Mental and behavioral health care access and satisfaction among older sexual minority women

This study expands upon syndemics, structural vulnerability, and health care utilization frameworks by examining individual and social factors influencing help-seeking, care barriers, and treatment satisfaction among sexual minority women (SMW; e.g., bisexual, lesbian) aged 50+ from Wave 3 of a community-based longitudinal study, the Chicago Health and Life Experiences of Women Study. Wave 3 data were collected in 2010-2012 (May 2010 to August 2012). Bivariate analyses were conducted to examine associations among help-seeking behaviors, self-rated physical and mental health, relationship status, and social support. We used multivariate logistic regression models to examine (1) associations between sociodemographic characteristics and help-seeking, (2) associations between help-seeking and treatment satisfaction variables and sociodemographic characteristics, (3) self-rated physical health and self-rated mental health as predictors of help-seeking and treatment satisfaction, and (4) interpersonal factors as predictors of help-seeking and treatment satisfaction. Participants (<i>N</i> = 196) were, on average, 58.15 years of age (SD = 6.61). Physical health and issues related to depression, anxiety, memory, and eating are synergistic among older SMW. Those with insufficient household incomes and identifying as bisexual, Black, or younger were more likely to seek help. Black and Latinx SMW reported fewer help-seeking barriers than White SMW. Self-rated poorer mental health was associated with greater difficulty accessing services; sociodemographic variables weakened this association. Poorer mental health and lower social support were associated with treatment dissatisfaction. Results highlight the relevance of structural vulnerabilities and social determinants of health among older SMW, emphasizing the need for integrated, culturally competent care models that enhance access and improve treatment satisfaction.