Department of Health Policy, Vanderbilt University School of Medicine, Nashville, TN 37203, USA.
Departments of Anesthesiology, Biomedical Informatics, Surgery & Health Policy, Vanderbilt University School of Medicine, Nashville, TN 37232, USA.
Int J Environ Res Public Health. 2018 Jun 1;15(6):1136. doi: 10.3390/ijerph15061136.
A large body of research has documented disparities in health and access to care for lesbian, gay, and bisexual (LGB) people in the United States. Less research has examined how the level of legal protection afforded to LGB people (the state policy environment) affects health disparities for sexual minorities. This study used data on 14,687 sexual minority adults and 490,071 heterosexual adults from the 2014⁻2016 Behavioral Risk Factor Surveillance System to document differences in health. Unadjusted state-specific prevalence estimates and multivariable logistic regression models were used to compare poor/fair self-rated health by gender, sexual minority status, and state policy environments (comprehensive versus limited protections for LGB people). We found disparities in self-rated health between sexual minority adults and heterosexual adults in most states. On average, sexual minority men in states with limited protections and sexual minority women in states with either comprehensive or limited protections were more likely to report poor/fair self-rated health compared to their heterosexual counterparts. This study adds new findings on the association between state policy environments and self-rated health for sexual minorities and suggests differences in this relationship by gender. The associations and impacts of state-specific policies affecting LGB populations may vary by gender, as well as other intersectional identities.
大量研究记录了美国女同性恋、男同性恋和双性恋（LGB）人群在健康和获得医疗保健方面的差距。较少的研究探讨了给予 LGB 人群的法律保护程度（州政策环境）如何影响少数性取向群体的健康差距。本研究使用了来自 2014-2016 年行为风险因素监测系统的 14687 名性少数成年人和 490071 名异性恋成年人的数据，记录了健康方面的差异。使用未经调整的州特定流行率估计值和多变量逻辑回归模型，按性别、性少数群体地位和州政策环境（对 LGB 人群的全面保护与有限保护）比较了不同性别、性少数群体地位的人群的健康自评状况。我们发现，在大多数州，性少数群体成年人和异性恋成年人的健康自评状况存在差异。平均而言，在只有有限保护的州，性少数男性和在既有全面保护又有有限保护的州，性少数女性与异性恋同龄人相比，更有可能报告健康自评较差/一般。本研究增加了关于州政策环境与性少数群体健康自评之间关联的新发现，并表明这种关联因性别而异。影响 LGB 人群的州特定政策的关联和影响可能因性别以及其他交叉性身份而异。
