Jackson Chandra L, Agénor Madina, Johnson Dayna A, Austin S Bryn, Kawachi Ichiro
Clinical and Translational Science Center, Harvard Catalyst, Harvard Medical School, 10 Shattuck Street, Boston, MA, 02215, USA.
Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
BMC Public Health. 2016 Aug 17;16(1):807. doi: 10.1186/s12889-016-3467-1.
Research shows that sexual minorities (e.g., lesbian, gay, and bisexual individuals) experience higher levels of discrimination, stigma, and stress and are at higher risk of some poor health outcomes and health behaviors compared to their heterosexual counterparts. However, the majority of studies have examined sexual orientation disparities in a narrow range of health outcomes and behaviors using convenience samples comprised of either men or women living in restricted geographic areas.
To investigate the relationship between sexual orientation identity and health among U.S. women and men, we used Poisson regression with robust variance to estimate prevalence ratios for health behaviors, outcomes, and services use comparing sexual minorities to heterosexual individuals using 2013 and 2014 National Health Interview Survey data (N = 69,270).
Three percent of the sample identified as sexual minorities. Compared to heterosexual women, lesbian (prevalence ratio (PR) = 1.65 [95 % confidence interval (CI): 1.14, 2.37]) and bisexual (PR = 2.16 [1.46, 3.18]) women were more likely to report heavy drinking. Lesbians had a higher prevalence of obesity (PR = 1.20 [1.02, 1.42]), stroke (PR = 1.96 [1.14, 3.39]), and functional limitation (PR = 1.17 [1.02, 1.34] than heterosexual women. Gay men were more likely to have hypertension (PR = 1.21 [1.03, 1.43]) and heart disease (PR = 1.39 [1.02, 1.88]). Despite no difference in health insurance status, sexual minorities were more likely than heterosexual individuals to delay seeking healthcare because of cost; however, members of this group were also more likely to have received an HIV test and initiated HPV vaccination.
Sexual minorities had a higher prevalence of some poor health behaviors and outcomes.
研究表明，性少数群体（例如女同性恋者、男同性恋者和双性恋者）遭受的歧视、污名化和压力更大，与异性恋者相比，他们出现某些不良健康状况和健康行为的风险更高。然而，大多数研究使用居住在有限地理区域的男性或女性组成的便利样本，在有限的健康状况和行为范围内研究性取向差异。
为了调查美国男性和女性中性取向身份与健康之间的关系，我们使用稳健方差的泊松回归来估计健康行为、结果和服务使用的患病率比，将性少数群体与异性恋者进行比较，使用2013年和2014年国家健康访谈调查数据（N = 69,270）。
3%的样本被认定为性少数群体。与异性恋女性相比，女同性恋者（患病率比（PR）= 1.65 [95%置信区间（CI）：1.14, 2.37]）和双性恋女性（PR = 2.16 [1.46, 3.18]）更有可能报告酗酒。女同性恋者肥胖（PR = 1.20 [1.02, 1.42]）、中风（PR = 1.96 [1.14, 3.39]）和功能受限（PR = 1.17 [1.02, 1.34]）的患病率高于异性恋女性。男同性恋者患高血压（PR = 1.21 [1.03, 1.43]）和心脏病（PR = 1.39 [1.02, 1.88]）的可能性更大。尽管在医疗保险状况方面没有差异，但性少数群体比异性恋者更有可能因费用问题而推迟寻求医疗保健；然而，该群体成员也更有可能接受过艾滋病毒检测并开始接种人乳头瘤病毒疫苗。
性少数群体中一些不良健康行为和结果的患病率更高。
