Examining the Role Between Social Antecedents and Depression among LGBTQ+ Older Adults Eligible for Low-Income Housing

Abstract

Housing is one of the top four most needed services for LGBTQ+ older adults, and this study focuses on the intersection of depression and social antecedents among LGBTQ+ older adults eligible for low-income housing. To explore social antecedents (i.e., demographics, early events, later events, social integration, and stressors) associated with screening positive for depression among low-income LGBTQ+ older adults from two cities in the Western United States. A cross-sectional study was conducted with LGBTQ+ older adults (n = 241). A two-item version of the Patient Health Questionnaire (PHQ-2) was used to screen for depression. Hierarchical logistic regression tested associations between screening positive for depression and social antecedents. The average age of participants was 68 years and 92.5% identified as LGBTQ+. Over 24% (n = 58) screened positive for depression (PHQ-2 ≥ 3). Bivariate analyses found associations between screening positive for depression and several social antecedents, including demographics, later events, social integration, and stressors. Hierarchical logistic regression models found that LGBTQ+ older adults earning $30,000 or less were nearly five times more likely to screen positive depression than those earning more (OR = 4.57, 95% CI = 1.53-13.66, p = 0.006). Additionally, stressors such as problems with memory (OR = 4.05, 95% CI = 1.66-9.85, p = 0.002) and poor/fair quality of life (OR = 5.44, 95% CI = 2.24-13.20, p < 0.001) were associated with a 4-to-5 times higher odds of screening positive for depression compared with those who did not have these stressors. These findings reveal patterns of associations between social antecedents and depression among LGBTQ+ older adults eligible for low-income housing. This emphasizes the need for future research on the impact of housing and related structural interventions to promote the mental health of diverse aging populations.