Abstract
Objectives
Lesbian, gay, and bisexual (LGB) individuals report worse mental health than heterosexuals; however, this disparity may vary across intersecting social locations and be moderated by community belonging.
Methods
We investigated these relationships using the Canadian Community Health Survey 2015–2016. Log-binomial regression models were used to estimate associations between self-rated mental health and social locations (sexual orientation, gender, race, immigration, education, income), community belonging, and interactions between explanatory variables.
Results
Poor mental health was 1.79 (95%CI: 1.37–2.33) times higher in lesbian/gay individuals and 3.3 (95%CI: 2.89–3.76) times higher in bisexuals when compared to heterosexuals. LGB participants across all social locations reported poorer mental health as compared with heterosexuals, with bisexuals consistently displaying worse mental health. Strong community belonging modifies this relationship, reducing disparities across all sexual orientations and social locations.
Conclusion
The intersections of differing social locations and community belonging should be considered when addressing LGB Canadians’ mental health needs.
Résumé
Objectifs
Les lesbiennes, les hommes gais et les personnes bisexuelles (LGB) déclarent une moins bonne santé mentale que les personnes hétérosexuelles, mais cette disparité peut varier selon l’emplacement social, et elle peut être modérée par l’appartenance communautaire.
Méthode
Nous avons examiné ces relations à l’aide de l’Enquête sur la santé dans les collectivités canadiennes de 2015–2016. Nous avons utilisé des modèles de régression log-binomiaux pour estimer les associations entre la santé mentale autoévaluée et les emplacements sociaux (l’orientation sexuelle, le genre, la race, l’immigration, l’instruction, le revenu), l’appartenance communautaire et les interactions entre les variables explicatives.
Résultats
La mauvaise santé mentale était 1,79 fois (IC de 95% : 1,37–2,33) plus élevée chez les lesbiennes et les hommes gais et 3,3 fois (IC de 95% : 2,89–3,76) plus élevée chez les personnes bisexuelles que chez les personnes hétérosexuelles. Les participantes et les participants LGB de tous les emplacements sociaux ont déclaré une moins bonne santé mentale que les personnes hétérosexuelles, et les personnes bisexuelles ont systématiquement fait état d’une moins bonne santé mentale. Une forte appartenance communautaire modifie cette relation en réduisant les disparités pour toutes les orientations sexuelles et tous les emplacements sociaux.
Conclusion
Les croisements entre les différents emplacements sociaux et l’appartenance communautaire devraient être pris en compte lorsqu’on aborde les besoins de santé mentale des Canadiennes et des Canadiens LGB.
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Availability of data and material
The 2015–2016 cycle of the Canadian Community Health Survey is available at this link: https://www150.statcan.gc.ca/n1/en/catalogue/82M0013X2019001.
Code availability
Not available.
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Funding
JJSD is supported by a Canada Graduate Scholarship – Doctoral Research Award from the Canadian Institutes of Health Research (2022–2025). TS is supported by a Michael Smith Foundation for Health Research Scholar Award (2019).
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JJSD conceptualized the study, led the analysis, and wrote the initial draft of the manuscript. TS and AA contributed to the analysis and edited the manuscript prior to submission. All authors have reviewed and approved this article for publication.
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All procedures performed in this study were in accordance with the ethical standards of research ethics boards at the University of British Columbia ((#LR9, 7.10) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
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Dulai, J.J.S., Salway, T. & Ablona, A. Strong community belonging moderates poor mental health in lesbian, gay, and bisexual individuals living in Canada: an intersectional analysis of a national population-based survey. Can J Public Health 114, 916–927 (2023). https://doi.org/10.17269/s41997-023-00794-1
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DOI: https://doi.org/10.17269/s41997-023-00794-1
Keywords
- Community belonging
- Intersectionality
- Lesbian, gay and bisexual health
- Mental health
- National population-based survey