Health and healthcare disparities among U.S. women and men at the intersection of sexual orientation and race/ethnicity: a nationally representative cross-sectional study

Abstract

BackgroundResearch has shown that sexual minorities (SMs) (e.g. lesbian, gay, and bisexual individuals), compared to their heterosexual counterparts, may engage in riskier health behaviors, are at higher risk of some adverse health outcomes, and are more likely to experience reduced health care access and utilization. However, few studies have examined how the interplay between race and sexual orientation impacts a range of health measures in a nationally representative sample of the U.S. population.MethodsTo address these gaps in the literature, we sought to investigate associations between sexual orientation identity and health/healthcare outcomes among U.S. women and men within and across racial/ethnic groups. Using 2013–2015 National Health Interview Survey data (N = 91,913) we employed Poisson regression with robust variance to directly estimate prevalence ratios (PR) comparing health and healthcare outcomes among SMs of color to heterosexuals of color and white heterosexuals, stratified by gender and adjusting for potential confounders.ResultsThe sample consisted of 52% women, with approximately 2% of each sex identifying as SMs. Compared to their heterosexual counterparts, white (PR = 1.25 [95% confidence interval (CI): 1.08–1.45]) and black (1.54 [1.07, 2.20]) SM women were more likely to report heavy drinking. Hispanic/Latino SM women and men were more likely to experience short sleep duration compared to white heterosexual women (1.33 [1.06, 1.66]) and men (1.51 [1.21, 1.90). Black SM women had a much higher prevalence of stroke compared to black heterosexual women (3.25 [1.63, 6.49]) and white heterosexual women (4.51 [2.16, 9.39]). White SM women were more likely than white heterosexual women to be obese (1.31 [1.15, 1.48]), report cancer (1.40 [1.07, 1.82]) and report stroke (1.91 [1.16, 3.15]. White (2.41 [2.24, 2.59]), black (1.40[1.20, 1.63]), and Hispanic/Latino SM (2.17 [1.98, 2.37]) men were more likely to have been tested for HIV than their heterosexual counterparts.ConclusionsSexual minorities had a higher prevalence of some poor health behaviors, health outcomes, and healthcare access issues, and these disparities differed across racial groups. Further research is needed to investigate potential pathways, such as discrimination, in the social environment that may help explain the relationship between sexual orientation and health.Electronic supplementary materialThe online version of this article (10.1186/s12889-017-4937-9) contains supplementary material, which is available to authorized users.

Depression and Victimization in a Community Sample of Bisexual and Lesbian Women: An Intersectional Approach

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Evidence of Diverse Identities in a Large National Sample of Sexual and Gender Minority Adolescents

“…This scholarship that challenges SGM identity measurement is important in order to improve our understanding of health disparities experienced by sexual and gender minorities, and to provide culturally responsive health care in clinical settings. After all, scholars have noted distinct disparities for ethnoracial SGM youth compared to their White SGM counterparts in BMI (Katz‐Wise et al., ), and a host of other health‐related outcomes such as risk of stroke, cancer, drinking and sleep problems, and obesity (Trinh, Agénor, Austin, & Jackson, ). Lacking in the extant literature is a full consideration of emerging identity labels among youth.…”

Real-time predictors of smoking among sexual minority and heterosexual young adults: An ecological momentary assessment study

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