Healthy ageing among older LGBTQIA+ adults: a conceptual framework for promoting inclusive ageing systems
TL;DR
The proposed framework demonstrates that healthy ageing results from the interaction between cumulative minority stress, resilience and supportive ecological environments across the life course and provides guidance for developing LGBTQIA+-affirming healthcare services, inclusive ageing policies and community-based interventions that promote equitable healthy ageing.
Abstract
This study aims to synthesise the existing literature on healthy ageing among older LGBTQIA + adults to develop a conceptual framework and discuss ways of creating inclusive ageing systems. An integrative literature review was conducted using peer-reviewed articles retrieved from the Scopus and Web of Science databases. Following the removal of duplicate and non-relevant records, 82 studies were included in the review. A thematic synthesis was undertaken to identify key themes related to minority stress, resilience, healthcare access, social support and healthy ageing. The findings informed the development of a conceptual framework grounded in minority stress theory, life course theory and ecological systems theory. The review indicates that cumulative minority stress contributes to poorer mental and physical health, social isolation, healthcare avoidance and reduced quality of life among older LGBTQIA + adults. However, resilience, chosen family, community connectedness and inclusive healthcare and policy environments act as protective mechanisms that mitigate these adverse effects. The proposed framework demonstrates that healthy ageing results from the interaction between cumulative minority stress, resilience and supportive ecological environments across the life course. The framework provides guidance for developing LGBTQIA+-affirming healthcare services, inclusive ageing policies and community-based interventions that promote equitable healthy ageing. This study integrates three complementary theories into a unified conceptual framework, offering a holistic understanding of healthy ageing among older LGBTQIA + adults and identifying directions for future research, policy and practice.