Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California.
Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California.
J Adolesc Health. 2021 Nov;69(5):746-753. doi: 10.1016/j.jadohealth.2021.07.021. Epub 2021 Aug 17.
The COVID-19 pandemic has exacerbated several existing health disparities in the U.S. Sexual and gender minority (SGM) health disparities may also be widening during the pandemic, though few studies have assessed this question. This study examined SGM young adult disparities in health-related behaviors to cope with isolation during the pandemic.
Respondents from a prospective cohort of Southern California young adults (N = 2,298) reported whether they engaged in various strategies (e.g., substance use, diet, exercise, relaxation) to cope with isolation during the pandemic (each: yes/no). Differences in coping were assessed across five SGM subgroups: heterosexual men and women, lesbian, gay, bisexual, pansexual, queer (LGBQ) men and women, transgender/nonbinary (TNB) respondents. Negative binomial regressions estimated sexual/gender identity differences in the number of positive or negative behaviors endorsed, adjusting for sociodemographic characteristics and prepandemic health behaviors. Differences were also tested across individual coping behaviors.
Heterosexual women (IRR = 1.11 [1.01-1.21]), LGBQ men (IRR = 1.31 [1.12-1.54]), LGBQ women (IRR = 1.33 [1.19-1.49]), and TNB respondents (IRR = 1.29 [1.03-1.61]) engaged in more negative coping behaviors than heterosexual men. LGBQ men (IRR = 1.19 [1.02-1.39]) and LGBQ women (IRR = 1.20 [1.08-1.34]) also reported more negative coping behaviors versus heterosexual women. Generally, LGBQ men reported the highest prevalence of substance use, while LGBQ women and TNB reported the highest prevalence of adverse eating behaviors and self-harm.
SGM young adults may be disproportionately, adversely impacted by the COVID-19 pandemic. Tailored public health and clinical interventions are needed to decrease pandemic-related SGM health disparities.
COVID-19 大流行加剧了美国存在的一些健康不平等现象。性少数群体和性别少数群体(SGM)的健康差距也可能在大流行期间扩大,尽管很少有研究对此进行评估。本研究探讨了 SGM 年轻成年人在与大流行期间隔离相关的健康行为方面的差异。
来自南加州年轻成年人前瞻性队列的受访者(N=2298)报告了他们在大流行期间是否采用了各种策略(例如,使用药物、饮食、运动、放松)来应对隔离。在五个 SGM 亚组中评估了应对方式的差异:异性恋男性和女性、女同性恋、男同性恋、双性恋、泛性恋、酷儿(LGBQ)男性和女性、跨性别/非二元性别(TNB)受访者。使用负二项回归估计了在认可的积极或消极行为数量方面的性/性别认同差异,调整了社会人口统计学特征和大流行前的健康行为。还针对个体应对行为测试了差异。
异性恋女性(IRR=1.11[1.01-1.21])、LGBQ 男性(IRR=1.31[1.12-1.54])、LGBQ 女性(IRR=1.33[1.19-1.49])和 TNB 受访者(IRR=1.29[1.03-1.61])比异性恋男性更倾向于采取消极应对行为。LGBQ 男性(IRR=1.19[1.02-1.39])和 LGBQ 女性(IRR=1.20[1.08-1.34])与异性恋女性相比,也报告了更多的消极应对行为。一般来说,LGBQ 男性报告的药物使用比例最高,而 LGBQ 女性和 TNB 报告的不良饮食行为和自残比例最高。
SGM 年轻成年人可能受到 COVID-19 大流行的不成比例的不利影响。需要量身定制的公共卫生和临床干预措施来减少与大流行相关的 SGM 健康差距。