A Florida State University assistant professor, Dr. Casey Xavier Hall, has been granted a First Year Assistant Professor award (FYAP) to improve the measurement of maltreatment and neglect in older adults for use in research and screening. Research on maltreatment and neglect in older LGBT adults is a field that is “next to nonexistent” according to Dr. Xavier Hall who aims to helps close the gap in LGBT aging research.

“The population is aging in the U.S. and a growing proportion of aging populations are openly identifying as LGBT,” Dr. Xavier Hall said. “It’s essential that we understand clinical barriers to healthy aging in LGBTS older adults such as abuse and neglect.”

According to the World Health Organization, the world’s aging population is set to grow from 9% to 16% by the year 2025. A study out of University of Washington in 2011 estimated LGBT elder abuse at about 7% overall (9% bisexual men, 14% bisexual women, and 15% transgender elders). However, according to Dr. Xavier Hall, the lack of studies addressing the topic means that we have a limited knowledge of the prevalence of abuse and neglect in aging LGBT populations.

The FYAP awards $20,000 which will go toward continuing Dr. Xavier Hall’s research in aging and care in older LGBT adults as well as people at risk for or living with HIV. Dr. Xavier Hall will be working with two different community health centers to conduct his research; The Howard Brown Health Clinic in Chicago and Found Care in Palm Beach County, Florida.

Howard Brown Health (HBH) is one of the nation’s largest LGBTQ+ organizations and serves more than 40,000 adults and youth in its diverse health and social service system. They focus their care around 7 major programmatic divisions:

1. Primary medical care
2. Behavioral health
3. Research
4. HIV/STI prevention
5. Youth and elder services
6. Community initiatives.

The center will be working with Dr. Xavier Hall to conduct community research through online surveys and in-depth interviews. The interviews allow for the gathering of data on the needs that HBH staff have identified of their older adult patients, which will act as a signal for further investigation into the need for screening for maltreatment. Howard Brown is a resourceful collaborator in this study given that they have a department of Geriatric Medicine, a team of aging services case managers, and their own Chief Clinical Officer is a geriatrician.

The Director of Program Evaluation and Epidemiology, Laura Rusie, expressed the center’s excitement for collaboration on this study and how the topic is highly relevant to HBH’s patient population. “This study aligns with an important component of Howard Browns mission, which is to provide services to help older adults manage isolation, navigate insurance, control chronic medical conditions, and meet their sexual, mental behavioral, and preventive healthcare needs.”

“This study also provides an important step towards achieving a three-year strategic goal of expanding access to culturally competent care for LGBTQ+ older adults and increasing the number of older adults who select HBH at their healthcare home,” said Rusie.

In Palm Beach County, Dr. Xavier Hall will also be working with Found Care, which originated as the Comprehensive AIDS Program. Since then, it has expanded its services to create their community health center which has grown to 7 sites: providing healthcare and social services for all individuals and families. One of their key services is providing HIV care to all populations; however, Dr. Xavier Hall will be focusing primarily on HIV care of the Elderly.

Dr. Xavier Hall is an investigator at the Center of Population Sciences for Health Equity (CPSHE), with appointments in the College of Nursing and College of Social Work. CPSHE leads and implements community-engaged research using principles and tools of populations sciences that promote health equity among marginalized and underserved populations.

Co-founder of CPSHE, Dr. Eugenia Millender, is an integral part of the research team and acts as a communication liaison between Dr. Xavier Hall and the community partner Found Care. Dr. Millender’s 15+ year relationship with Found Care has built a foundation of trust between the health center and the researchers.

Dr. Millender expressed her passion for involvement and trust with community partners that work with CPSHE. “CPSHE is making sure that we are embedded in the community, developing trusting relationships with people who are doing the day-to-day work that we use for research and evaluating outcomes in order to build a better process.”

It is not uncommon for community centers to be cautious when working with researchers because of the egocentric reputation of researchers and how they conduct their work. Community centers have experienced researchers using their data and then leaving without creating a rich and symbiotic relationship.

It is important for CPSHE to nurture and cultivate those symbiotic relationships with community partners. “Our center brings authenticity through our long-embedded community relationships, which makes us different from any other research center,” said Dr. Millender.

CPSHE is excited to work with both Howard Brown Health and Found Care to conduct research on the maltreatment and neglect of elders within the LGBTQ community. The center is proud to have Dr. Xavier Hall as one of its lead investigators and to have his exemplary work acknowledged with the First Year Assistant Professor Award.