Document Type

Capstone Experience

Graduation Date


Degree Name

Master of Public Health


Health Promotion

First Committee Member

Michelle Strong, PhD, MPH

Second Committee Member

Athena Ramos, PhD, MS, MBA, CPM

Third Committee Member

Dejun Su, PhD

Fourth Committee Member

Jim Medder MD, MPH


The purpose of this literature review is to comprehensively examine and synthesize existing research on present barriers to health access and utilization that contribute to the disparities in chronic disease prevalence within the adult LGBTQ+ population. In the context of this review, the social-ecological model (SEM) was used to describe the nuanced and multifaceted nature of healthcare access and utilization. This literature review was based upon the following question: ‘Using the social-ecological model, what are the barriers to health access and utilization that contribute to high rates of chronic disease in LGBTQ+ adults?’ Outcome measures of interest included the following chronic diseases: cardiovascular disease, cancer, diabetes, and respiratory diseases. The selected literature was analyzed for themes surrounding healthcare access and utilization, which were then categorized by applicable levels of influence within the SEM. While all identified literature addressed the intrapersonal level, with factors such as socioeconomic status, insurance status, and utilization of preventative care services, only three articles discussed community-level factors such as provider competency and social stigma. Future work is needed to utilize existing data to guide policy and programming and promote additional research on areas of deficit that could ultimately improve healthcare access and health service utilization.