Life-Course Minority Stress, Social Isolation, and Depression/Suicide Risk in Older Sexual Minority Men
Study Purpose
Examine how life-course minority stress and aging-related social isolation contribute to depression and suicide risk among sexual minority men age 50 and older in the United States.
Theoretical Framework
Theoretical Foundation: Theory of Cumulative Advantage/Disadvantage
This study is grounded in cumulative advantage/disadvantage theory, a life-course framework that emphasizes how early social, structural, and psychological advantage or disadvantage become differentiated over time. Cumulative disadvantage compounds over time, producing diverging health trajectories that become most pronounced in later adulthood. Rather than viewing health outcomes as the result of discrete or contemporaneous exposures, cumulative disadvantage theory emphasizes the accumulation of repeated and persistent stressors, shaping long-term vulnerability through biological, psychological, and social pathways.
Conceptual Framework: Older Minority Depression and Suicide (OMDS)
Guided by cumulative disadvantage theory, the OMDS conceptual framework specifies the mechanisms through which accumulated lifecourse minority stress contributes to late-life depression and suicidality among sexual minority men age 50 and older. OMDS translates a general lifecourse theory into a population-specific, testable model by identifying key pathways linking historical exposures to current mental health outcomes.
Overall Study Design
This project employs a three-stage, sequential mixed methods design integrating:
Stage 1 (Current). Population and Cohort Data Analyses (e.g., AoU, NHIS, BRFSS)
We are integrating analyses of national health surveillance datasets (NHIS, BRFSS) and the NIH All of Us Research Program to examine population-level patterns of depression, social isolation, and suicide-related risk among sexual minority men age 50+. While NIHIS and BRFSS provide nationally representative estimates of mental health disparities, AoU offers complementary depth in clinical, social, and functional domains. Together, these datasets will be used to identify patterns of late-life mental health burden and social isolation consistent with cumulative disadvantage. We will then test whether associations between sexual minority status, isolation, and depression are amplified with advancing age.
Stage 2 (Future). Primary survey data collection
Stage 3 (Future). Cross-dataset integration and comparative synthesis