Are sociodemographic, lifestyle, and psychosocial characteristics associated with sexual orientation group differences in mental health disparities? Results from a national population-based study
- 52 Downloads
Sexual minority mental health disparities are well documented. However, distinct sexual minority subgroups are often collapsed into a single “lesbian, gay, or bisexual” (LGB) analytic group. While limited research has shown sexual minority subgroup differences in mental health, little is known about the factors underlying these differences. This study examines whether sociodemographic, lifestyle, and psychosocial characteristics are associated with sexual orientation subgroup differences in mental health.
Using the National Epidemiologic Survey on Alcohol and Related Conditions, Wave III, differences in various mental health measures, and sociodemographic, lifestyle, and psychosocial characteristics were assessed across three sexual minority subgroups [lesbians/gay men, bisexuals, and heterosexuals reporting same-sex attractions or behaviors (“heterosexual-identified sexual minorities, HSM”)] and heterosexuals reporting only opposite-sex attractions and behaviors (“heterosexuals”). Sequential linear regressions evaluated the degrees to which different factors attenuated mental health (SF-12) disparities between heterosexuals and sexual minority subgroups. Analyses were sex-stratified.
Several sociodemographic, lifestyle, and psychosocial characteristic differences existed between sexual orientation groups. Further, all sexual minority subgroups had lower SF-12 scores than heterosexuals, except lesbian women. Sociodemographic factors attenuated the disparity for bisexual men. Sociodemographic, lifestyle, plus psychosocial factors attenuated the disparity for HSM men. However, sociodemographic, lifestyle, and psychosocial factors partially, but did not fully, attenuate the disparity for gay men, bisexual women, or HSM women.
Different factors are associated with mental health disparities for sexual minority subgroups. To maximize health intervention efforts, additional research is needed to uncover the specific mechanisms contributing to health disparities across diverse sexual minority populations.
KeywordsSexual orientation Mental health Disparities Social epidemiology
This manuscript was prepared using a limited access data set obtained from the National Institute on Alcohol Abuse and Alcoholism and does not reflect the opinions or views of NIAAA or the U.S. Government. No additional financial disclosures were reported by the authors of this paper. On behalf of all authors, the corresponding author states that there is no conflict of interest.
- 1.Institute of Medicine (2011) The health of lesbian, gay, bisexual, and transgender people: building a foundation for better understanding. Institute of Medicine, Washington, D.C.Google Scholar
- 2.Ward BW, Dahlhamer JM, Galinsky AM, Joestl SS Among (2014) Sexual Orientation and Health. National Health Interview Survey, 2013, U.S. AdultsGoogle Scholar
- 5.Russell ST, Fish JN (2016) Mental health in lesbian, gay, bisexual, and transgender (LGBT) youth. Annu Rev Clin Psychol 12:465–487. https://doi.org/10.1146/annurev-clinpsy-021815-093153 CrossRefPubMedPubMedCentralGoogle Scholar
- 20.Link BG, Phelan J (1995) Social conditions as fundamental causes of disease. J Health Soc Behav 80–94Google Scholar
- 22.Dressler WW, Oths KS, Gravlee CC (2005) Race and ethnicity in public health research: models to explain health disparities. Annu Rev Anthropol 34:231–252. https://doi.org/10.1146/annurev.anthro.34.081804.120505 CrossRefGoogle Scholar
- 36.Gattis MN, Sacco P, Cunningham-Williams RM (2012) Substance use and mental health disorders among heterosexual identified men and women who have same-sex partners or same-sex attraction: results from the national epidemiological survey on alcohol and related conditions. Arch Sex Behav 41:1185–1197. https://doi.org/10.1007/s10508-012-9910-1 CrossRefPubMedPubMedCentralGoogle Scholar
- 42.Silva TJ, Whaley RB (2017) Bud-sex, dude-sex, and heteroflexible men: the relationship between straight identification and social attitudes in a nationally representative sample of men with same-sex attractions or sexual practices. Sociol Perspect 61:426 – 443. https://doi.org/10.1177/0731121417745024 CrossRefGoogle Scholar
- 45.Grant BF, Chu A, Sigman R et al (2014) Source and accuracy statement: national epidemiologic survey on alcohol and related conditions-III (NESARC-III). National Institute on Alcohol Abuse and Alcoholism, Rockville, MDGoogle Scholar
- 47.Data Notes: National epidemiologic survey on alcohol and related conditions-III (NESARC-III). National Institute on Alcohol Abuse and Alcoholism, Rockville, MDGoogle Scholar
- 48.(2018) Physical activity guidelines: adults. In: Off. Dis. Prev. Heal. Promot. https://health.gov/paguidelines/guidelines/adults.aspx. Accessed 5 July 2017
- 50.Dr. Cohen’s Scales: interpersonal support evaluation list (ISEL). http://www.psy.cmu.edu/~scohen/scales.html
- 51.Badgett L, Goldberg NE (2009) Best practices for asking questions about sexual orientation on surveys. The Williams Institute, Los Angeles, CAGoogle Scholar