Socioeconomic status as context for minority stress and health disparities among lesbian, gay, and bisexual individuals.

Abstract

Despite the robust, graded association between socioeconomic status (SES) and health, SES has largely been ignored in the field of psychology and in lesbian, gay, and bisexual (LGB) health research specifically. This inattention to SES is partly attributable to the “myth of gay affluence” (the assumption that LGB people are wealthier than the general population), which evidence is beginning to disprove. Given that there is no integrated framework for understanding the role of SES in LGB health, this review proposes theory-based expectations according to an integration of the minority stress model and the reserve capacity model, synthesizes the existing literature, and identifies future research directions. Three key questions at the intersection of SES and sexual orientation are examined: (a) Do LGB people differ from the general population in SES?, (b) What is unique and health-relevant about the intersection of being LGB and lower-SES?, and (c) How does SES provide context for understanding minority stress processes and health disparities among LGB people? The review has implications for the existing literature on LGB health, the design of future research studies, and targeted interventions.

Integrating diversity into therapy processes: The role of individual and cultural diversity competences in promoting equality of care

“…In fact, while issues of religion and migration background were identified by some participants, other dimensions were more invisible (sexual orientation, social class and socio‐economic status) in case conceptualisation. This finding strengthens recognition of the need to integrate SES into research on health inequalities, and its interaction with other identity dimensions, as it may be an unexamined fundamental variable (McGarrity, ). In addition, White (heterosexual/lesbian, Christian) clients were rarely perceived as cultural.…”

“…Research has begun to explore the role of intersections of social categories, including socio‐economic status and its combination with individual and cultural minorities (e.g. Adler & Stuwart, ; McGarrity, ). Results have suggested the importance of examining health inequalities in the context of socio‐economic status (SES).…”

“…Results have suggested the importance of examining health inequalities in the context of socio‐economic status (SES). For example, among the Lesbian Gay Bisexual and Transgender (LGBT) population, findings support that there is much diversity in terms of SES and that the intersection of being LGBT and lower‐SES represents a unique experience (such as exposure to more hostile environment to identity disclosure, stricter standards for gender conformity, more isolation from the mainstream LGBT community) resulting in greater psychological and physiological vulnerability to negative effects of discrimination (McGarrity, ). The search for mechanisms which may explain the processes by which socio‐economic status can affect health has also taken into consideration the environment.…”

Sexual Orientation-Based Discrimination, Excessive Alcohol Use, and Substance Use Disorders Among Sexual Minority Adults

“…Sexual minorities with less education may similarly be exposed to more negative life events and chronic stressors compared to those with higher levels of education. 31 The combined impact of minority stress and other stressors on health is thought to be exacerbated for those with less education and lower socioeconomic status because they are more vulnerable psychologically and physically due to deficiencies in their resources for resilience and a limited capacity to replenish resources for coping with stressful life events, a concept known as the reserve capacity model. 31,32 Findings from this study also suggested that Hispanic sexual minority adults may be more vulnerable to misusing nicotine or other substances in the presence of sexual orientation-based discrimination.…”

“…31 The combined impact of minority stress and other stressors on health is thought to be exacerbated for those with less education and lower socioeconomic status because they are more vulnerable psychologically and physically due to deficiencies in their resources for resilience and a limited capacity to replenish resources for coping with stressful life events, a concept known as the reserve capacity model. 31,32 Findings from this study also suggested that Hispanic sexual minority adults may be more vulnerable to misusing nicotine or other substances in the presence of sexual orientation-based discrimination. Recently, Ortiz et al 33 observed that Latino sexual minorities were at increased risk, although nonsignificantly, of smoking compared to other sexual minorities in all of their models; however, they noted an absence of work done to identify reasons for these differences in smoking patterns among sexual minorities.…”