An academic research survey published in January found that most lesbians have adequate health coverage, but those over the age of 60 are less likely to reveal their sexual orientation to health care workers. The survey, entitled “Identifying the Health Needs of Aging and Older Lesbians,” was released on the Web site www.womenshealthsurvey.org.

Linda Martinez, a registered nurse who has spent 18 years in the health care profession with primary interest in women’s health and psychology, researched and compiled the results of the survey for her master’s thesis in Arizona State University’s nurse practitioner program. The survey examined women 45 years of age and older whose primary emotional and/or sexual relationships are with women. She said there is limited information available regarding the attitudes, beliefs, practices, experiences and concerns of lesbians within this group toward health care, making it difficult to determine specific issues that may be unique to this population.

In the survey results, Martinez cites the study “Lesbians over 65: A triply invisible minority” by Monika Kehoe, which argues that older lesbians have a triple minority: status, gender and age. Kehoe’s study appeared in the Journal of Homosexuality in 1986.

Martinez said only 9-10 percent of participants in larger studies related to lesbian health were over the age of 45, and asked what would happen as they aged in a system that is predominantly heterosexual.

“Most women are taking very good care of themselves, but worry about how they will continue to do so as they grow older,” Martinez said. “Some are worried about their partners, for whom they’ve cared for a long time.”

The methodology included self-administered surveys – completed online or on paper – distributed to 1,135 self-identified lesbians over the age of 45 from across the country, including 266 from 60 to over 90 years of age. Most respondents (88 percent) self-identified as “lesbian” or “gay.”

The survey found that 38.7 percent have a somewhat positive feeling about aging, 19.6 percent have a very positive feeling, 19.9 percent are neutral and 16.1 percent have a somewhat negative feeling.

In terms of health insurance coverage, the survey said 79 percent believe they currently have adequate coverage, while 19 percent stated they do not.

A large percentage of survey respondents – 78.3 percent – said they do not have financial difficulties when obtaining medication, while 19.6 percent do.

Seventy-four percent said they worry about having adequate insurance or the financial ability to obtain health care and medication as they age, while 23.5 do not have such worries.

Among those 45-59 years of age, the most important health concerns related to aging are maintaining physical mobility, physical health and having the financial ability to obtain needed health care and medications. Those 60 and over said physical mobility and health are their top two concerns, followed by the ability to obtain needed vision and hearing assessments and treatment.

The top three current medical diagnoses in this group of women are arthritis (25 percent), hypertension (20 percent) and depression (11 percent).

The health risk category included 12.2 percent who said they smoke daily, compared to 78.9 percent who do not. Thirty-four percent said they never consume alcohol, 24.4 percent drink once a month, 11.1 percent drink several times a month, 11.8 consume alcohol several times per week and 6 percent said they drink daily.

Over half surveyed – 64 percent – said they visit a doctor on a yearly basis for a check-up, while 15.3 percent said they only visit a doctor when ill. Mammograms were slightly less likely, with 56.7 percent of respondents getting a mammogram annually and 19.3 percent saying they have one every two years. Fifty percent of respondents have a pap smear annually.

The Women’s Needs Assessment survey, conducted by The Center’s Women’s Resource Center and released in April, found similar trends. The women surveyed were apprehensive about visiting their doctor, which excluded them from receiving preventative care in areas where they have a higher disease risk, such as with breast, endometrial and ovarian cancers.

“We found that the most prominent concern of LBT women when accessing health care was finding an ‘LGBT-friendly provider,’” said Claudia Lucero, Women’s Resource Center and Senior Services coordinator. “…Overwhelmingly, however, we found that most LBT women do not prioritize taking care of their own health, such as searching for a good provider, setting appointments and including the cost of insurance and health care in their budgets. The Center offers resources and referrals to overcome some of these barriers, but women need to be encouraged to take the first step by accessing this information.”

Another obstacle faced by older lesbians, according to Martinez’s survey, is counting on partner benefits and social security, and stabilizing financial matters when their significant other dies. This may impact a lesbian’s health maintenance and financial security as she ages.

“Unfortunately, this happens all too often,” Lucero said. “Until we achieve full equality and our families are fully recognized, older lesbians are forced to face particular challenges. A proactive approach and powerful planning can and do make a difference. Domestic partnership is one institution that may provide for some of the needs older lesbians have when a partner passes away.”