Comparison of Health and Health Risk Factors Between Lesbian, Gay, and Bisexual Adults and Heterosexual Adults in the United States Results From the National Health Interview Survey
Comparison of Health and Health Risk Factors Between Lesbian, Gay, and Bisexual Adults and Heterosexual Adults in the United States Results From the National Health Interview Survey
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DOI：
10.1001/jamainternmed.2016.3432
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发表时间：
2016-09-01
影响因子：
39
通讯作者：
Henning-Smith, Carrie
中科院分区：
文献类型：
--
作者：
Gonzales, Gilbert;Przedworski, Julia;Henning-Smith, Carrie
重要性 先前的研究确定了男女同性恋和双性恋 (LGB) 成年人之间健康和健康风险因素的差异，但先前的调查仅限于不能代表美国成年人口的样本，或者在规模或地理范围上受到限制。 2013 年和 2014 年国家健康访谈调查在其漫长的历史中首次纳入了性取向问题，提供了来自全国领先健康调查的性少数群体的健康信息。 目的 比较美国 LGB 成年人和异性恋成年人之间的健康和健康风险因素。 设计、设置和参与者 2013 年和 2014 年全国健康访谈调查的全国代表性数据用于比较不同人群的健康结果使用逻辑回归分析 18 岁或以上的女同性恋 (n = 525)、男同性恋 (n = 624) 和双性恋 (n = 515) 成年人及其异性恋同龄人 (n = 67 150)。 主要结果和测量 自评健康、功能状态、慢性病、心理困扰、饮酒和吸烟。 结果 研究队列由 68 814 名参与者组成。他们的平均 (SD) 年龄为 46.8 (11.8) 岁，其中 51.8%（68 814 人中的 38 063 人）为女性。在控制社会人口统计学特征后，与异性恋男性相比，男同性恋者更有可能报告严重的心理困扰（比值比[OR]，2.82；95% CI，1.55-5.14）、酗酒（OR，1.97；95% CI，1.08-3.58）和中度吸烟（OR，1.98；95% CI，1.39-2.81）；与异性恋男性相比，双性恋男性更有可能报告严重的心理困扰（OR，4.70；95% CI，1.77-12.52）、酗酒（OR，3.15；95% CI，1.22-8.16）和大量吸烟（OR，2.10；95% CI，1.08-4.10）；女同性恋女性更有可能报告中度心理困扰（OR，1.34；95% CI，1.02-1.76）、健康状况不佳或一般（OR，1.91；95% CI，1.24-2.95）、多种慢性病（OR，1.58；95% CI，1.12-2.22）、酗酒（OR，2.63；95% CI， 1.54-4.50）和大量吸烟（OR，2.29；95% CI，1.36-3.88）高于异性恋女性；双性恋女性更有可能报告多种慢性病（OR，2.07；95% CI，1.34-3.20）、严重心理困扰（OR，3.69；95% CI，2.19-6.22）、酗酒（OR，2.07；95% CI，1.20-3.59）和中度吸烟（OR，1.60；95% CI， 1.05-2.44) 高于异性恋女性。 结论和相关性 这项研究支持了先前的研究发现，美国 LGB 成年人存在巨大的健康差异，这可能是由于 LGB 人群因人际和结构性歧视而经历的压力造成的。在筛查健康问题时，临床医生应对性少数患者的需求保持敏感。
IMPORTANCE Previous studies identified disparities in health and health risk factors among lesbian, gay, and bisexual (LGB) adults, but prior investigations have been confined to samples not representative of the US adult population or have been limited in size or geographic scope. For the first time in its long history, the 2013 and 2014 National Health Interview Survey included a question on sexual orientation, providing health information on sexual minorities from one of the nation's leading health surveys.OBJECTIVE To compare health and health risk factors between LGB adults and heterosexual adults in the United States.DESIGN, SETTING, AND PARTICIPANTS Data from the nationally representative 2013 and 2014 National Health Interview Survey were used to compare health outcomes among lesbian (n = 525), gay (n = 624), and bisexual (n = 515) adults who were 18 years or older and their heterosexual peers (n = 67 150) using logistic regression.MAIN OUTCOMES AND MEASURES Self-rated health, functional status, chronic conditions, psychological distress, alcohol consumption, and cigarette use.RESULTS The study cohort comprised 68 814 participants. Their mean (SD) age was 46.8 (11.8) years, and 51.8%(38 063 of 68 814) were female. After controlling for sociodemographic characteristics, gay men were more likely to report severe psychological distress (odds ratio [OR], 2.82; 95% CI, 1.55-5.14), heavy drinking (OR, 1.97; 95% CI, 1.08-3.58), and moderate smoking (OR, 1.98; 95% CI, 1.39-2.81) than heterosexual men; bisexual men were more likely to report severe psychological distress (OR, 4.70; 95% CI, 1.77-12.52), heavy drinking (OR, 3.15; 95% CI, 1.22-8.16), and heavy smoking (OR, 2.10; 95% CI, 1.08-4.10) than heterosexual men; lesbian women were more likely to report moderate psychological distress (OR, 1.34; 95% CI, 1.02-1.76), poor or fair health (OR, 1.91; 95% CI, 1.24-2.95), multiple chronic conditions (OR, 1.58; 95% CI, 1.12-2.22), heavy drinking (OR, 2.63; 95% CI, 1.54-4.50), and heavy smoking (OR, 2.29; 95% CI, 1.36-3.88) than heterosexual women; and bisexual women were more likely to report multiple chronic conditions (OR, 2.07; 95% CI, 1.34-3.20), severe psychological distress (OR, 3.69; 95% CI, 2.19-6.22), heavy drinking (OR, 2.07; 95% CI, 1.20-3.59), and moderate smoking (OR, 1.60; 95% CI, 1.05-2.44) than heterosexual women.CONCLUSIONS AND RELEVANCE This study supports prior research finding substantial health disparities for LGB adults in the United States, potentially due to the stressors that LGB people experience as a result of interpersonal and structural discrimination. In screening for health issues, clinicians should be sensitive to the needs of sexual minority patients.