Health inequalities among sexual minority adults: evidence from ten U.S. states, 2010

Am J Prev Med. 2014 Apr;46(4):337-49. doi: 10.1016/j.amepre.2013.11.010.


Background: Improving the health of lesbian, gay, and bisexual (LGB) individuals is a Healthy People 2020 goal; however, the IOM highlighted the paucity of information currently available about LGB populations.

Purpose: To compare health indicators by gender and sexual orientation statuses.

Methods: Data are from Behavioral Risk Factor Surveillance System surveys conducted January-December of 2010 with population-based samples of non-institutionalized U.S. adults aged over 18 years (N=93,414) in ten states that asked about respondents' sexual orientation (response rates=41.1%-65.6%). Analyses were stratified by gender and sexual orientation to compare indicators of mental health, physical health, risk behaviors, preventive health behaviors, screening tests, health care utilization, and medical diagnoses. Analyses were conducted in March 2013.

Results: Overall, 2.4% (95% CI=2.2, 2.7) of the sample identified as LGB. All sexual minority groups were more likely to be current smokers than their heterosexual peers. Compared with heterosexual women, lesbian women had more than 30% decreased odds of having an annual routine physical exam, and bisexual women had more than 2.5 times the odds of not seeking medical care owing to cost. Compared with heterosexual men, gay men were less likely to be overweight or obese, and bisexual men were twice as likely to report a lifetime asthma diagnosis.

Conclusions: This study represents one of the largest samples of LGB adults and finds important health inequalities, including that bisexual women bear particularly high burdens of health disparities. Further work is needed to identify causes of and intervention for these disparities.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Behavioral Risk Factor Surveillance System
  • Early Detection of Cancer / statistics & numerical data
  • Female
  • Health Behavior*
  • Health Services / statistics & numerical data
  • Health Status Disparities*
  • Humans
  • Male
  • Mental Health*
  • Middle Aged
  • Minority Groups / psychology
  • Minority Groups / statistics & numerical data*
  • Risk-Taking
  • Sex Factors
  • Sexuality / psychology
  • Sexuality / statistics & numerical data*