Using IPD meta-analysis to explore health and care inequalities among lesbian, gay, bisexual and transgender people

Session: 

Oral session: Global health and equity

Date: 

Monday 17 September 2018 - 12:00 to 12:20

Location: 

Ochil 2

All authors in correct order:

Kneale D1, French R2, Henley J2, Thomas J1
1 EPPI-Centre, UCL Institute of Education, UCL, UK
2 Cardiff University, UK
Presenting author and contact person

Presenting author:

Dylan Kneale

Contact person:

Dylan Kneale
Abstract text
Background: Modelling the health and care trajectories of lesbian, gay, bisexual and transgender (LGBT) is essential to identify health inequalities and support needs, yet because of the small sample of LGBT people in any one survey, current evidence relies on studies that have poor generalisability and low power. This lack of data results in knowledge gaps for decision-makers seeking to plan health and care services for LGBT people.
Objectives: This presentation will:
1) describe differential ageing trajectories followed by older LGBT people through presenting the results from a scoping review;
2) demonstrate how different approaches to identifying LGBT people in large surveys leads to a differential understanding of public health challenges;
3) assess health inequalities facing older people, using exemplar evidence on alcohol consumption and wellbeing from individual participant data (IPD) meta-analysis of UK data.
Methods: IPD meta-analysis allows more flexible, complex statistical analysis of study data. Use of IPD meta-analysis to explore LGBT health and care differentials is a novel application to exploring issues of health and care equity based on sexuality in later life, and the results for measures of quality of life and alcohol consumption will be presented, based on pooling a wide range of different UK data sources.
Results: Early results suggest that inequalities in health are particularly visible for older LGB women. Furthermore, the wellbeing of this group may be compromised further by other age-related transitions, such as the adoption of family caring duties at a much earlier age. Measurement issues around the identification of people as being LGBT within large scale surveys are also examined, and the implications for generating evidence for public health decision-making from IPD meta-analysis of minority populations will be considered in full.
Conclusions: IPD meta-analysis holds great promise for understanding the health trajectories of minority groups, although measurement and identification of minority groups across survey data presents new challenges not encountered (as frequently) in reviews of experimental data.
Patient or healthcare consumer involvement: Working in partnership with an institution specialising in ageing, a lay group of older people will be consulted on how these findings can be translated into recommendations

Relevance to patients and consumers: 

Modelling the health and care trajectories of lesbian, gay, bisexual and transgender (LGBT) is essential to identify health and support needs, yet because of the small sample of LGBT people in any one survey, current evidence relies on studies that have poor generalisability and low power. This lack of data results in knowledge gaps for decision-makers seeking to plan health and care services for LGBT people, including for older people. This presentation on IPD meta-analysis outlines the challenges of synthesising evidence for health and care decision-making for older LGBT people as well as presenting some initial findings.