Grant: Oper. Gra. Adv. 2S_LGBTQI+ Heal. Thr. Resea. - Metho. Measu. Second. Data Analy.

Lesbian, gay, bisexual, transgender, queer, and other sexually and gender diverse (LGBTQI+) people make up more than 1.3 million individuals in Canada. Despite growing visibility, LGBTQI+ populations continue to experience poorer health outcomes and greater barriers to care than the general population. Most existing research has focused on mental health or HIV, while much less is known about access to primary care, preventive services such as cancer screening and vaccination, long-term chronic illness, disability, and avoidable hospital use. This study will examine how health care access, chronic disease burden, and unmet health care needs evolve over time among LGBTQI+ populations in Canada. Using linked national census, survey, and health administrative data, we will follow millions of Canadians over up to 20 years to understand differences in primary care use, preventive screening, vaccination, chronic disease accumulation, disability onset, and preventable emergency department visits and hospitalizations. We will analyze data from three major sources: the Canadian Census Health and Environment Cohort, the Canadian Community Health Survey linked to health records, and detailed clinical and primary care data from Ontario. These data allow us to identify sexual orientation and gender identity, track health outcomes over time, and examine how experiences differ by age, geography, income, and other social factors. By moving beyond one-time snapshots to long-term health trajectories, this research will identify when and where gaps in care emerge and which groups are most affected. The findings will provide actionable evidence to support more inclusive, equitable, and effective health systems, helping policymakers and providers improve primary care access, preventive services, and chronic disease management for LGBTQI+ individuals across Canada.