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Applying a Capabilities Approach to Understanding Older LGBT People’s Disclosures of Identity in Community Primary Care

Internationally, there is increasing recognition that lesbian, gay, bisexual and trans (LGBT) populations experience substantial public health inequalities and require interventions to address these inequalities, yet data on this population is often not routinely collected. This paper considers the...

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Autores principales: Toze, Michael, Fish, Julie, Hafford-Letchfield, Trish, Almack, Kathryn
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7589792/
https://www.ncbi.nlm.nih.gov/pubmed/33086672
http://dx.doi.org/10.3390/ijerph17207614
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author Toze, Michael
Fish, Julie
Hafford-Letchfield, Trish
Almack, Kathryn
author_facet Toze, Michael
Fish, Julie
Hafford-Letchfield, Trish
Almack, Kathryn
author_sort Toze, Michael
collection PubMed
description Internationally, there is increasing recognition that lesbian, gay, bisexual and trans (LGBT) populations experience substantial public health inequalities and require interventions to address these inequalities, yet data on this population is often not routinely collected. This paper considers the case study of the UK, where there are proposals to improve government and health data collection on LGBT populations, but also a degree of apparent uncertainty over the purpose and relevance of information about LGBT status in healthcare. This paper applies a health capabilities framework, arguing that the value of health information about LGBT status should be assessed according to whether it improves LGBT people’s capability to achieve good health. We draw upon 36 older LGBT people’s qualitative accounts of disclosing LGBT status within UK general practice healthcare. Participants’ accounts of the benefits and risks of disclosure could be mapped against multiple domains of capability, including those that closely align with biomedical accounts (e.g., longevity and physical health), but also more holistic considerations (e.g., emotion and affiliation). However, across all domains, individuals tend to assess capabilities at an individual level, with relatively little reference to population-level impact of disclosure. Clearer articulation of the benefits of disclosure and data collection for the collective capabilities of LGBT populations may be a beneficial strategy for improving the quality of information on LGBT populations.
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spelling pubmed-75897922020-10-29 Applying a Capabilities Approach to Understanding Older LGBT People’s Disclosures of Identity in Community Primary Care Toze, Michael Fish, Julie Hafford-Letchfield, Trish Almack, Kathryn Int J Environ Res Public Health Article Internationally, there is increasing recognition that lesbian, gay, bisexual and trans (LGBT) populations experience substantial public health inequalities and require interventions to address these inequalities, yet data on this population is often not routinely collected. This paper considers the case study of the UK, where there are proposals to improve government and health data collection on LGBT populations, but also a degree of apparent uncertainty over the purpose and relevance of information about LGBT status in healthcare. This paper applies a health capabilities framework, arguing that the value of health information about LGBT status should be assessed according to whether it improves LGBT people’s capability to achieve good health. We draw upon 36 older LGBT people’s qualitative accounts of disclosing LGBT status within UK general practice healthcare. Participants’ accounts of the benefits and risks of disclosure could be mapped against multiple domains of capability, including those that closely align with biomedical accounts (e.g., longevity and physical health), but also more holistic considerations (e.g., emotion and affiliation). However, across all domains, individuals tend to assess capabilities at an individual level, with relatively little reference to population-level impact of disclosure. Clearer articulation of the benefits of disclosure and data collection for the collective capabilities of LGBT populations may be a beneficial strategy for improving the quality of information on LGBT populations. MDPI 2020-10-19 2020-10 /pmc/articles/PMC7589792/ /pubmed/33086672 http://dx.doi.org/10.3390/ijerph17207614 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Toze, Michael
Fish, Julie
Hafford-Letchfield, Trish
Almack, Kathryn
Applying a Capabilities Approach to Understanding Older LGBT People’s Disclosures of Identity in Community Primary Care
title Applying a Capabilities Approach to Understanding Older LGBT People’s Disclosures of Identity in Community Primary Care
title_full Applying a Capabilities Approach to Understanding Older LGBT People’s Disclosures of Identity in Community Primary Care
title_fullStr Applying a Capabilities Approach to Understanding Older LGBT People’s Disclosures of Identity in Community Primary Care
title_full_unstemmed Applying a Capabilities Approach to Understanding Older LGBT People’s Disclosures of Identity in Community Primary Care
title_short Applying a Capabilities Approach to Understanding Older LGBT People’s Disclosures of Identity in Community Primary Care
title_sort applying a capabilities approach to understanding older lgbt people’s disclosures of identity in community primary care
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7589792/
https://www.ncbi.nlm.nih.gov/pubmed/33086672
http://dx.doi.org/10.3390/ijerph17207614
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