Reproductive health disparities and sexual orientation in girls and women

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 DESCRIPTION (provided by applicant): Compared to their heterosexual peers, sexual minority (i.e., lesbian and bisexual) female youth are particularly vulnerable to having poor health, especially poor reproductive health. Emerging research shows that the health of sexual minorities can be adversely affected by state-level discriminatory laws. This discrimination can occur in states that have failed to enact protections around hate crimes, job discrimination, or same-sex marriage. However, little is known about the association of these types of public policies with reproductive health. Policy environments are also highly variable across U.S. states and dynamic across time, as demonstrated by the U.S. Supreme Court overturning the Defense of Marriage Act in 2013. Therefore, this research is vital for understanding how the rapidly shifting policy environment may affect sexual minorities. Empirical evidence is needed to inform new public policy development and public health strategies to improve reproductive health, but few researchers have the training needed to explore such disparities and translate findings into action. In the proposed project, Dr. Charlton argues that public policy may be associated with the reproductive health of sexual minority girls and women. She will explore this through the following aims: (1) Identify how public policy may be associated with the reproductive health of sexual minority girls and women; (2) Elucidate what adverse reproductive health outcomes may be associated with public policy among sexual minority girls and women and where these reproductive health outcomes occur; and (3) Examine potential reasons why adverse reproductive health outcomes disproportionately burden sexual minority girls and women. To fulfill these aims, national data will be analyzed from two longitudinal cohorts of adolescents and young adults (Growing Up Today Study I/II) along with a cohort of their mothers (Nurses' Health Study II). In order complete the proposed research, Dr. Charlton must build on her epidemiology skills with formal training in health-related public policy. As such, her mentors have developed a plan to advance her training in areas such as policy analysis and econometrics. This training will enable her to create a comprehensive database representing the various policy environments in every U.S. state and analyze how this environment is associated with the reproductive health of sexual minority girls and women. The proposed research is in line with the NICHD Office of Health Equity's initiatives and will be among the firs to examine public policy and a range of reproductive health issues among sexual minority girls and women. Dr. Charlton will have access is to uniquely detailed data and her findings will further the understanding of sexual orientation health disparities and promote research in diverse populations. This training and research will give Dr. Charlton a solid foundation in health-related public policy, which, combined with her epidemiology background, will enable her to build a career as an independent research scientist.