Mechanisms Underlying Sexual Minority Health Disparities in the United States

项目摘要/摘要 以性少数和性别少数为户主的家庭在人口中所占比例越来越大，但性和性少数 自评健康、慢性病、健康行为等领域的少数民族健康性别差异 抑郁症持续存在。少数民族压力已被认为是健康问题的一个关键原因，而家庭 功能、情绪调节、夫妻层面的少数族裔压力和社区环境已被确定为 这些联系背后的潜在机制。当代理论模型尚待检验 由于缺乏数据，而且，这种数据的缺乏使得对种族和民族的交集进行了研究 少数民族压力与性压力和性别压力有关。这个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的、多方法的、全面的研究 他们的伴侣，以及在不同性别的工会中顺势性别的个人的比较样本。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 方法嵌入时间日记，考察1)情绪调节的中介作用，2)二元应激 压力与随后的健康行为和时间使用之间的联系的过程 性别伴侣。目的3.调查社区层面的因素之间的关系，包括经济因素 不利地位、获得医疗保健的机会以及性少数群体和性别少数群体的政治气候(即国家就业 保护)以及性少数群体和性别少数群体的身心健康和健康行为。目标4. 确定性别[和性别]少数族裔之间的种族和民族健康差距，并评估潜在的保护 可以将这些差距缩小的因素。我们将招募2690名18至60岁的美国成年人同居或 与同性和不同性别的伴侣结婚，以及他们的伴侣。该示例将包括一个 对有色人种的受访者进行过抽样。具有人口代表性的盖洛普样本提供了独特而有效的 有机会通过有针对性的抽样来研究性和性别少数群体。使用移动电话 在手机应用平台上，我们还将收集时间日记和经验采样方法数据。初级阶段 本项目的意义在于：1)确定家庭功能和情绪调节为调节因素 由于耻辱和歧视以及不良的身心健康造成的性和性别少数群体压力 和健康行为，以及2)二元数据的收集，将阐明二元少数民族应激过程。 这项拟议的研究具有创新性，因为它是第一项当代的、具有人口代表性的 性和性别少数民族健康，包括家庭功能、情绪调节、二元数据和 种族和少数民族样本过多。这些数据将帮助研究人员更好地了解如何改进 通过阐明导致健康差距的潜在机制，促进性少数群体和性别少数群体的健康。 世界各地的学者将通过ICPSR和美国传统时间使用研究获得数据。

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.