Assessment of LGBT Needs and Health in Kentucky: Results of a Statewide Needs Assessment.

Abstract

The health and social needs of LGBT older adults remain underrepresented in public health research, particularly in states where data collection on sexual and gender minorities has been limited. This study reports findings from the Kentucky LGBT Health Needs Assessment, a community-generated, statewide evaluation of adults aged 50 and older. Employing a cross-sectional, mixed methods design, the survey was developed in collaboration with LGBT community stakeholders. The assessment captured a broad range of demographic, health, psychosocial, and service access variables, with 672 individuals completing the study. Findings reveal a predominantly white, highly educated sample with a mean age of 59.5 years. Participants reported relatively positive perceptions of their general health, yet high rates of chronic conditions such as arthritis, hypertension, and obesity. While most found healthcare information accessible, 21% had unmet medical needs and 18% delayed care due to lack of affirming providers. Mental health and counseling services were especially difficult to access, particularly among rural respondents. Long-term care concerns were prominent, with strong preferences for LGBT-specific facilities and uncertainty about future caregiving arrangements and financing. Although participants largely expressed pride and comfort in their LGBT identity, experiences of discrimination, verbal abuse, and stereotyping were common. Despite high identity affirmation, community engagement was limited, often reflecting safety concerns and structural stigma. This needs assessment provides one of the first statewide snapshots of LGBT aging in Kentucky, highlighting both strengths and vulnerabilities in health and social well-being. Findings underscore the urgent need for inclusive policies, provider training, and tailored aging services.