Columbia School of Social Work, Columbia University, New York, New York, USA.
LGBT Health. 2022 Jan;9(1):27-33. doi: 10.1089/lgbt.2020.0482. Epub 2021 Oct 25.
This study aimed to investigate mortality disparities for sexual minority adults in the United States. We used data from 26,384 adult respondents using the 1999-2014 National Health and Nutrition Examination Survey, linked with National Death Index mortality files. Respondents reporting one or more same-sex sexual partners in their lifetime or who identified as gay, lesbian, or bisexual were considered sexual minority adults (617 sexual minority males and 963 sexual minority females). We examined gender-stratified mortality frequencies by sexual minority status and used gender-stratified Cox proportional hazard models to investigate mortality risk for sexual minority adults compared with non-sexual-minority adults. We observed significantly elevated mortality risk among sexual minority females compared with non-sexual-minority females, robust across model specifications. Estimates ranged from an adjusted hazard ratio of 2.0 (95% confidence interval [CI]: 1.3-3.2) to 2.1 (95% CI: 1.4-3.3) among sexual minority females compared with non-sexual-minority females, with estimates at approximately double the risk of mortality. We found no evidence of differential mortality risk for sexual minority males compared with non-sexual-minority males. These results suggest mortality disparities for sexual minority females compared with non-sexual-minority females. Future research should consider mortality disparities among subgroups of sexual minority adults and include targeted data collection to increase understanding of the mechanisms behind mortality disparities.
本研究旨在调查美国性少数群体成年人的死亡率差异。我们使用了来自 1999 年至 2014 年全国健康和营养检查调查的 26384 名成年受访者的数据，这些数据与国家死亡指数死亡档案相关联。报告一生中存在一个或多个同性性伴侣或自认为是同性恋、女同性恋或双性恋的受访者被视为性少数群体成年人（617 名男性性少数群体成年人和 963 名女性性少数群体成年人）。我们按性少数群体状况检查了性别分层死亡率频率，并使用性别分层 Cox 比例风险模型调查了性少数群体成年人与非性少数群体成年人相比的死亡率风险。我们观察到，与非性少数群体女性相比，性少数群体女性的死亡率风险显著升高，各种模型的结果均稳健。估计值从性少数群体女性与非性少数群体女性相比的调整后危险比 2.0（95%置信区间 [CI]：1.3-3.2）到 2.1（95% CI：1.4-3.3）不等，死亡率风险估计值约为两倍。我们没有发现性少数群体男性与非性少数群体男性相比死亡率风险存在差异的证据。这些结果表明，性少数群体女性与非性少数群体女性相比存在死亡率差异。未来的研究应该考虑性少数群体成年人亚组之间的死亡率差异，并包括有针对性的数据收集，以增加对死亡率差异背后机制的理解。
