Sexual orientation disparities in the co-occurrence of substance use and psychological distress: a national population-based study (2008–2015)

Abstract

PurposeAlthough strong evidence documents the elevated prevalence of both substance use and mental health problems among sexual minorities (i.e., gay, lesbian, and bisexuals), relatively less research has examined whether risk of the co-occurrence of these factors is elevated among sexual minorities compared to heterosexuals. The object of this study was to (1) explore sexual orientation-based differences in substance use, psychological distress, and their co-occurrence in a representative sample in Sweden, and (2) examine if greater exposure to stressors, such as discrimination, victimization/threats, and social isolation, could explain these potential disparities and their co-occurrence.MethodsData come from the cross-sectional Swedish National Public Health Survey, which collected random samples of individuals (16–84 years of age) annually from 2008 to 2015, with an overall response rate of 49.7% (n = 79,568 individuals; 1673 self-identified as lesbian, gay, or bisexual). Population-level sexual orientation differences in substance use (i.e., alcohol, tobacco, and cannabis) and psychological distress were examined.ResultsOur findings showed significantly elevated prevalence of high-risk alcohol use, cannabis use, and daily tobacco smoking, among sexual minorities compared to heterosexuals. These substantial disparities in substance use more often co-occurred with psychological distress among sexual minorities than among heterosexuals. The elevated risk of co-occurring psychological distress and substance use was most notable among gay men relative to heterosexual men (adjusted odds ratio [AOR] = 2.65, CI 1.98, 3.55), and bisexual women relative to heterosexual women (AOR = 3.01, CI 2.43, 3.72). Multiple mediation analyses showed that experiences of discrimination, victimization, and social isolation partially explained the sexual orientation disparity in these co-occurring problems.ConclusionsThis study adds to a growing body of research showing that sexual minorities experience multiple threats to optimal health and points toward future interventions that address the shared sources of these overlapping health threats in stigma-related stress.

Do New Zealand sexual minorities engage in more hazardous drinking than non‐sexual minorities?

“…depression) than non‐SMs . Similar disparities in alcohol use and mental health issues have been observed in Europe , Canada and Australia .…”

LGBT friendly healthcare providers’ tobacco treatment practices and recommendations

“…Tobacco‐related disparities for sexual and gender minorities are attributable to and impacted by multiple diverse, interrelated, and evolving factors such as the social determinants of health, tobacco industry influence, and the lack of comprehensive tobacco control policies . High rates of smoking by LGBT individuals have been linked, in part, to the stigma and discrimination associated with being a sexual or gender minority . Bränström and Pachankis’ research found that tobacco use cooccurred with psychological distress more often in LGB people than in their heterosexual counterparts.…”

“…High rates of smoking by LGBT individuals have been linked, in part, to the stigma and discrimination associated with being a sexual or gender minority . Bränström and Pachankis’ research found that tobacco use cooccurred with psychological distress more often in LGB people than in their heterosexual counterparts. In another study, LGB and queer/questioning college students who reported frequent experiences of microaggressions in the last year were significantly more likely to report recent tobacco use .…”

Cigarette smoking, ENDS use and dual use among a national sample of lesbians, gays and bisexuals

“…Historically, lesbian, gay and bisexual (LGB) individuals have higher rates of smoking 4 , often attributed to targeted tobacco advertising 5,6 , exposure to stressors (i.e. minority status, stigma, homophobia, and gay bashing) 7,8 and psychological distress 9 . The same tendency of elevated ENDS use among LGB individuals has recently been documented 10 LGB groups are not homogeneous and differences may exist between tobacco use by men and women within the groups.…”