Mechanisms Underlying Sexual Minority Health Disparities in the United States

项目概要/摘要 以性少数群体为户主的家庭在人口中所占比例不断增长，但性少数群体和性别少数群体 性别少数群体在自我评价健康、慢性病、健康行为等领域的健康差异 抑郁症持续存在。少数群体的压力被认为是健康问题和家庭问题的一个关键原因 功能、情绪调节、夫妻层面的少数压力和社区环境已被确定为 这些关联背后的潜在机制。当代理论模型尚待检验 由于缺乏数据，此外，这种数据的缺乏使得对种族和民族交叉点的研究成为可能。 少数群体的压力与性和性别少数群体的压力有关。该项目将产生第一批人口—— 对同居和已婚的性少数群体和性别少数群体进行代表性、多方法、充分有力的研究 他们的伴侣，以及不同性别联盟中顺性别个体的比较样本。目标 1. 评估 家庭功能（例如关系质量）是否以及如何调节压力的负面影响 对身心健康和健康行为的歧视。目标 2. 使用经验抽样 嵌入时间日记的方法，检查 1）情绪调节的中介作用，以及 2）二元压力 压力与随后的健康行为和时间使用之间的关联过程 性别情侣。目标 3. 调查社区层面因素（包括经济因素）之间的关联 劣势、获得医疗保健的机会以及性少数和性别少数的政治氛围（即国家就业） 保护）以及性和性别少数群体的身心健康和健康行为。目标 4。 确定性[和性别]少数群体之间的种族和民族健康差距，并评估潜在的保护作用 可以最小化这些差距的因素。我们将招募 2690 名 18 至 60 岁的同居或同居美国成年人 与同性和异性伴侣及其伴侣结婚。该示例将包括一个 对不同肤色受访者进行过采样。具有代表性的盖洛普样本提供了独特且高效的方法 通过有针对性的抽样研究工会中的性少数群体和性别少数群体的机会。使用手机 手机应用平台，我们还将收集时间日记和经验采样方法数据。初级 该项目的意义在于 1）确定家庭功能和情绪调节作为家庭功能和情绪调节的中介因素 由于耻辱和歧视以及身体和心理健康状况不佳而造成的性少数和性别少数压力 和健康行为，2）收集二元数据，以阐明二元少数压力过程。 拟议的研究具有创新性，因为它是第一个当代的、具有人口代表性的研究 性和性别少数群体的健康，包括家庭功能、情绪调节和二元数据以及 对少数种族和族裔进行过度抽样。这些数据将帮助研究人员更好地了解如何改进 通过阐明健康差异背后的潜在机制来关注性少数群体的健康。 数据将通过 ICPSR 和美国遗产时间利用研究向世界各地的学者提供。

Project Summary/Abstract Families headed by sexual and gender minorities are a growing segment of the population, yet sexual and gender minority health disparities in areas including self-rated health, chronic conditions, health behaviors, and depression persist. Minority stress has been implicated as a key cause of health problems, and family functioning, emotion regulation, couple-level minority stress, and community contexts have been identified as potential mechanisms underlying these associations. Contemporary theoretical models have yet to be tested due to a lack of data, and further, this lack of data has made studies of the intersection of racial and ethnic minority stress with sexual and gender minority stress difficult. This project will produce the first population- representative, multi-method, fully-powered study of cohabiting and married sexual and gender minorities and their partners, and a comparison sample of cis-gender individuals in different-gender unions. Aim 1. Evaluate whether and how family functioning (e.g. relationship quality) mediates the negative effects of stress due to discrimination on physical and mental health and health behaviors. Aim 2. Using an experience sampling method embedded in a time-diary, examine 1) the mediating role of emotion regulation, and 2) dyadic stress processes in the association between stress and subsequent health behaviors and time-use among same- gender couples. Aim 3. Investigate the association between community-level factors including economic disadvantage, access to healthcare, and the sexual and gender minority political climate (i.e. state employment protections) and sexual and gender minorities’ physical and mental health and health behaviors. Aim 4. Determine race and ethnic health gaps among sexual [and gender] minorities and evaluate potential protective factors that may minimize these gaps. We will recruit 2690 US adults aged 18 to 60 who are cohabiting or married to same- and different-gender partners, along with their partners. The sample will include an oversample of respondents of color. Population-representative Gallup samples afford a unique and efficient opportunity to study sexual and gender minorities who are in unions via targeted sampling. Using a mobile phone application platform, we will also collect time-diary and experience sampling method data. The primary significance of this project is 1) the identification of family functioning and emotion regulation as mediators of sexual and gender minority stress due to stigma and discrimination and poor physical and psychological health and health behaviors, and 2) the collection of dyadic data that will elucidate dyadic minority stress processes. The proposed research is innovative because it is the first contemporary, population-representative study of sexual and gender minority health that includes family functioning, emotion regulation, and dyadic data and an oversample of racial and ethnic minorities. These data will help researchers better understand how to improve the health of sexual and gender minorities by illuminating potential mechanisms underlying health disparities. Data will be available to scholars across the world through ICPSR and the American Heritage Time Use Study.