Are alcohol‐related disparities between sexual minority and heterosexual youth decreasing?

Abstract

Background and Aims Although sexual-orientation-related alcohol use disparities are well established, researchers have not identified whether disparities are diminishing as societal attitudes towards lesbian/gay and bisexual (LGB) people become more accepting. We examined changes in four alcohol-related disparities between heterosexual and LGB youth from 1998–2013 by (1) estimating the prevalence of these behaviors; (2) estimating disparities in alcohol-related outcomes between heterosexual and LGB youth within each wave year; and (3) testing whether the degree of difference in alcohol-related disparities between heterosexual and LGB youth has changed. Design Logistic regression models and year-by-sexual-orientation interactions with repeated, cross-sectional, provincially-representative data. Setting British Columbia, Canada. Participants Students (ages 12–19) from the 1998 (n = 22,858), 2003 (n = 29,323), 2008 (n = 25,254), and 2013 (n = 21,938) British Columbia Adolescent Health Survey (total N = 99,373, 48.7% male, M ®age = 14.84). Measurements We modeled age-adjusted differences in lifetime alcohol use, age of onset, past 30-day drinking, and past 30-day heavy episodic drinking between heterosexual and three subgroups of sexual minority youth (i.e., mostly heterosexual, bisexual, and lesbian/gay). Findings Generally, alcohol use declined for all youth, although less so among LGB youth (average aOR = .58 and aOR = .53 for heterosexual males and females and aOR = .71 and aOR = .57 for sexual minority males and females, respectively). Within-year comparisons demonstrated elevated rates of alcohol use among LGB compared with heterosexual youth for each of the four survey years, especially among females. Findings indicate few changes over time; however, results show an increase in risky alcohol use from 1998 to 2013 among mostly heterosexual (aOR = 1.58 for lifetime alcohol use, aOR = 1.58 for 30-day alcohol use, and aOR = 1.34 for 30-day heavy episodic drinking), and bisexual (aOR = 1.95 for lifetime alcohol use) females. Conclusion Despite the general decline in the prevalence of alcohol use among young people in Canada since 1998, lesbian/gay and bisexual youth in Canada continue to show elevated rates of alcohol use compared with heterosexual youth.

Adolescent Boys in Ireland: Alcohol, Cannabis, Sexual Orientation and Mood.

“…This may be similar to the situation found in Canada (Fish, et al, 2017) though more research would be needed to confirm this. Nevertheless, it appears that just over three-quarters of the boys had drunk alcohol, 99.6% of whom had started drinking underage.…”

Mental health disparities and high‐risk alcohol use among non‐heterosexual high school students

“…In addition to disproportionate mental health burden, LGB youth are more likely to report engaging in riskier substance use behaviors; for example, there is a higher prevalence among LGB youth of cigarette smoking, marijuana use, and use of other drugs such as cocaine and ecstasy . Additionally, LGB youth have higher lifetime alcohol use, earlier initiation of alcohol use, and higher rates of binge drinking, all of which increase the risk of an alcohol use disorder and are associated with more problems related to alcohol use …”

Cigarette Smoking Disparities Between Sexual Minority and Heterosexual Youth

“…A more detailed explanation of this approach is available elsewhere. 19,20 Data analyses were conducted in 2017.…”

“…Considering the link between anti-LGB attitudes and elevated rates of substance use among SMY and sexual minority adults, [15][16][17][18] there has been emerging interest in whether health disparities between heterosexual and LGB youth have diminished as social attitudes toward LGB people have improved. [19][20][21] Despite public discourse emphasizing the benefits of growing up LGB in the most recent decade, there has been limited empirical research explicitly examining whether sexual identity disparities in health, including substance use, have changed during this time. Until recently, national surveys of youth have excluded measures of sexual identity, attractions, or behaviors (exclusions that have stymied efforts to understand the health and well-being of SMY at the population level).…”