Abstract
BackgroundResearch shows that sexual minorities (e.g., lesbian, gay, and bisexual individuals) experience higher levels of discrimination, stigma, and stress and are at higher risk of some poor health outcomes and health behaviors compared to their heterosexual counterparts. However, the majority of studies have examined sexual orientation disparities in a narrow range of health outcomes and behaviors using convenience samples comprised of either men or women living in restricted geographic areas.MethodsTo investigate the relationship between sexual orientation identity and health among U.S. women and men, we used Poisson regression with robust variance to estimate prevalence ratios for health behaviors, outcomes, and services use comparing sexual minorities to heterosexual individuals using 2013 and 2014 National Health Interview Survey data (N = 69,270).ResultsThree percent of the sample identified as sexual minorities. Compared to heterosexual women, lesbian (prevalence ratio (PR) = 1.65 [95 % confidence interval (CI): 1.14, 2.37]) and bisexual (PR = 2.16 [1.46, 3.18]) women were more likely to report heavy drinking. Lesbians had a higher prevalence of obesity (PR = 1.20 [1.02, 1.42]), stroke (PR = 1.96 [1.14, 3.39]), and functional limitation (PR = 1.17 [1.02, 1.34] than heterosexual women. Gay men were more likely to have hypertension (PR = 1.21 [1.03, 1.43]) and heart disease (PR = 1.39 [1.02, 1.88]). Despite no difference in health insurance status, sexual minorities were more likely than heterosexual individuals to delay seeking healthcare because of cost; however, members of this group were also more likely to have received an HIV test and initiated HPV vaccination.ConclusionSexual minorities had a higher prevalence of some poor health behaviors and outcomes.
Highlights
Research shows that sexual minorities experience higher levels of discrimination, stigma, and stress and are at higher risk of some poor health outcomes and health behaviors compared to their heterosexual counterparts
Studies show that many sexual minorities – namely, individuals who self-identify as gay, lesbian, or bisexual and who engage in same-gender sexual behavior or report same-gender sexual attractions but do not selfidentify as such – have a higher prevalence of health risk behaviors [3, 4] and poor health outcomes [4,5,6,7,8] and a lower prevalence of access to health insurance as well as healthcare [4, 5, 7, 9] compared to their heterosexual counterparts, even after controlling for socioeconomic position (SEP)
Based on the minority stress model, which postulates that sexual orientation disparities in health are due to sexual minorities’ unique exposure to stigma and discrimination that can be experienced differently depending on gender and age group [11,12,13,14,15], we hypothesized that sexual minorities have a higher prevalence of health behaviors and poor health outcomes and a lower prevalence of health services use compared to heterosexual persons across gender and age groups
Summary
Research shows that sexual minorities (e.g., lesbian, gay, and bisexual individuals) experience higher levels of discrimination, stigma, and stress and are at higher risk of some poor health outcomes and health behaviors compared to their heterosexual counterparts. Based on the minority stress model, which postulates that sexual orientation disparities in health are due to sexual minorities’ unique exposure to stigma and discrimination that can be experienced differently depending on gender and age group [11,12,13,14,15], we hypothesized that sexual minorities have a higher prevalence of health behaviors and poor health outcomes and a lower prevalence of health services use compared to heterosexual persons across gender and age groups
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