Khanolkar Amal R, Frost David M, Tabor Evangeline, Redclift Victoria, Amos Rebekah, Patalay Praveetha
MRC Unit for Lifelong Health and Ageing at UCL, London, United Kingdom.
Department of Population Health Sciences, School of Life Course and Population Sciences, King' College London, London, United Kingdom.
LGBT Health. 2023 Jan;10(1):26-40. doi: 10.1089/lgbt.2021.0473. Epub 2022 Sep 1.
This study employed an intersectional framework to examine impact of inequalities related to sexual minority (SM) and ethnic minority (EM) identities in risk for health, well-being, and health-related behaviors in a nationally representative sample. Participants included 9789 (51% female) adolescents aged 17 years from the U.K.-wide Millennium Cohort Study, with data on self-identified sexual and ethnic identities. Adolescents were grouped into White heterosexual, White-SM, EM-heterosexual, and EM-SM categories. Questionnaires assessed mental health (e.g., self-reported psychological distress, doctor-diagnosed depression, attempted suicide), general health (self-rated health, chronic illness, body mass index), and health-related behaviors (e.g., smoking, substance use). Associations were analyzed using multivariable logistic regression. SM individuals (White: 18% and EM: 3%) had increased odds for mental health difficulties and attempted suicide, with higher odds for White-SM individuals than for EM-SM individuals. Compared with White heterosexual individuals, White-SM and EM-SM individuals had higher risk for psychological distress (adjusted odds ratios [OR] 3.47/2.24 for White-SM/EM-SM, respectively) and emotional symptoms (OR 3.17/1.65). They had higher odds for attempted suicide (OR 2.78/2.02), self-harm (OR 3.06/1.52), and poor sleep quality (OR 1.88/1.67). In contrast, the White heterosexual and White-SM groups had similarly high proportions reporting risky behaviors except for drug use (OR 1.45) and risky sex (OR 1.40), which were more common in White-SM individuals. EM-heterosexual and EM-SM individuals had decreased odds for health-related behaviors. SM (White and EM) individuals had substantially worse mental health compared with heterosexual peers. Adverse health-related behaviors were more common in White-SM individuals. Investigation into the mechanisms leading to these differences is needed.
本研究采用交叉性框架，在一个具有全国代表性的样本中，考察与性少数群体（SM）和少数族裔（EM）身份相关的不平等对健康、幸福感及健康相关行为风险的影响。参与者包括来自全英国千禧队列研究的9789名17岁青少年（51%为女性），他们提供了自我认定的性取向和种族身份数据。青少年被分为白人异性恋、白人性少数、少数族裔异性恋和少数族裔性少数几类。问卷评估了心理健康（如自我报告的心理困扰、医生诊断的抑郁症、自杀未遂）、总体健康（自我评定的健康状况、慢性病、体重指数）以及健康相关行为（如吸烟、物质使用）。使用多变量逻辑回归分析相关性。性少数群体个体（白人：18%，少数族裔：3%）出现心理健康问题和自杀未遂的几率增加，白人性少数个体的几率高于少数族裔性少数个体。与白人异性恋个体相比，白人性少数和少数族裔性少数个体出现心理困扰（白人性少数/少数族裔性少数的调整优势比[OR]分别为3.47/2.24）和情绪症状（OR 3.17/1.65）的风险更高。他们自杀未遂（OR 2.78/2.02）、自我伤害（OR 3.06/1.52）和睡眠质量差（OR 1.88/1.67）的几率更高。相比之下，白人异性恋和白人性少数群体报告危险行为的比例同样较高，但药物使用（OR 1.45）和危险性行为（OR 1.40）除外，这两种行为在白人性少数个体中更为常见。少数族裔异性恋和少数族裔性少数个体出现健康相关行为的几率降低。性少数群体（白人及少数族裔）个体的心理健康状况明显比异性恋同龄人差。不良健康相关行为在白人性少数个体中更为常见。需要对导致这些差异的机制进行研究。
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