Disadvantaged Minority Groups Research Articles

The Amplified Effects of Covid-19: Analysis of Health Risks and Global Socio-Economic Conditions

Introduction: The COVID-19 pandemic has emerged as an unprecedented global challenge, exposing and exacerbating existing health inequalities. The historical analysis of past pandemics and the understanding of social determinants of health during COVID-19 underscore the need for a holistic and equitable approach in responding to the pandemic, recognizing and addressing the social disparities that shape health outcomes. Objective: This study aims to analyze the social health disparities exacerbated by the COVID-19 pandemic, focusing on vulnerable populations, identifying social determinants and assessing the impact of public health measures. Methodology: We carried out an integrative review in the PubMed and BVS (Lilacs & Medline) databases. Systematic review studies, epidemiological studies, observational studies and original articles were selected, excluding duplicates, small samples, dissertations and theses. Studies published in the last 5 years 2018 to 2023 made available completely and free of charge. At the end of the 6 parts of the analysis, 10 articles were selected to take into account the current revision. Results and Discussions: The analysis of the reviewed studies revealed substantial disparities in risk factors and health outcomes during the pandemic, highlighting the crucial influence of socioeconomic determinants. Socio-economic inequalities have been identified as playing a crucial role in the incidence and severity of the disease, with disproportionately disadvantaged and economically disadvantaged minority groups. Factors such as race, ethnicity and limited access to health care contribute to these disparities, highlighting the intersection between social determinants and health. The lack of fairness in the distribution of health resources and in the implementation of public policies may exacerbate existing disparities, making a more equitable approach to responding to the pandemic essential. Conclusion: The COVID-19 pandemic has highlighted the complexity of health gaps, highlighting the need for integrated and holistic approaches to address these challenges and promote health equity.

Attitudes Formation toward Minority Outgroups in Times of Global Crisis-The Role of Good and Bad Digital News Consumption.

This paper examines the relationships between the consumption of 'bad' or 'good' digital economic news and attitudes toward immigrant and ethnic minorities during the crisis that developed during the COVID-19 pandemic. The study considered attitudes toward two minority groups in Israel: immigrant citizens from English-speaking countries, and Israeli Palestinian citizens, an ethnic minority. The data were collected through an online survey of 866 respondents, who were members of the majority population group. The study found that, during the global crisis, exposure to bad digital news was associated with more positive attitudes toward both disadvantaged and non-disadvantaged minority groups. Moreover, in times of global crisis, people focused mostly on local rather than global digital news. In contrast to the idea of Intergroup Threat Theory, the study revealed that feelings of economic threat during the global crisis engendered higher cohesion between different population groups, and more positive attitudes toward minorities. In times of crisis, bad news for the economy brings good news for social solidarity-people tend to rally around the flag; this phenomenon even occurs between groups engaged in years-long, protracted conflict.

Psychological mediators of relations between socio-structural variables and physical activity: A proposed mechanistic model

Regular participation in moderate-to-vigorous physical activity has been associated with adaptive physical and psychological health benefits including lower risk of non-communicable disease and reduced incidence of mental health conditions. However, a substantive majority the global population does not participate in sufficient physical activity to confer these health benefits, and inactivity levels are particularly high in underrepresented and disadvantaged minority groups, as indicated by negative associations between physical activity participation and socio-structural variables (e.g., socioeconomic status, income, education, health literacy). In addition, evidence suggests that participation in health behaviors such as physical activity partially mediates the association between these sociodemographic variables and health outcomes. We propose a process model specifying a candidate mechanism that may explain the association between socio-structural variables that represent disparity and health behaviors such as physical activity. Specifically, we propose a model in which beliefs such as attitudes, subjective norms, risk perceptions, and self-efficacy mediate associations between socio-structural variables and physical activity participation. After proposing the basic tenets of the model, we provide several examples illustrating the proposed effects for socio-structural variables including socioeconomic status and income, education, and health literacy in Asian contexts, and outline how these effects should be interpreted. We conclude by outlining the theoretical and practical relevance of these findings, and how they may inform interventions aimed at having adaptive effects on health outcomes by promoting physical activity participation and assisting in reducing health behavior disparities in Asian populations.

Popularizing Fairness: Group Fairness and Individual Welfare

Group-fair learning methods typically seek to ensure that some measure of prediction efficacy for (often historically) disadvantaged minority groups is comparable to that for the majority of the population. When a principal seeks to adopt a group-fair approach to replace another, the principal may face opposition from those who feel they may be harmed by the switch, and this, in turn, may deter adoption. We propose that a potential mitigation to this concern is to ensure that a group-fair model is also popular, in the sense that, for a majority of the target population, it yields a preferred distribution over outcomes compared with the conventional model. In this paper, we show that state of the art fair learning approaches are often unpopular in this sense. We propose several efficient algorithms for postprocessing an existing group-fair learning scheme to improve its popularity while retaining fairness. Through extensive experiments, we demonstrate that the proposed postprocessing approaches are highly effective in practice.

Cultivating resilience among Hong Kong's underprivileged ethnic minority groups in the face of a pandemic through a social justice lens

PurposeIn this study, the authors investigated ways to cultivate resilience through a social justice lens among ethnic minorities against COVID-19 in Hong Kong.Design/methodology/approachA qualitative (case study) methodology was adopted to interview 15 social service providers from diverse ethnic backgrounds serving disadvantaged ethnic minority groups (South and Southeast Asian groups from low-income households, foreign domestic workers and asylum seekers/refugees).FindingsTwo major protective factors were identified, contributing to the development of resilience among diverse ethnic groups: (1) individual-based resilience (including being optimistic) and (2) socio-environmental factors (including ongoing support from strong family, peer and religious settings' support, consulates' support, on-going material and nonmaterial donations, support of young volunteers and importance of online connection and communication) using the integration of resilience and social justice frameworks.Originality/valueThis study showed that the protective factors were found to dynamically interact with each other and the environment. The present study recommends additional culturally sensitive service and policy implications for preventing the long-term impact of mass crises among Hong Kong's marginalized minorities.

Breast Cancer Disparities and the Digital Divide.

Socioeconomically disadvantaged populations and minority groups suffer from high breast cancer mortality, a disparity caused by decreased access to specialty care, lower treatment adherence, co-morbidities, and genetic predisposition for biologically aggressive breast tumor subtypes. Telehealth has the potential to mitigate breast cancer disparities by increasing access to specialty care and health information. However, unequal access to high-speed/broadband internet service and telehealth itself magnifies breast cancer disparities in vulnerable populations. This review evaluates the impact of the digital divide on breast cancer outcomes, as well as strategies for leveraging telehealth to reduce breast cancer disparities. There is a paucity of research specific to employing telehealth to address breast cancer disparities. Previous studies provide examples of telehealth utilization for increasing screening mammography, in addition to improving access to breast cancer care, including breast cancer specialist, nurse navigators, and clinical trials. Telehealth can also be used as an approach to risk reduction, with strategies to support weight management and genetic testing. Eliminating the digital divide holds enormous potential for mitigating breast cancer disparities through an intentional focus on improving access to telehealth. With increased accessibility, resource allocation, and improved digital infrastructure, telehealth can be used to address disparities in early detection, quality of breast cancer care, treatment adherence, and risk assessment. Further research is essential to elucidate best practices in breast cancer telehealth approaches in underserved communities.

Legality of Explicit Racial Discrimination in the Distribution of Lifesaving COVID-19 Treatments

In 2021, the Federal Drug Administration released a statement advocating for race and ethnicity to be used in rationing lifesaving COVID-19 treatments. By January 2022, three states had implemented policies explicitly prioritizing treatments based on race, which resulted in multiple legal challenges. This Article analyzes the uphill battle such policies would face in an equal protection challenge. It also rebuts the attempt to analogize these policies to the legally acceptable practice of racial preferences in college admissions. Finally, nonlegal, pragmatic consequences are considered, such as how the policy risks disproportionately favoring the wealthy reduces trust in future government pronouncements regarding COVID-19, perpetuates harmful stereotypes about racial inferiority, breeds racial resentment, and causes unnecessary delays in treatment.
 The racially disparate outcomes from the COVID-19 pandemic illuminate numerous background factors that disadvantage minority groups. However, the implementation of racial preferences in lifesaving treatments is not the answer. As demonstrated in this Article, such policies spectacularly fail judicial scrutiny. Furthermore, the nonlegal, pragmatic considerations establish that such a policy does far more harm than good. These considerations are of paramount importance not only for the current COVID-19 crisis but also for future pandemics and the rationing of other limited medical resources, such as organ transplants and intensive care unit beds.

Reducing Metabolic Dysregulation in Obese Latina and/or Hispanic Breast Cancer Survivors Using Physical Activity (ROSA) Trial: A Study Protocol.

BackgroundLatina and Hispanic breast cancer survivors (LHBCS) are at increased risk for long-term complications and poorer metabolic health, including metabolic dysregulation (MetD) before and following breast cancer diagnosis. MetD can increase risk of cancer recurrence, death, and comorbid conditions by increasing inflammation and cancer cell proliferation. While exercise improves physical fitness and metabolic outcomes in breast cancer survivors, there is a lack of studies including underrepresented and disadvantaged minority groups such as LHBCS.MethodsOur 12-month randomized (exercise or attention control) controlled trial (the ROSA trial) aims to utilize a progressive combined aerobic and resistance exercise program to improve MetD, insulin resistance, and visceral adiposity among obese LHBCS. We aim to recruit 160 women with Stage I-III breast cancer who are sedentary, centrally obese, and have completed treatment (e.g., surgery, radiation, chemotherapy) prior to enrollment. Participants randomized to the exercise group receive 16-weeks of virtually supervised aerobic and resistance training, followed by 16-weeks of unsupervised home-based aerobic and resistance exercise, and 16-weeks of follow-up. The attention control group receive a 12-month home-based stretching program. Primary and secondary outcomes are measured every 4-weeks during study visits.DiscussionThe ROSA trial is the first exercise oncology trial targeting high-risk sedentary, obese LHBCS to improve MetD-related outcomes. Results of this trial will help illuminate how exercise impacts health-related outcomes, survivorship, and recurrence, and inform future exercise oncology guidelines to reduce health disparities among minority cancer survivors.

The role of the teacher in the educational achievement of Roma children

This paper discusses the role of the teacher as the one who has the most profound influence on school mobility. My analysis draws attention to the teacher, who can facilitate the performance of Roma children at school by fostering a positive attitude toward learning, encouraging positive relationships, and thereby supporting the overall social mobility of this disadvantaged minority group. The research underlying this particular study consists of analyses of the life stories of Roma individuals who hold or about to obtain university degrees and have been particularly successful in the mobility channel of the education system by the standards of the Roma community. I point to the social factors that help or hinder the progress of the individual. In the analysis, particular attention was paid to the microsocial relationships affecting the school performance of Roma students as well as to the question of secondary socialisation.

Vulnerable Elders, Social Determinants and COVID-19: A perfect storm

The COVID-19 pandemic has brought to an even more glaring spotlight the impact of social determinants of health on the medical and psychiatric morbidity and mortality outcomes from the infection in individuals both in the US and globally. Social determinants of health (SDOH) impact health outcomes for both medical and psychiatric disorders (Compton and Shim 2015). . In this session, we will begin with a vignette presented by Dr. Ahmed that illustrates this phenomenon. Dr. Trinh will then facilitate group discussions of the case. We will transition to an overview of SDOH led by Emily Tan, in which she will discuss how social determinants implicated in poor medical and mental health outcomes include being part of a disadvantaged minority or immigrant group or other marginalized population, experiencing systemic and structural racism, poverty, living environment (including crowding, pollution, and climate change), and having limited access to healthcare. Dr. Trinh will then present on the ways SDOH can increase the likelihood of numerous mental health concerns, including dementia, depression, suicide, anxiety disorders, and substance use disorder– all of which themselves have been identified as risk factors in contracting and experiencing poorer outcomes from COVID-19 infection. Dr. Nix will discuss how the intersectionality of older age, SDOH, and COVID-19 has led to a perfect storm of widespread devastation from the COVID-19 pandemic, impacting medical comorbidity and mortality. Three groups in particular have disproportionately suffered this health burden: (1) ethnic/racial minorities; (2) the socio-economically disadvantaged; and (3) the elderly, especially those living in residential care homes and nursing homes (Ali, Asaria, and Stranges, 2020). We will wrap up the session with a presentation from Dr. Ahmed on lessons learned from the pandemic and future directions, with a focus on how we can support elders and those affected by SDOH.

Critical Care Among Disadvantaged Minority Groups Made Equitable: Trends Throughout the COVID-19 Pandemic.

BackgroundUS racial and ethnic minorities have well-established elevated rates of comorbidities, which, compounded with healthcare access inequity, often lead to worse health outcomes. In the current COVID-19 pandemic, it is important to understand existing disparities in minority groups’ critical care outcomes and mechanisms behind these—topics that have yet to be well-explored.ObjectiveAssess for disparities in racial and ethnic minority groups’ COVID-19 critical care outcomes.DesignRetrospective cohort study.ParticipantsA total of 2125 adult patients who tested positive for COVID-19 via RT-PCR between March and December 2020 and required ICU admission at the Cleveland Clinic Hospital Systems were included.Main MeasuresPrimary outcomes were mortality and hospital length of stay. Cohort-wide analysis and subgroup analyses by pandemic wave were performed. Multivariable logistic regression models were built to study the associations between mortality and covariates.Key ResultsWhile crude mortality was increased in White as compared to Black patients (37.5% vs. 30.5%, respectively; p = 0.002), no significant differences were appraised after adjustment or across pandemic waves. Although median hospital length of stay was comparable between these groups, ICU stay was significantly different (4.4 vs. 3.4, p = 0.003). Mortality and median hospital and ICU length of stay did not differ significantly between Hispanic and non-Hispanic patients. Neither race nor ethnicity was associated with mortality due to COVID-19, although APACHE score, CKD, malignant neoplasms, antibiotic use, vasopressor requirement, and age were.ConclusionsWe found no significant differences in mortality or hospital length of stay between different races and ethnicities. In a pandemic-influenced critical care setting that operated outside conditions of ICU strain and implemented standardized protocol enabling equitable resource distribution, disparities in outcomes often seen among racial and ethnic minority groups were successfully mitigated.Supplementary InformationThe online version contains supplementary material available at 10.1007/s40615-022-01254-1.

Learning language and gaining employment: problems for refugee migrants in Australia

PurposeMuslim refugee migrants are a growing ethno-religious disadvantaged minority group in several Western societies, and host-country language proficiency and employment are essential factors in reducing this disadvantage. This paper thus explores the efficacy of English training programs in facilitating the settlement and employment of a group of male Muslim refugees in Australia.Design/methodology/approachThis study is qualitative in nature, with data collected using semi-structured, in-depth interviews with the eight participants in the study. Analysis was conducted using Bourdieu's concepts of field, capital and habitus.FindingsEnglish training programs offered to Australian Muslim men are problematic in their aim of linking them to employment. Areas of concern are identified in respect to the training hours offered, their learning environment, their content and pedagogy, their lack of focus on employment and their failure to recognise the existing work skills of the migrants.Research limitations/implicationsThe study is conducted with a small sample of male Muslim migrants: while the findings may be similar for other refugee groups, further research is necessary to confirm this.Practical implicationsThere is a need to restructure the current English training programs offered to refugee migrants in Australia, Muslim or otherwise. This study identifies several areas where such restructuring might occur, both at the policy and pedagogical levels.Originality/valueFew studies focus on Australian male Muslim migrants. This study enhances understanding of this under-researched group and their struggles to learn English, find employment and rise above their disadvantaged societal position.

‘I don't feel insulted’: Constructions of prejudice and identity performance among Roma in Bulgaria

AbstractDrawing on studies showing that arguments about the nature of intergroup prejudice allow members of privileged groups to ‘perform’ a positive social identity, the present study explores how arguments about the nature of prejudice are produced by targets of prejudice in order to consolidate or challenge their own social identity. We conducted interviews with Bulgarian Roma and, based on a discursive psychology approach, analysed the way participants contested being assigned to a Roma‐exclusive identity category, which they treated as produced by prejudiced beliefs of the non‐Roma high‐status majority population. Positive intergroup contact was used to demonstrate the absence of prejudice and counter Roma identity threat. Auto‐stereotyping and disidentification, in turn, revealed how one's own situation is distinguished from the group. We discuss how identity performances founded on prejudice constructions work to maintain or challenge intergroup boundaries. We conclude that studies revealing prejudice constructions of minority groups can explain the sedative effect of positive intergroup contact on ethnic activism and help to reflect on integration strategies that would be compatible with social change in favour of disadvantaged minority groups.

The gethnic approach for explaining the search for health information on social media

Abstract Gender and ethnic inequalities in searching for health information have been studied extensively in the context of the internet as a whole, but rarely with respect to social media. Moreover, locality size has rarely been considered as a determinant in the search for health information. Furthermore, little attention has been paid to differences between searching for health information in general and for information on specific health issues. This study proposes a gethnic diversification approach to understand these phenomena. This approach maintains that the triple disadvantage of belonging simultaneously to three disadvantaged groups is translated into an advantage with respect to the probability of searching for health information online. The sample consisted of social media users in Israel (N = 803). The study's outcomes variables were general types of health information (medical vs. non-medical) and searching for specific health issues. The results of logistic regression analyses provide support for the gethnic diversification approach. These results imply that disadvantaged minorities residing in small localities (but also in large ones) use social media to search for health information to a greater extent than their counterparts from larger localities and than members of the advantaged group in order to compensate for their restricted amount of health-related social capital. This finding signals a major need for accessible and quality health services in small localities where many disadvantaged minority groups reside. Key messages Minority women residing in small localities should be treaten as a special group by the public health officials. More resources should be invested in developing health services in localities populated by minorities.

An Empirical Exploration of Southeast Asian-Americans in Education Research: A Qualitative Meta-Analysis

This research examined how Southeast Asian-Americans are treated in leading K-12 and higher education research. A qualitative meta-analysis was conducted using secondary data sources. I analyzed 1,192 pages of text from 151 peer-reviewed academic articles in six K-12 and higher education journals. In a span of 10 years (2007-2016), only four of the 151 articles (2.6%) reviewed specifically addressed in whole or in part Southeast Asian-Americans – one of the most disadvantaged ethnic minority groups in America. Findings demonstrated that aggregating racial data for Asian-Americans silences under-represented Southeast Asian-Americans, suggesting that the continued fight for racial equality in educational research for Southeast Asian-Americans requires more attention at the most basic level.

Do dominant group members have different emotional responses to observing dominant-on-dominantversus dominant-on-disadvantagedostracism? Some evidence for heightened reactivity to potentially discriminatory ingroup behavior.

The importance of social connection to well-being is underscored by individuals’ reactivity to events highlighting the potential for rejection and exclusion, which extends even to observing the social exclusion of others (“vicarious ostracism”). Because responses to vicarious ostracism depend at least in part on empathy with the target, and individuals tend to empathize less readily with outgroup than ingroup members, the question arises as to whether there is a boundary condition on vicarious ostracism effects whereby individuals are relatively immune to observing ingroup-on-outgroup ostracism. Of particular interest is the case where members of a dominant ethnic group observe fellow ingroup members ostracize a member of a disadvantaged ethnic minority group, as here there is a compelling potential alternative: Perceived violation of contemporary social norms condemning prejudice and discrimination might instead lead dominant group members to be especially upset by “dominant-on-disadvantaged” ostracism. Accordingly, the present research examines, across four studies and 4413 participants, individuals’ affective reactions to observing dominant-on-disadvantaged versus dominant-on-dominant ostracism. In each study, dominant group members (White/Europeans) observed dominant group members include or ostracize a fellow dominant group member or a disadvantaged ethnic minority group member (a Black individual) in an online Cyberball game. Results revealed that dominant group members felt more guilt, anger, and sadness after observing severe ostracism of a disadvantaged as opposed to dominant group member. Although no direct effects emerged on behavioral outcomes, exploratory analyses suggested that observing ostracism of a disadvantaged (versus dominant) group member had indirect effects on behavior via increased feelings of anger. These results suggest that observing ostracism may be a sufficiently potent and relatable experience that when it occurs across group boundaries it awakens individuals’ sensitivity to injustice and discrimination.

Immigration Policy and the Rise of Self-Employment Among Mexican Immigrants

Over the past two decades, the U.S. has seen a drastic growth in self-employment among Mexican immigrants, the largest immigrant population in the country. This is an interesting yet puzzling trend, in stark contrast to the stagnated growth of self-employment among other disadvantaged minority groups such as blacks and even a significant decline among whites. Little is known of what drives that growth. We propose that the expansion of interior immigration enforcement, a characteristic of the U.S. immigration policy during that time span, might have contributed to this unique trend by pushing Mexican immigrants into self-employment as an alternative livelihood. Exploiting temporal and geographic variation in immigration enforcement measures from 2005 to 2017, we show that tougher enforcement has been responsible for 10 to 20 percent of the rise in Mexican self-employment. The impact mainly concentrates among likely undocumented immigrants. It is mainly driven by police-based enforcement measures responsible for most deportations, as opposed to employment-based enforcement. Our results suggest that apprehension fear, instead of lack of employment opportunities, is the main push factor.

Obergefell and the Dignitary Harm of Identity-Based Military Service Exclusion

Author(s): Merriam, Eric | Abstract: In Obergefell v. Hodges, the Supreme Court recognized the right of same-sex couples to be married.[1] In doing so, the Court remedied the demeaning exclusion of a historically disadvantaged minority group from a nationally cherished institution, noting the stigma and injury the exclusion caused. The sweeping language of the majority opinion in Obergefell and its focus on exclusionary harm suggested a new era of inclusion for lesbian, gay, bisexual, and transgender Americans.[2] This Article argues that the exclusion of transgender persons from military service constitutes the type of harm Obergefell and the Equal Protection Clause prohibit.This Article first provides background on the pre-Obergefell landscape for constitutional challenges to military service exclusion. Second, the Article assesses Obergefell’s jurisprudential expansions of substantive due process and equal protection doctrines through its recognition of the exclusionary harm done to gay people by excluding them from the institution of marriage. The Article uses the Court’s exclusionary harm analysis to assess the exclusion of a historically disadvantaged minority group from another nationally cherished institution: the Trump Administration’s ban on transgender persons serving in the military. Third, the Article argues that Obergefell advanced a new equal protection doctrine: the government may not demean a group by excluding it from an important positive right resulting in dignitary harm. The Article concludes that the transgender military ban constitutes the type of dignitary harm that Obergefell and the Equal Protection Clause prohibit. [1]. Obergefell v. Hodges, 135 S. Ct. 2584, 2608 (2015). [2]. While the opinion did not explicitly address transgender rights, the Court wrote, “[t]he Constitution promises liberty to all within its reach, [including the right] to define and express their identity.” Id. at 2593. Some commentators observed this extended protections to transgender people. See, e.g., Scott Skinner-Thompson, How Obergefell Could Help Transgender Rights, Slate (June 26, 2015), https://slate.com/human-interest/2015/06/obergefell-and-trans-rights-the-supreme-courts-endorsement-of-identity-expression-could-help-trans-activism.html [https://perma.cc/ZF3W-PVWP]; J. Courtney Sullivan, What Marriage Equality Means for Transgender Rights, N.Y. Times (July 16, 2015), https://www.nytimes.com/2015/07/16/opinion/what-marriage-equality-means-for-transgender-rights.html [https://perma.cc/23M3-T2NV].

Negotiating language ideologies in learning Putonghua: Myanmar ethnic minority students’ perspectives on multilingual practices in a borderland school

ABSTRACT This case study investigates how a cohort of Myanmar ethnic minority students’ language ideologies shape their Putonghua learning and educational trajectories at government schools and Chinese supplementary schools in the borderland next to China. The data were collected through semi-structured interviews and from the participants’ autobiographies on their language learning experiences. The findings indicate that Myanmar ethnic minority students are often linguistically and culturally excluded in government schools because of their lack of proficiency in the Burmese language. Yet having access to Putonghua and other Chinese-related resources provides them with an agentive strategy and capital to reposition themselves from being a disadvantaged ethnic minority group in a peripheral region to moving towards full inclusion and empowerment as part of China. The paper highlights the multiplicity and contested nature of language ideologies that mediate between learners’ language practices and social structures during socio-economic transformations. It also sheds light on Myanmar’s language policy-making and the expansion of China’s soft power through the increasing capital of Putonghua in the borderland of neighbouring countries.

Bisexuality, Union Status, and Gender Composition of the Couple: Reexamining Marital Advantage in Health.

It has long been documented that married individuals have better health outcomes than unmarried individuals. However, this marital advantage paradigm has been developed primarily based on heterosexual populations. No studies to date have examined the health effects of marriage among bisexuals, one of the most disadvantaged but understudied sexual minority groups, although a few have shown mixed results for gays and lesbians. Similarly, no research has examined how the gender composition of a couple may shape bisexuals' health outcomes above and beyond the effects of sexual orientation. We analyzed pooled data from the 2013-2017 National Health Interview Survey (n = 154,485) and found that the health advantage of marriage applied only to heterosexuals and, to a lesser extent, gays and lesbians. Married bisexuals, however, exhibited poorer health than unmarried bisexuals when socioeconomic status and health behaviors were adjusted for. Moreover, bisexuals in same-gender unions were healthier than bisexuals in different-gender unions primarily because of their socioeconomic advantages and healthier behaviors. Together, our findings suggest that bisexuals, particularly those in different-gender unions, face unique challenges in their relationships that may reduce the health advantage associated with marriage.