Introduction
Inequities in social determinants of health are plausible contributors to worse health
of sexual minorities relative to heterosexuals. Sexual minorities may have higher
rates of housing, food, and financial insecurity as adults owing to adverse childhood
experiences or policies that induce social disadvantage. This study compares the prevalence
of 3 types of social determinants of health among sexual minority and heterosexual
adults.
Methods
Data were from the Behavioral Risk Factor Surveillance System 2017 survey of U.S.
states that administered the optional Social Determinants of Health module and Sexual
Orientation and Gender Identity modules. In August 2019, authors estimated the odds
of food, housing, and financial insecurity among sexual minority men and women, compared
with heterosexuals.
Results
Sexual minority women and men had higher odds of housing insecurity, housing instability,
and food insecurity, but no differences were observed for perceived neighborhood safety.
Sexual minority women had higher odds of financial insecurity than their heterosexual
peers.
Conclusions
Sexual minorities have more housing and food insecurity than heterosexuals, which
may contribute to their risk for poorer health. Future research should address the
causes and consequences of these differences.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to American Journal of Preventive MedicineAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
REFERENCES
- Health inequalities among sexual minority adults: evidence from ten U.S. states, 2010.Am J Prev Med. 2014; 46: 337-349
- Sexual minority health and health risk factors: intersection effects of gender, race, and sexual identity.Am J Prev Med. 2016; 50: 746-755
- Meanings and misunderstandings: a social determinants of health lexicon for health care systems.Milbank Q. 2019; 97: 407-419
- Housing affordability and health among homeowners and renters.Am J Prev Med. 2010; 39: 515-521
- The health effects of the foreclosure crisis and unaffordable housing: a systematic review and explanation of evidence.Soc Sci Med. 2016; 162: 88-96
- High burden of homelessness among sexual-minority adolescents: findings from a representative Massachusetts high school sample.Am J Public Health. 2011; 101: 1683-1689
- Disproportionate exposure to early-life adversity and sexual orientation disparities in psychiatric morbidity.Child Abuse Negl. 2012; 36: 645-655
- Psychiatric risk in unstably housed sexual minority women: relationship between sexual and racial minority status and human immunodeficiency virus and psychiatric diagnoses.Womens Health Issues. 2017; 27: 294-301
- Food insecurity and health outcomes.Health Aff (Millwood). 2015; 34: 1830-1839
- LGBT people are disproportionately food insecure.Published 2014https://williamsinstitute.law.ucla.edu/research/health-and-hiv-aids/lgbt-people-are-disproportionately-food-insecure/Date accessed: January 22, 2020
- Life-course financial strain and health in African-Americans.Soc Sci Med. 2010; 71: 259-265
- Meta‐analysis of the effects of sexual orientation on earnings.Ind Relat J Econ Soc. 2015; 54: 4-32
- Minority stress and binge eating among lesbian and bisexual women.J Homosex. 2015; 62: 971-992
- Body image and eating disorder symptoms in sexual minority men: a test and extension of objectification theory.J Couns Psychol. 2010; 57: 154-166
- Disordered eating behaviours and food insecurity: a qualitative study about children with obesity in low-income households.Obes Res Clin Pract. 2016; 10: 544-552
- Food insecurity and eating disorder pathology.Int J Eat Disord. 2017; 50: 1031-1040
- Adverse childhood experiences related to poor adult health among lesbian, gay, and bisexual individuals.Am J Public Health. 2016; 106: 314-320
- Intimate partner violence among sexual minority populations: a critical review of the literature and agenda for future research.Psychol Violence. 2015; 5: 112-121
- Risk and protective factors for homophobic bullying in schools: an application of the social–ecological framework.Educ Psychol Rev. 2012; 24: 271-285
- Hate crimes and stigma-related experiences among sexual minority adults in the United States: prevalence estimates from a national probability sample.J Interpers Violence. 2009; 24: 54-74
- That's So Gay! Microaggressions and the Lesbian, Gay, Bisexual, and Transgender Community.American Psychological Association, Washington, DC2013
Obergefell v. Hodges, 576 U.S. ___ (2015).
- Centers for Medicare & Medicaid Services. Obergefell v. Hodges and Eligibility for Medicaid/CHIP.Published 2015www.medicaid.gov/sites/default/files/Federal-Policy-Guidance/downloads/SHO-15-005.pdfDate accessed: February 3, 2020
- Introduction to same-sex marriage claims. Program Operations Manual System (POMS).Published 2017https://secure.ssa.gov/apps10/poms.nsf/lnx/0200210001Date accessed: January 22, 2020
- Same sex marriage and SNAP mandatory household states memo.Published 2015www.fns.usda.gov/snap/eligibility/same-sex-marriage-mandatory-householdDate accessed: January 22, 2020
- An empirical analysis of sexual orientation discrimination.Univ Chic Law Rev. 2019; 86: 1-76https://lawreview.uchicago.edu/publication/empirical-analysis-sexual-orientation-discriminationDate accessed: October 10, 2019
- Equal Access to housing in HUD programs regardless of sexual orientation or gender identity. Vol 24 CFR Parts 5, 200, 203, 236, 570, 574, and 982.2011
- Rental market discrimination against same-sex couples: evidence from a pairwise-matched email correspondence test.Hous Policy Debate. 2019; 29: 250-272
- Gender differences in structural and behavioral determinants of health: an analysis of the social production of health.Soc Sci Med. 1999; 48: 1221-1235
- Comparison of health and health risk factors between lesbian, gay, and bisexual adults and heterosexual adults in the United States: results from the National Health Interview Survey.JAMA Intern Med. 2016; 176: 1344-1351
- Lending practices to same-sex borrowers.Proc Natl Acad Sci U S A. 2019; 116: 9293-9302
- An estimate of housing discrimination against same-sex couples.SSRN Journal. 2013;
- Housing and household instability.Urban Aff Rev. 2016; 52: 421-436
- Same-sex and different-sex cohabiting couple relationship stability.Demography. 2016; 53: 937-953
- Disparities in adverse childhood experiences among sexual minority and heterosexual adults: results from a multi-state probability-based sample.PloS One. 2013; 8: e54691
- Sex and sexual orientation disparities in adverse childhood experiences and early age at sexual debut in the United States: results from a nationally representative sample.Child Abuse Negl. 2015; 46: 89-102
- Suicidality and depression disparities between sexual minority and heterosexual youth: a meta-analytic review.J Adolesc Health. 2011; 49: 115-123
- Differences by sexual orientation in perceptions of neighborhood cohesion: implications for health.J Commun Health. 2018; 43: 578-585
Article Info
Publication History
Published online: March 19, 2020
Identification
Copyright
© 2020 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
