Dharma Christoffer, Bauer Greta R
Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, ON.
Can J Public Health. 2017 Apr 20;108(1):e21-e26. doi: 10.17269/cjph.108.5848.
Public health research on inequalities in Canada depends heavily on population data sets such as the Canadian Community Health Survey. While sexual orientation has three dimensions - identity, behaviour and attraction - Statistics Canada and public health agencies assess sexual orientation with a single questionnaire item on identity, defined behaviourally. This study aims to evaluate this item, to allow for clearer interpretation of sexual orientation frequencies and inequalities.
Through an online convenience sampling of Canadians ≥14 years of age, participants (n = 311) completed the Statistics Canada question and a second set of sexual orientation questions.
The single-item question had an 85.8% sensitivity in capturing sexual minorities, broadly defined by their sexual identity, lifetime behaviour and attraction. Kappa statistic for agreement between the single item and sexual identity was 0.89; with past year, lifetime behaviour and attraction were 0.39, 0.48 and 0.57 respectively. The item captured 99.3% of those with a sexual minority identity, 84.2% of those with any lifetime same-sex partners, 98.4% with a past-year same-sex partner, and 97.8% who indicated at least equal attraction to same-sex persons.
Findings from Statistics Canada surveys can be best interpreted as applying to those who identify as sexual minorities. Analyses using this measure will underidentify those with same-sex partners or attractions who do not identify as a sexual minority, and should be interpreted accordingly. To understand patterns of sexual minority health in Canada, there is a need to incorporate other dimensions of sexual orientation.
加拿大关于不平等问题的公共卫生研究在很大程度上依赖于诸如加拿大社区健康调查之类的人口数据集。虽然性取向有三个维度——身份认同、行为和吸引力——但加拿大统计局和公共卫生机构通过一个关于身份认同的单一问卷项目（从行为角度定义）来评估性取向。本研究旨在评估该项目，以便更清晰地解释性取向频率和不平等情况。
通过对14岁及以上加拿大人进行在线便利抽样，参与者（n = 311）完成了加拿大统计局的问题以及第二组性取向问题。
该单一项目问题在捕捉性少数群体方面的敏感度为85.8%，性少数群体广义上由其性身份认同、终身行为和吸引力来定义。该单一项目与性身份认同之间的一致性卡方统计量为0.89；与过去一年、终身行为和吸引力的一致性卡方统计量分别为0.39、0.48和0.57。该项目涵盖了99.3%有性少数群体身份的人、84.2%有过任何终身同性伴侣的人、98.4%有过去一年同性伴侣的人以及97.8%表示对同性至少有同等吸引力的人。
加拿大统计局调查的结果最好解释为适用于那些自我认同为性少数群体的人。使用这一衡量标准的分析将无法识别那些有同性伴侣或吸引力但不自我认同为性少数群体的人，对此应相应地进行解释。为了解加拿大性少数群体的健康模式，有必要纳入性取向的其他维度。
