: Lehavot
authors.affiliation: School of Social Work, University of Washington.
authors.forename: Karina L
authors.initials: KL
authors.lastname: Walters
authors.affiliation: Department of Psychology, University of Washington.
authors.forename: Joyce
authors.initials: J
authors.lastname: Yang
authors.affiliation: School of Social Work, University of Washington.
authors.forename: Charles P
authors.initials: CP
authors.lastname: Hoy-Ellis
authors.affiliation: Department of Sociology, Loyola Marymount University.
authors.forename: Anna
authors.initials: A
authors.lastname: Muraco
mesh_terms: D001727:Bisexuality / Q000523:psychology*; D005260:Female; D006293:Health Promotion / Q000592:standards*; D054624:Health Status Disparities; D018452:Homosexuality, Female / Q000523:psychology*; D018451:Homosexuality, Male / Q000523:psychology*; D006801:Humans; D008297:Male; D008960:Models, Psychological; D063106:Transgender Persons / Q000523:psychology*