Comparison of Health and Health Risk Factors Between Lesbian, Gay, and Bisexual Adults and Heterosexual Adults in the United States: Results From the National Health Interview Survey
- PMID: 27367843
- DOI: 10.1001/jamainternmed.2016.3432
Comparison of Health and Health Risk Factors Between Lesbian, Gay, and Bisexual Adults and Heterosexual Adults in the United States: Results From the National Health Interview Survey
Abstract
Importance: Previous studies identified disparities in health and health risk factors among lesbian, gay, and bisexual (LGB) adults, but prior investigations have been confined to samples not representative of the US adult population or have been limited in size or geographic scope. For the first time in its long history, the 2013 and 2014 National Health Interview Survey included a question on sexual orientation, providing health information on sexual minorities from one of the nation's leading health surveys.
Objective: To compare health and health risk factors between LGB adults and heterosexual adults in the United States.
Design, setting, and participants: Data from the nationally representative 2013 and 2014 National Health Interview Survey were used to compare health outcomes among lesbian (n = 525), gay (n = 624), and bisexual (n = 515) adults who were 18 years or older and their heterosexual peers (n = 67 150) using logistic regression.
Main outcomes and measures: Self-rated health, functional status, chronic conditions, psychological distress, alcohol consumption, and cigarette use.
Results: The study cohort comprised 68 814 participants. Their mean (SD) age was 46.8 (11.8) years, and 51.8% (38 063 of 68 814) were female. After controlling for sociodemographic characteristics, gay men were more likely to report severe psychological distress (odds ratio [OR], 2.82; 95% CI, 1.55-5.14), heavy drinking (OR, 1.97; 95% CI, 1.08-3.58), and moderate smoking (OR, 1.98; 95% CI, 1.39-2.81) than heterosexual men; bisexual men were more likely to report severe psychological distress (OR, 4.70; 95% CI, 1.77-12.52), heavy drinking (OR, 3.15; 95% CI, 1.22-8.16), and heavy smoking (OR, 2.10; 95% CI, 1.08-4.10) than heterosexual men; lesbian women were more likely to report moderate psychological distress (OR, 1.34; 95% CI, 1.02-1.76), poor or fair health (OR, 1.91; 95% CI, 1.24-2.95), multiple chronic conditions (OR, 1.58; 95% CI, 1.12-2.22), heavy drinking (OR, 2.63; 95% CI, 1.54-4.50), and heavy smoking (OR, 2.29; 95% CI, 1.36-3.88) than heterosexual women; and bisexual women were more likely to report multiple chronic conditions (OR, 2.07; 95% CI, 1.34-3.20), severe psychological distress (OR, 3.69; 95% CI, 2.19-6.22), heavy drinking (OR, 2.07; 95% CI, 1.20-3.59), and moderate smoking (OR, 1.60; 95% CI, 1.05-2.44) than heterosexual women.
Conclusions and relevance: This study supports prior research finding substantial health disparities for LGB adults in the United States, potentially due to the stressors that LGB people experience as a result of interpersonal and structural discrimination. In screening for health issues, clinicians should be sensitive to the needs of sexual minority patients.
Comment in
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Health Care for Lesbian, Gay, and Bisexual People Comes Out of the Closet.JAMA Intern Med. 2016 Sep 1;176(9):1352. doi: 10.1001/jamainternmed.2016.3828. JAMA Intern Med. 2016. PMID: 27367483 No abstract available.
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Advancing the Health of Lesbian, Gay, and Bisexual Adults.JAMA Intern Med. 2017 Feb 1;177(2):288. doi: 10.1001/jamainternmed.2016.8629. JAMA Intern Med. 2017. PMID: 28166347 Free PMC article. No abstract available.
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Advancing the Health of Lesbian, Gay, and Bisexual Adults-Reply.JAMA Intern Med. 2017 Feb 1;177(2):288-289. doi: 10.1001/jamainternmed.2016.8632. JAMA Intern Med. 2017. PMID: 28166356 No abstract available.
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