Anthony Amato

Topic

An Intersectionality-Informed Analysis of Loneliness and Discrimination Experienced by 2S/GBTQ+ People Living With Disabilities Before and During the COVID-19 Pandemic

Social Dimensions of Health

Date & location

• Friday, April 5, 2024
• 1:00 P.M.
• Virtual Defence

Examining Committee

Supervisory Committee

• Dr. Nathan Lachowsky, School of Public Health and Social Policy, University of Victoria (Supervisor)
• Dr. Kiffer Card, School of Public Health and Social Policy, UVic (Co-Supervisor)

External Examiner

• Dr. Vera Caine, School of Nursing, UVic

Chair of Oral Examination

• Dr. Susan Ramsundarsingh, School of Social Work, UVic

Abstract

Introduction: Social inequities such as loneliness and discrimination due to sexual orientation (herein, discrimination) are prevalent across disabled people and Two-Spirit, Gay, Bisexual and Trans men, Queer and Non-Binary (2S/GBTQ+) communities. However, little is known about how loneliness and discrimination were experienced in Canada at the intersection of disability and 2S/GBTQ+ communities, especially before and during the COVID-19 pandemic.

Method: To address this knowledge gap, four cycles (2019, 2020, 2021, 2022) of cross-sectional, bilingual, community-based Sex Now survey data were used, which included 2S/GBTQ+ people aged 15 years or older and living in Canada. A total of 12,354 2S/GBTQ+ participants responded to loneliness outcomes, and 11,575 to discrimination outcomes. A multi-stage data analysis was conducted. First, crosstabulations and chi-square tests were used to describe and test for differences across outcomes across the four survey cycles. Second, pooled data were analyzed to describe and test for differences in outcomes based on social determinants of health. Third, stratified analyses were repeated for participants living with and without a disability. Finally, only among 2S/GBTQ+ participants living with disabilities, multivariable logistic regression models of each outcome identified 1) temporal trends by survey year, and 2) social determinants of health correlates.

Results: There were statistically significant differences in outcomes across survey cycles, which were greater among 2S/GBTQ+ participants living with a disability. Compared with 2019 (before COVID-19), the odds of reporting loneliness were greater for 2S/GBTQ+ participants living with disabilities in 2020 and 2021 (but not 2022). 2S/GBTQ+ participants living with a disability who reported a racialized identity, financial strain, or a gender-expansive identity had greater odds of reporting loneliness. Compared with 2019 (before COVID-19), decreased odds of reporting discrimination were found in 2021 and 2022 (but not 2020). Generally, older 2S/GBTQ+ participants living with a disability were less likely to experience discrimination. 2S/GBTQ+ participants living with disabilities who were racialized, queer versus bisexual identified, and gender-expansive reported greater odds of discrimination.

Conclusions: These findings suggest that 2S/GBTQ+ people living with disabilities were impacted by greater loneliness and lesser discrimination during COVID-19. However, social inequities were also present among 2S/GBTQ+ people living with disabilities. Equitable policy planning is needed to ensure that underserved yet deserving communities are not disproportionally affected by future pandemics and associated public health responses.