At a time when lesbian, gay, bisexual, and transgender individuals—often referred to under the umbrella acronym LGBT—are becoming more visible in society and more socially acknowledged, clinicians and researchers are faced with incomplete information about their health status. While LGBT populations often are combined as a single entity for research and advocacy purposes, each is a distinct population group with its own specific health needs. Furthermore, the experiences of LGBT individuals are not uniform and are shaped by factors of race, ethnicity, socioeconomic status, geographical location, and age, any of which can have an effect on health-related concerns and needs. While some research about the health of LGBT populations has been conducted, researchers still have a great deal to learn. To help assess the state of the science, the National Institutes of Health (NIH) asked the Institute of Medicine (IOM) to assess current knowledge of the health status of lesbian, gay, bisexual, and transgender populations; to identify research gaps and opportunities; and to outline a research agenda to help NIH focus its research in this area. A committee of experts was convened by the IOM to consider this task, and its findings are presented in its report, The Health of Lesbian, Gay, Bisexual, and Transgender People: Building a Foundation for Better Understanding.

The Health of Lesbian, Gay, Bisexual, and Transgender People: Building a Foundation for Better Understanding

An examination of data from the 1982 National Long-Term Care Survey reveals that informal caregivers to the disabled elderly are predominantly female and that three-quarters of them live with the care recipient. The data suggest that caregivers as well as care recipients are a vulnerable group since one-third are over age 65, report incomes in the poor to near-poor category and describe t eir health status as fair or poor. Less than 10 percent of the caregivers purchase services. There also is evidence of competing familial and employment demands among a subgroup of caregivers.

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Caregivers of the Frail Elderly: A National Profile

Effects of caregiving on physical health have received less theoretical and empirical attention than effects on psychological health. This meta-analysis integrates results from 176 studies on correlates of caregiver physical health. Caregiver depressive symptoms had stronger associations with physical health than did objective stressors. Higher levels of care recipient behavior problems were more consistently related to poor caregiver health than were care receiver impairment and intensity of caregiving. Higher age, lower socioeconomic status, and lower levels of informal support were related to poorer health. Predictors of physical health are not identical to predictors of psychological health. Associations of caregiving stressors with health were stronger among older samples, dementia caregivers, and men. In sum, negative effects of caregiving on physical health are most likely to be found in psychologically distressed caregivers facing dementia-related stressors.

Correlates of Physical Health of Informal Caregivers: A Meta-Analysis

Parent Care as a Normative Family Stress

A widely held stereotype associates old age with social isolation and loneliness. However, only 5% to 15% percent of older adults report frequent loneliness. In this study, we report a meta-analysis of the correlates of loneliness in late adulthood. A U-shaped association between age and loneliness is identified. Quality of social network is correlated more strongly with loneliness, compared to quantity; contacts with friends and neighbors show stronger associations with loneliness, compared to contacts with family members. Being a woman, having low socioeconomic status and low competence, and living in nursing homes were also associated with higher loneliness. Age differences in the association of social contacts and competence with loneliness are investigated as well.

Influences on Loneliness in Older Adults: A Meta-Analysis

Strain Among Caregivers: A Study of Experience in the United States

This research presents empirical findings concerning the extent to which older people in the inner city neighborhoods of New York City have an informal network of friends and neighbors and the nature of the interactions which occur. The characteristics associated with individuals possessing extensive friend-neighbor networks are discussed, and the preferences of older people for assistance from kin versus nonkin in a variety of situations are explored. Several theoretical models concerning the operation of the informal support system are considered, and the author postulates a new model—the hierarchical-compensatory model-as best fitting the empirical data at hand. The findings are from the largest cross-cultural study of the elderly in urban poverty, The Elderly in the Inner City of New York with an N of 1,552, including 49% white, 37% black, and 13% Hispanic elderly.

Neighbors and Friends An Overlooked Resource in the Informal Support System

A holistic approach to the provision of social care of the elderly can best meet their future needs for assistance. In this paper, the concept of social care is delineated, and a systemwide model presented. This model emphasizes the interrelatedness of the component parts--informal, mediating, and formal--and the need for well-articulated linkages among them. Trends affecting future demand for care, and the ability of family and community to respond, are discussed. Although the family will retain an important role, some of its functions may shift to formal care in the decades ahead. Within the proposed framework, a research and policy agenda is suggested.

Family and Community: Changing Roles in an Aging Society

Life Space and the Social Support System of the Inner City Elderly of New York

Social support becomes an increasingly important resource for people as they age. Research has shown that the needs of older gay men are no different than those of their heterosexual counterparts, ...

Marjorie H. Cantor

Papers

Strain Among Caregivers: A Study of Experience in the United States

Neighbors and Friends An Overlooked Resource in the Informal Support System

Family and Community: Changing Roles in an Aging Society

Life Space and the Social Support System of the Inner City Elderly of New York

Social Networks of Aging Gay Men