Health and Health Care of Sexual Minority Individuals in the Rural United States: A Systematic Review

Lesser health care access and utilization in rural areas are associated with rural-urban health outcome disparities. While some work has examined similar disparities by sexual orientation, little has explicitly explored the combined influences of rural residence and lesbian, gay, and bisexual (LGB) status. This study aims to explore literature specific to rural LGB health care access and utilization, identify gaps, and suggest future research. Several databases were searched to identify studies specific to LGB health care access and utilization, and 18 articles were identified and divided into two categories: barriers and facilitators to health care access. Barriers included provider training, discrimination, distance and physical access, and fewer social supports. The data also indicated that sexual orientation disclosure is associated with better health care. Rural sexual minority individuals undergo health care access and utilization inequities, even in excess of their heterosexual rural peers that may be addressed with training and social interventions. Further research is warranted.