Abstract P140: Sexual Orientation Disparities in Cardiovascular Risk Factors Differ by Sex and Race/Ethnicity Among High School Aged Youth

Abstract

Compared to their sex-matched heterosexual counterparts, sexual minority high school aged youth have been found to be more likely to be overweight or obese and less likely to meet physical activity guidelines. Racial/ethnic minority (REM) youth have been shown to face similar disparities. These disparities mirror the cardiovascular (CVD) health disparities that have also been detected among sexual minority and REM adults later in life. To date, no national studies have investigated how health disparities associated with poor future CVD outcomes differ at the intersections of sex and race/ethnicity among diverse sexual minority high school aged youth. To compare weight and physical activity outcomes using an intersectional approach, we performed sex-stratified logistic regressions using a pooled national Youth Risk Behavior Surveillance (YRBS) dataset from 2009-2015; White heterosexual students as the dual reference group for all analyses. From these regressions, adjusted Prevalence risk ratios (PRR) were calculated. A total of 409,843 high school aged youth who completed the YRBS surveys across 45 jurisdictions across the United States were included in analyses. Overall, by race/ethnicity, 47.7% of respondents were White, 16.6% were Black, 25.5% were Hispanic/Latino, and 10.2% were “Other” race youth. Among male youth, 92.6% identified as heterosexual, 2.2% as gay, 2.4% as bisexual, and 2.7% as not sure, while among female students, 85.9% identified as heterosexual, 1.86% as lesbian, 8.25% as bisexual, and 4.0% as not sure. With the exception of heterosexual and not sure Other race students, all sexual minority/REM female students had 1.51 to 2.23 times higher risk of being overweight or obese compared to White heterosexual students. All non-White and non-heterosexual male youth were at greater risk of not meeting physical activity guidelines compared to their White heterosexual male student counterparts. Significant interactions between race/ethnicity and sexual identity were detected for both overweight/obesity and physical activity outcomes among female but not male high school aged youth. Future work should continue to characterize CVD risk factors among sexual minority and REM youth and explore how the intersections of these identities may predict risk factors for CVD related outcomes across the life course.