Deployment Health Research Department, Naval Health Research Center, San Diego, California; Leidos, San Diego, California.
Deployment Health Research Department, Naval Health Research Center, San Diego, California; Leidos, San Diego, California.
Am J Prev Med. 2022 Oct;63(4):521-531. doi: 10.1016/j.amepre.2022.04.034. Epub 2022 Jul 3.
This study investigated whether health disparities exist among lesbian, gay, and bisexual individuals serving in the U.S. military by examining the associations of sexual orientation with mental, physical, and behavioral health among a population-based sample of service members and veterans.
Sexual orientation and health outcomes were self-reported on the 2016 Millennium Cohort Study follow-up questionnaire (N=96,930). Health outcomes were assessed across 3 domains: mental health (post-traumatic stress disorder, depression, anxiety, binge eating, problematic anger), physical health (multiple somatic symptoms, physical functioning, BMI), and behavioral health (smoking, problem and risky drinking, insomnia). Adjusted logistic regression models conducted between 2019 and 2022 estimated the associations between sexual orientation and each health outcome.
Lesbian, gay, and bisexual individuals (3.6% of the sample) were more likely to screen positive for post-traumatic stress disorder, depression, anxiety, binge eating, problematic anger, multiple somatic symptoms, and insomnia than heterosexual individuals. Gay/lesbian and bisexual women reported more adverse health outcomes (overweight and obesity, smoking, problem/risky drinking) than heterosexual women. Gay and bisexual men reported some adverse health outcomes (e.g., smoking and problem drinking) but better physical health (e.g., less overweight/obesity) than heterosexual men.
Lesbian, gay, and bisexual service members reported poorer mental, physical, and behavioral health than heterosexual peers, most notably among gay/lesbian women and bisexual individuals. Findings suggest that lesbian, gay, and bisexual service members experience health disparities, despite many having equal eligibility for health care, highlighting the need for improved equity initiatives that promote cultural responsiveness, acceptance, and approaches to support the healthcare needs of lesbian, gay, and bisexual military members.
本研究通过考察性取向与服务人员和退伍军人样本的心理健康、身体健康和行为健康之间的关联，调查了在美国军队中服役的同性恋、双性恋和异性恋个体是否存在健康差异。
性取向和健康结果是在 2016 年千禧年队列研究随访问卷（N=96930）中自我报告的。健康结果在 3 个领域进行评估：心理健康（创伤后应激障碍、抑郁、焦虑、暴饮暴食、问题性愤怒）、身体健康（多种躯体症状、身体机能、BMI）和行为健康（吸烟、问题和危险饮酒、失眠）。2019 年至 2022 年进行的调整后的逻辑回归模型估计了性取向与每种健康结果之间的关联。
同性恋、双性恋和异性恋个体（占样本的 3.6%）比异性恋个体更有可能出现创伤后应激障碍、抑郁、焦虑、暴饮暴食、问题性愤怒、多种躯体症状和失眠的阳性筛查结果。女同性恋/双性恋和双性恋女性比异性恋女性报告了更多的不良健康结果（超重和肥胖、吸烟、问题/危险饮酒）。男同性恋和双性恋男性报告了一些不良健康结果（例如吸烟和危险饮酒），但身体健康状况更好（例如超重/肥胖的情况较少）比异性恋男性。
同性恋、双性恋和异性恋服务人员报告的心理健康、身体健康和行为健康状况比异性恋同龄人差，尤其是女同性恋/双性恋女性和双性恋个体。研究结果表明，尽管许多同性恋、双性恋和异性恋服务人员享有平等的医疗保健资格，但他们仍存在健康差异，这突出表明需要改善公平倡议，以促进文化响应性、接受度和支持同性恋、双性恋和异性恋军人医疗保健需求的方法。
