Gays, lesbians, and bisexuals have poorer health than heterosexuals in Massachusetts and bisexuals fare the worst, according to a federal health survey offering one of the few windows into health differences among the people who make up sexual orientation minorities.
Kerith Conron of Northeastern University and the Harvard School of Public Health analyzed responses to the 2001-2008 Massachusetts Behavioral Risk Factor Surveillance survey, part of a national collaboration between the US Centers for Disease Control and Prevention and state public health agencies. In 2001, Massachusetts residents were asked for the first time to identify their sexual orientation. Of the adults who completed the telephone survey from 2001 through 2008, a total of 3 percent, or 2,271 people, identified themselves as gay, lesbian, or bisexual. Conron and her colleagues write about their answers in the current American Journal of Public Health.
Compared to heterosexuals, gays, lesbians, and bisexuals were more likely to say their health was worse on 16 of 22 measures. They were more likely to be tense or worried, to smoke, have asthma, abuse drugs, or be victims of sexual abuse. Bisexual men and women were also more likely than heterosexuals to say they faced barriers to getting health care, had higher cardiovascular risk, felt sad, and had contemplated suicide in the past year. Binge drinking was more common among bisexual women than heterosexuals.
The survey also found that gay men are less likely to be overweight than straight men and lesbians are more likely to be overweight than straight women. Bisexuals and heterosexuals weighed about the same.
Bisexuals, but not gays or lesbians, were more likely than heterosexuals to be poor. Bisexual women were the most likely to report having been sexually assaulted.
"All told, bisexual women had the worst health," Conron said in an interview. "We were surprised that there were such differences for bisexual people compared to gay and lesbian people."
Although the study didn't investigate the causes for the gaps among people with different sexual orientations, Conron said she hopes further research will look at the social stigma bisexual people may face not only from heterosexuals, but also from gay men and lesbians.
"Bisexual people may feel in between the two and may not necessarily be fully accepted by either group," she said. "I think it merits further investigation. We know isolation is bad for health."
Dr. Stephen Boswell, president and chief executive officer of Fenway Health, said the study confirms what previous research has shown about smoking, mental health, and violence in sexual minorities. But few of those studies' findings have been based on whole populations, such as the state of Massachusetts. Larger studies like Conron's allow the prevalence of disparities to be estimated, he said in an interview.
"I think what these studies can do is to point out the differences and then beg us to answer why those differences exist so the underlying process can be addressed," said Boswell, who was not involved in Conron's research.
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