Abstract

Purpose: To examine the intersection of sexual identity and race/ethnicity on self-reported cardiometabolic risk in sexual minority women (SMW).Methods: Data from the Chicago Health and Life Experiences of Women study were analyzed. Logistic regression models examined racial/ethnic differences in cardiometabolic risk (including obesity, hypertension, and diabetes) in SMW, accounting for psychosocial and behavioral factors. A variable accounting for the intersection of sexual identity and race/ethnicity was added to regression models (White lesbian women were the reference group).Results: The analytic sample included 601 SMW (237 White, 219 Black, 145 Latina). Black (adjusted odds ratio [AOR] 2.96, 95% confidence interval [CI]=1.48–5.94) and Latina (AOR 2.30, 95% CI=1.18–4.48) SMW had higher rates of lifetime trauma than White SMW. Black SMW reported higher rates of obesity (AOR 3.05, 95% CI=1.91–4.88), hypertension (AOR 1.99, 95% CI=1.08–3.66), and diabetes (AOR 3.77, 95% CI=1.46–9.74) relative to White SMW. Intersectional analyses revealed that Black lesbian (AOR 2.94, 95% CI=1.74–4.97) and Black bisexual (AOR 3.43, 95% CI=1.69–6.96) women were more likely to be obese than White lesbian women. Black lesbian women also reported higher rates of hypertension (AOR 2.09, 95% CI=1.08–4.04) and diabetes (AOR 3.31, 95% CI=1.26–8.67) than White lesbian women. No differences in cardiometabolic risk were found between Latina and White SMW.Conclusion: This study extends previous research on racial/ethnic differences in cardiometabolic risk among SMW. Prevention strategies are needed to reduce cardiometabolic risk in Black SMW. Findings highlight the need for cardiovascular disease research in SMW that incorporates longitudinal designs and objective measures.

Highlights

  • Cardiovascular disease (CVD) is the leading cause of death and disability among women worldwide.[1]

  • CVD disparities related to sex/gender and race/ethnicity are well documented,[3,4] little is known about sexual identity differences in cardiometabolic risk

  • No differences in cardiometabolic risk were found between Latina and White sexual minority women (SMW)

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Summary

Introduction

Cardiovascular disease (CVD) is the leading cause of death and disability among women worldwide.[1]. SMW have higher rates of poor mental health,[5,6,7,8] tobacco use,[6,9,10,11] heavy drinking,[6,12,13] obesity,[8,14,15,16,17,18] and hyperglycemia[15,19] that may predispose them to CVD relative to heterosexual women. In the United States, Black and Latina women have significantly elevated cardiometabolic risk compared with White women.[20,21] racial/ethnic minority women report lower rates of tobacco use and Columbia University School of Nursing, New York, New York

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