Sexual minority health disparities: an examination of age-related trends across adulthood in a national cross-sectional sample

Abstract

Purpose: Sexual minorities experience significant health disparities across a variety of mental, behavioral, and physical health indicators. Yet, an understanding of the etiology and progression of sexual minority health disparities across the lifespan is limited.

Methods: We used the U.S. National Epidemiologic Survey of Alcohol and Related Conditions III to evaluate the association between sexual minority status and seven past-year health outcomes (alcohol use disorder, tobacco use disorder, drug use disorder, major depressive episode, generalized anxiety disorder, sexually transmitted infection, and cardiovascular conditions). To do this, we used unadjusted and adjusted logistic regression among our study sample (n = 30,999; aged 18-65 years) and time-varying effect models to evaluate how sexual orientation differences in these outcomes vary across adulthood.

Results: Relative to heterosexuals, sexual minorities had elevated odds of past-year alcohol use disorder and drug use disorder across all ages (18-65 years) although the magnitude of the disparity varies by age. Sexual minorities were also more likely to experience major depressive episode, generalized anxiety disorder, tobacco use disorder, sexually transmitted infection, and cardiovascular disease, but only at specific ages.

Conclusions: Sexual minority health disparities vary appreciably across the adult lifespan, thus elucidating critical periods for focused prevention efforts.

Keywords: Epidemiology; Health inequalities; Public health; Sexual minority; Sexually transmitted diseases; Substance abuse; lesbian, gay, or bisexual.