Blog Post #4, summary of a peer reviewed article

  

Fig. 1 Loftus, P. Gen Silent [digital image] Glaad.org

The article I chose to focus on for this blog post is, "The Cascading Effects of Marginalization and Pathways of Resilience in Attaining Good Health Among LGBT Older Adults". The research is drawn from on a project founded by Karen I. Fredricksen-Goldsen called, "Aging with Pride."

http://age-pride.org/ 

A brief note on terminology: throughout this blog post I will use LGBT simply because this is the form the authors use in the article.

The authors are Amanda E. B. Bryan, Ph.D., Charles A. Emlet, Ph.D., Chengshi Shiu, Ph.D., HyunJun Kim, Ph.D., and Karen I. Fredriksen-Goldsen, Ph.D. These individuals are all associated with the University of Washington School of Social Work. Fredrickson-Goldsen and Emlet are professors at the University of Washington. Hyun-Jun Kim is a research scientist at the same institution. These three individuals are all associated with a longitudinal study of aging among LGBT individuals called Aging with Pride: National Health, Aging and Sexuality/Gender Study (NHAS). Fredrickson-Goldsen is the founder of this project.

Credentials and Authority of the Authors:

These scholars have collaborated on research and published articles together in the past, and they have similar and overlapping areas of expertise. Fredriksen-Goldsen, Kim, and Emlet work primarily on health issues among aging marginalized people, primarily LGBT individuals and those living with HIV-AIDS. Shiu has a body of work dealing with Chinese women living with HIV, LGBT individuals in China, and Chinese diaspora immigrant communities in the US and Canada. Amanda Bryan is a licensed clinical psychologist practicing in Seattle, Washington. She is also associated with the University of Washington School of Social Work. The institutional links, additional published work, and correlations between the individual authors- the fact that many of them have co-authored similar articles in the past, establishes them as highly credible and lends authority to the article. 

Scope of the study:

"Aging with Pride: National Health, Aging and Sexuality/Gender Study (NHAS) is the first longitudinal research project designed to examine the health, aging, and well-being of LGBT adults aged 50 and older" (Bryan, Emlet, Shiu, Kim, Fredrickson-Goldsen, 2017).

According to the article, the authors collected survey data from 2,450 participants between the ages of 50-98. These were individuals who self-identified as LGBT and were born in 1964 or before. The information was collected in 2014. Surveys were both online and offline. The survey was distributed by means of LGBT organizations. Some 35 surveys were not included in the study due to incomplete data, according to the authors. (Bryan et al, 2017).

Methodology:

Researchers attempted to measure participants experiences of marginalization over the course of a lifetime. Sample questions included asking if the participant had ever been threatened with physical violence and then assessed how often this had occurred. This section on marginalization included victimization- a direct threat or attack, marginalization- loss of a job or housing, and microaggressions including insults, invalidation, and hostile environments.

The study assessed psychological resources- attempting to determine if participants had a positive identity associated with being LGBT or had internalized stigma. They describe this as identity affirmation and identity stigma (Bryan et al, 2017). The study also measured social resources, asking about partnerships, friendships, and community engagement. The study assessed mental health based on the self-reported frequency of positive or negative affect and perception of stress. 

The survey additionally asked about health-related behaviors such as engaging in physical activities, versus health-risk activities such as smoking or drinking. The survey also measured physical health and chronic health conditions.

Finally, the survey included demographic information, asking respondents about their age, race, self-identity, education level, employment status, and income.

Findings:

The authors hypothesized that LGBT adults over 50 would report a greater number of chronic health conditions in comparison to cisgender heterosexual individuals of the same or similar ages. They presumed that marginalization, overt bias, and the resulting stress would lead to worse physical and mental health. Additionally, however, they hypothesized that individuals with a stronger positive identity formation and closer ties to the LGBT community and other social supports would experience greater resilience, and would report comparatively better health and mental health. The data supported that hypothesis:

We identified a direct association between marginalization and physical health and delineated multiple indirect pathways to explain the association. As hypothesized, identity affirmation and social resources contributed positively to mental health, which in turn predicted physical health via health behaviors (Bryan et al, 2017).

The authors suggest that more research is yet to be done on the salutary effects of positive identity formation and social resources. They note that in studies regarding race and ethnicity this variable is often included, and conclude that it is a useful addition for LGBT individuals as well.

Reflections

I chose this article because I had begun by focusing rather heavily on LGBTQIA youth, on the coming-out process, and concurrent information seeking behaviors of youth and young adults. I happened upon an article by Fredrickson-Goldsen and was intrigued by her research into the process of aging for this community. I decided to explore more of her research as a result. Fredrickson-Goldsen speaks frankly about her own negative experience with end of life care for her own partner.  She describes the way the hospital offered her little or no information and sought her partner's parents to make a final decision about cutting off life support. Fredrickson-Goldsen explains her interest in LGBT elders and aging as stemming from this experience.  Yet she also refuses to focus solely on negative aspects of marginalized identities. I found the particular approach of this article refreshing and appreciated the emphasis on resilience. Fredrickson-Goldsen is doing invaluable work by investigating the lives of LGBT elders, and there are clear and obvious benefits to her research for that segment of the population. 

I was interested in learning more about the unique challenges LGBT elders face but also can see how the results are generalizable to a larger population and related to the information services sector. If positive identity formation and social supports have such a strong correlation with health outcomes, it only raises the stakes for information professionals to provide a range of information for the diverse communities we serve. This article is also a good balance for me, considering the great number of articles I've encountered which detail the challenges and adversity that this community faces. I'd like to find a balance between addressing that reality and positing solutions that will better support that community.

For those interested in seeing more of Frederick-Goldsen, or hearing more about her work. I found the following speech on youtube:

https://www.youtube.com/watch?v=dc791zFfVFk&t=333s

References:

 

Aging with Pride. (n.d.). Retrieved from http://age-pride.org/

 

Fredriksen-Goldsen, K., Kim, H., PhD., B Bryan, Amanda E,,PhD, Shiu, C., PhD., & Emlet, C. A., PhD. (2017). The cascading effects of marginalization and pathways of resilience in attaining good health among LGBT older adults. The Gerontologist, 57doi:http://dx.doi.org.libaccess.sjlibrary.org/10.1093/geront/gnw170

 

Loftus/Digital Campaigns Intern, P. (2015, November 9). Gen Silent [Digital image]. Retrieved March 24, 2019, from https://www.glaad.org/blog/gensilent-needs-your-support-lgbt-elders-day-and-beyond

Val's LGBTI Ageing & Aged Care. “Professor Karen Fredriksen-Goldsen Speaking at 3rd National LGBTI Ageing & Aged Care Conference.” YouTube, YouTube, 12 Dec. 2017, www.youtube.com/watch?v=dc791zFfVFk&t=333s.