Disparities in Chronic Health Outcomes and Health Behaviors Between Lesbian and Heterosexual Adult Women in Pittsburgh: A Longitudinal Study

J Womens Health (Larchmt). 2020 Aug;29(8):1059-1067. doi: 10.1089/jwh.2019.8052. Epub 2020 Jul 7.


Background: Compared to heterosexual women, lesbian women experience higher rates of many chronic diseases, including depression, obesity, hypertension, and diabetes. Lesbian women report higher rates of risky health behaviors such as hazardous drinking and cigarette smoking. However, little longitudinal research has been done to examine changes in disparities between lesbian and heterosexual adult women. Methods: A total of 1,084 women were initially recruited from Pittsburgh, PA to participate in the Epidemiologic Study of HEalth Risk in Women (ESTHER) study and completed a baseline survey between 2003 and 2006. In 2015 or 2016, N = 483 women, 270 of whom were lesbian, completed a follow-up survey. Participants completed a questionnaire at both baseline and follow-up and completed a clinic visit for the baseline study to provide biometric data. Results: At baseline, lesbian participants reported higher rates of obesity (p = 0.03), depression (p = 0.02), and smoking (p = 0.04). Lesbian participants had elevated measured C-reactive protein levels (p = 0.05). By the time of the follow-up survey 10 years later, lesbian women continued to have higher rates of smoking (p = 0.04), but the disparity in depression (p = 0.53) and obesity (p = 0.24) rates had resolved. We found no differences in any other outcomes of interest. Conclusions: To our knowledge, this is the first study to report a resolution in obesity or depression disparities between lesbian and heterosexual women. Future research is necessary to determine if other disparities, such as respiratory conditions, appear over time and how lesbian women's health may continue to improve relative to heterosexual women and stem this public health inequity.

Keywords: health behavior; heterosexual women; lesbian women; sexual orientation; women's health.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • C-Reactive Protein / metabolism
  • Depression / epidemiology*
  • Depression / psychology
  • Female
  • Health Behavior*
  • Health Status Disparities*
  • Heterosexuality / psychology
  • Heterosexuality / statistics & numerical data
  • Homosexuality, Female / psychology
  • Homosexuality, Female / statistics & numerical data
  • Humans
  • Longitudinal Studies
  • Male
  • Mental Health / statistics & numerical data*
  • Obesity / epidemiology*
  • Obesity / psychology
  • Outcome Assessment, Health Care
  • Pennsylvania / epidemiology
  • Sexual and Gender Minorities / psychology*
  • Sexual and Gender Minorities / statistics & numerical data*
  • Smoking / epidemiology*
  • Smoking / psychology
  • Surveys and Questionnaires


  • C-Reactive Protein