Lee Joseph G L, Boynton Marcella H, Shook-Sa Bonnie E, Wimark Thomas
Department of Health Education and Promotion, College of Health and Human Performance, and Center for Health Disparities, Brody School of Medicine, East Carolina University, Greenville, North Carolina, USA.
Cancer Prevention and Control, UNC Lineberger Comprehensive Cancer Center, Chapel Hill, North Carolina, USA.
Ann LGBTQ Public Popul Health. 2020;1(2):96-114. doi: 10.1891/lgbtq-2019-0009.
Emerging evidence using the concentration of same-sex couples from the U.S. Census suggests lesbian, gay, and bisexual (LGB), and transgender (LGBT; i.e., sexual and gender minority [SGM]) people living as a same-sex couple are concentrated in less healthful neighborhoods. However, it is unclear if findings would be different if based on where LGBT individuals live. Thus, we sought to assess differences in neighborhood, county, and state characteristics between same-sex couples and LGBT individuals to inform population health research and policy interventions on LGBT health inequities. In 2017, we conducted a cross-sectional national, probability survey of LGBT adults in the U.S. and geocoded addresses (=407). We linked locations with census tract, county, and state characteristics selected based on health inequities theories. In 2019, we used weighted analysis to calculate descriptive statistics and conducted planned contrasts of location characteristics by both cohabitation status and gender. Many location characteristics were similar by cohabitation status and gender. However, the tract proportion of Black residents and county crime rate were lower for cohabitating than non-cohabitating men. State smoke-free air score was weaker for cohabitating than non-cohabitating women. The use of same-sex couples to determine the geographical clustering of LGBT lives in the U.S. may give a reasonable indication of overall spatial characteristics but can underestimate some important determinants of health. Care should be taken using same-sex couples as a proxy for LGBT concentration when racial segregation is a potential confounder.
美国人口普查中有关同性伴侣集中程度的新证据表明，以同性伴侣身份生活的女同性恋、男同性恋、双性恋（LGB）及跨性别者（LGBT，即性取向和性别少数群体[SGM]）集中在健康状况较差的社区。然而，如果基于LGBT个体的居住地点，研究结果是否会有所不同尚不清楚。因此，我们试图评估同性伴侣与LGBT个体在社区、县和州特征方面的差异，以为有关LGBT健康不平等问题的人群健康研究和政策干预提供信息。2017年，我们在美国对LGBT成年人进行了一项全国性的横断面概率调查，并对地址进行了地理编码（n = 407）。我们将这些地点与基于健康不平等理论选择的普查区、县和州特征相关联。2019年，我们使用加权分析来计算描述性统计数据，并按同居状况和性别对地点特征进行了计划对比。许多地点特征在同居状况和性别方面相似。然而，同居男性所在普查区的黑人居民比例和县犯罪率低于非同居男性。同居女性所在州的无烟空气评分比非同居女性低。在美国，用同性伴侣来确定LGBT生活的地理聚集情况可能会合理地反映总体空间特征，但可能会低估一些重要的健康决定因素。当种族隔离是一个潜在的混杂因素时，使用同性伴侣作为LGBT集中程度的替代指标时应谨慎。
