Mortality Disparities Among Sexual Minority Adults in the United States.

Abstract

Purpose: This study aimed to investigate mortality disparities for sexual minority adults in the United States. Methods: We used data from 26,384 adult respondents using the 1999-2014 National Health and Nutrition Examination Survey, linked with National Death Index mortality files. Respondents reporting one or more same-sex sexual partners in their lifetime or who identified as gay, lesbian, or bisexual were considered sexual minority adults (617 sexual minority males and 963 sexual minority females). We examined gender-stratified mortality frequencies by sexual minority status and used gender-stratified Cox proportional hazard models to investigate mortality risk for sexual minority adults compared with non-sexual-minority adults. Results: We observed significantly elevated mortality risk among sexual minority females compared with non-sexual-minority females, robust across model specifications. Estimates ranged from an adjusted hazard ratio of 2.0 (95% confidence interval [CI]: 1.3-3.2) to 2.1 (95% CI: 1.4-3.3) among sexual minority females compared with non-sexual-minority females, with estimates at approximately double the risk of mortality. We found no evidence of differential mortality risk for sexual minority males compared with non-sexual-minority males. Conclusion: These results suggest mortality disparities for sexual minority females compared with non-sexual-minority females. Future research should consider mortality disparities among subgroups of sexual minority adults and include targeted data collection to increase understanding of the mechanisms behind mortality disparities.