Sexual Minority Health and Health Risk Factors

Abstract

Introduction Although population studies have documented the poorer health outcomes of sexual minorities, few have taken an intersectionality approach to examine how sexual orientation, gender, and race jointly affect these outcomes. Moreover, little is known about how behavioral risks and healthcare access contribute to health disparities by sexual, gender, and racial identities. Methods Using ordered and binary logistic regression models in 2015, data from the 2013 and 2014 National Health Interview Surveys (N=62,302) were analyzed to study disparities in self-rated health and functional limitation. This study examined how gender and race interact with sexual identity to create health disparities, and how these disparities are attributable to differential exposure to behavioral risks and access to care. Results Conditional on sociodemographic factors, all sexual–gender–racial minority groups except straight white women, gay white men, and bisexual non-white men reported worse self-rated health than straight white men (p<0.05). Some of these gaps were attributable to differences in behaviors and healthcare access. All female groups, as well as gay non-white men, were more likely to report a functional limitation than straight white men (p<0.05), and these gaps largely remained when behavioral risks and access to care were accounted for. The study also discusses health disparities within sexual–gender–racial minority groups. Conclusions Sexual, gender, and racial identities interact with one another in a complex way to affect health experiences. Efforts to improve sexual minority health should consider heterogeneity in health risks and health outcomes among sexual minorities.

Sexual orientation differences in functional limitations, disability, and mental health services use: Results from the 2013–2014 National Health Interview Survey.

“…Also, as others have observed (Austin et al, 2016; Björkenstam et al, 2016; Boehmer et al, 2014; Cochran & Mays, 2007; Fredriksen-Goldsen et al, 2013; Gonzales & Henning-Smith, 2015; Hsieh & Ruther, 2016; Siordia, 2015), LGB respondents in the NHIS evidenced higher prevalence of functional limitations and disability than did heterosexual respondents. Capitalizing on NHIS’s extensive measurement of limitations and disability, we were also able to extend these findings by showing that much of the health disadvantages in mobility, independence, and social engagement that LGB individuals reported were associated with MHSA-related factors.…”

“…Studies have found that LGB individuals, especially women, are more likely than heterosexual women and men to report a health disability (Austin et al, 2016; Boehmer et al, 2014; Cochran & Mays, 2007; Fredriksen-Goldsen et al, 2013; Frisch & Simonsen, 2013; Hsieh & Ruther, 2016). However, these studies did not assess the nature or extent of that disability.…”

Sexual Identity and Behavior Among U.S. High School Students, 2005–2015

“…Multiple population-based studies have documented the prevalence of sexual minority identity and behavior among U.S. adults using these metrics (Chandra, Mosher, Copen, & Sionean, 2011;Copen, Chandra, & Febo-Vazquez, 2016;Farley, Stephens, Harvey, Sikes, & Wenger, 1992;Hsieh & Ruther, 2016). However, few of these studies have examined changes in the prevalence of sexual minority status over time using more than one dimension of sexual orientation or assessed if these trends vary among demographic groups (Chandra et al, 2011;Copen et al, 2016;Patterson et al, 2017).…”

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

“…Resources such as personal coping and group solidarity may counteract minority stress and help explain findings in which multiple marginalized statuses do not necessarily lead to poorer mental and physical health outcomes. Previous studies tout the consideration of both risk and protective factors in health disparities research as the minority stress model may be overly simplistic [ 30 , 31 ].…”