Sexual Orientation Disparities in Risk Factors for Adverse COVID-19–Related Outcomes, by Race/Ethnicity — Behavioral Risk Factor Surveillance System, United States, 2017–2019

Abstract

Sexual minority persons experience health disparities associated with sexual stigma and discrimination and have a high prevalence of several health conditions that have been associated with severe coronavirus disease 2019 (COVID-19) (1,2). Current COVID-19 surveillance systems do not capture information about sexual orientation. To begin bridging the gap in knowledge about COVID-19 risk among sexual minority adults, CDC examined disparities between sexual minority and heterosexual adults in the prevalence of underlying conditions with strong or mixed evidence of associations with severe COVID-19-related illness (3), by using data from the 2017-2019 Behavioral Risk Factor Surveillance System (BRFSS).* When age, sex, and survey year are adjusted, sexual minority persons have higher prevalences than do heterosexual persons of self-reported cancer, kidney disease, chronic obstructive pulmonary disease (COPD), heart disease (including myocardial infarction, angina, or coronary heart disease), obesity, smoking, diabetes, asthma, hypertension, and stroke. Sexual minority adults who are members of racial/ethnic minority groups disproportionately affected by the pandemic also have higher prevalences of several of these health conditions than do racial/ethnic minority adults who are heterosexual. Collecting data on sexual orientation in COVID-19 surveillance and other studies would improve knowledge about disparities in infection and adverse outcomes by sexual orientation, thereby informing more equitable responses to the pandemic.

Nonattendance at Scheduled Appointments in Outpatient Clinics Due to COVID-19 and Related Factors in Taiwan: A Health Belief Model Approach

“…Sexual minority individuals are less likely to seek health care due to stigma and discrimination [ 31 ]. Furthermore, compared with heterosexual individuals, the COVID-19 pandemic disproportionately impacted mental health [ 32 ] and economic capability [ 33 ] of sexual minority individuals and thus may compromise their ability to access health care services. A recent study reported that the COVID-19 pandemic resulted in interruptions of HIV treatment in sexual minority individuals [ 34 ].…”

Sexual Orientation and the Incidence of COVID-19: Evidence from Understanding Society in the UK Longitudinal Household Study

“…To date, there have been no other estimates published in the world on the incidence, hospitalization, or death rates in sexual and gender minority populations. A number of countries have been calling for this data, for example, in the US, where it is known that sexual minority individuals have a higher self-reported prevalence of several underlying health conditions associated with severe outcomes from COVID-19 than do heterosexual individuals [19].…”

Perceived Weight Gain and Eating Disorder Symptoms among LGBTQ+ Adults during the COVID-19 Pandemic: A Convergent Mixed-Method Study

“…33 Emerging research has documented LGBTQ + people's increased vulnerability to severe COVID-related outcomes based on their higher prevalence of comorbidities. 34 Elevated levels of existing mental health challenges among LGBTQ + individual's likely increases their vulnerability to pandemic-stress. [35][36][37] Preliminary studies suggest LGBTQ + people's health has been uniquely impacted by pandemic mitigation efforts, such that social distancing simultaneously shaped increases in alcohol use and reductions in LGBTQ + community connections and minority stress.…”