Study Finds Substantial Mental, Physical Health Disparities Among LGB Adults

Lesbian, gay, and bisexual (LGB) adults reported higher rates of severe psychological distress and impaired physical health than did heterosexuals, according to data from one of the nation’s leading, most representative health surveys.

The study of 68,814 adults was published in JAMA Internal Medicine by researchers at Vanderbilt University School of Medicine and University of Minnesota School of Public Health. The authors, led by Gilbert Gonzales, PhD, MHA, assistant professor of health policy at Vanderbilt, said the study adds to previous research on health disparities in this community and should serve as a call to healthcare professionals and public health practitioners to pay particular attention to this vulnerable population.

Although previous studies have shown disparities in health and health risk factors among LGB adults, samples have not been representative of the US population or were limited in size or geographic scope. The change came about because for the first time in its 60-year history, the 2013 and 2014 National Health Interview Surveys, which were used for this new study, included a question on sexual orientation. This change provided health information on sexual minorities from one of the nation’s leading health surveys.

The study compared self-rated health data from 525 lesbian, 624 gay, and 515 bisexual adults who were 18 and over with 67,150 heterosexual peers using logistic regression. Functional status, chronic conditions, psychological distress, alcohol consumption, and cigarette use was also measured. The mean age of the study subjects was 46.8 years and 51.8% were female.

After controlling for sociodemographic characteristics, the study found the following:

• Gay men were more likely to report severe psychological distress, heavy drinking, and moderate smoking than heterosexual men
• Bisexual men were more likely to report severe psychological distress, heavy drinking, and heavy smoking than heterosexual men
• Lesbian women were more likely to report moderate psychological distress, poor or fair health, multiple chronic conditions, heavy drinking, and heavy smoking than heterosexual women
• Bisexual women were more likely to report multiple chronic conditions, severe psychological distress, heavy drinking, and moderate smoking than heterosexual women

Earlier research has also linked poorer health outcomes in the LGB population to the chronic stress of being a member of a marginalized minority group. The report noted that discriminatory environments and policies can engender feelings of rejection, shame, and low self-esteem, all of which can shape health and health-related behaviors in a negative way.

“Clinicians, healthcare providers, and health policy makers should be sensitive to the health and social issues affecting LGBT patients,” Gonzalez said.