LGB adults experience higher rates of distress, impaired physical health than heterosexuals

In one of the largest, most representative health surveys conducted to date, lesbian, gay and bisexual adults reported substantially higher rates of severe psychological distress, heavy drinking and smoking, and impaired physical health than did heterosexuals.

The National Health Interview Survey, one of the nation's leading health surveys, collected responses from approximately 68,000 adults. The results were reported today in the journal JAMA Internal Medicine by researchers at Vanderbilt University School of Medicine and University of Minnesota School of Public Health.

The results, which support earlier findings of smaller, less representative surveys of the LGB and transgender community, "should serve as a call to health care professionals and public health practitioners to pay particular attention to ... this small, diverse and vulnerable population," the authors concluded.

"This study adds to the previous research on LGBT health disparities and has important implications for policy and practice," said Gilbert Gonzales, Ph.D., M.H.A., the study's corresponding author and assistant professor of Health Policy at Vanderbilt.

"Clinicians, health care providers and health policymakers should be sensitive to the health and social issues affecting LGBT patients," he said. Gonzales' co-authors were Julia Przedworski and Carrie Henning-Smith, Ph.D., M.P.H., M.S.W., at the University of Minnesota.

Beginning in 2013, the National Health Interview Survey, which has been administered by the U.S. Census Bureau for nearly 60 years, included a question on sexual orientation. Responses from the 2013 and 2014 surveys revealed the following results. Compared to heterosexuals:

• Gay men were more likely to report severe psychological distress, heavy drinking and moderate smoking;
• Bisexual men were more likely to report severe psychological distress, heavy drinking and heavy smoking;
• Lesbian women were more likely to report moderate psychological distress, poor or fair health, multiple chronic conditions, heavy drinking and heavy smoking; and
• Bisexual women were more likely to report multiple chronic conditions, severe psychological distress, heavy drinking and moderate smoking.

Previous studies have linked the poorer health outcomes in this group to "the chronic stress of being a member of a marginalized minority group," the report said. Discriminatory environments and policies can "engender feelings of rejection, shame and low self-esteem, which can negatively shape their health and health-related behaviors."

Establishing baseline nationally representative estimates of the physical, functional and mental health status and health risk factors for LGB adults can help eliminate health disparities and avoidable differences in health based on sexual orientation, the authors concluded.