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Terry E, Pharr JR, Batra R, Batra K. Protective and Risk Factors for Suicidal Ideation and Behavior Among Sexual Minority Women in the United States: A Cross-Sectional Study. LGBT Health 2024. [PMID: 38324060 DOI: 10.1089/lgbt.2023.0003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2024] Open
Abstract
Purpose: The purpose of this study was to understand the factors associated with suicidal ideation and behavior and serious suicidal ideation and behavior among sexual minority women (SMW), including resilience, discrimination, mental health, and sociodemographic characteristics. Methods: Web-based surveys were conducted with SMW from across the United States during January-February, 2022 using psychometric valid tools. Bivariate, hierarchical regression, and logistic regression analyses were used to analyze the data. Results: Of 497 participants, 70% were identified as bisexual and 30% as lesbian. The mean scores for anxiety, depression, and stress were significantly higher among bisexual women compared to their lesbian counterparts (p < 0.05). The proportion of serious suicidal ideation and behavior was higher among bisexual women compared to lesbian women (53.9% vs. 41.2%, p = 0.012). Conversely, the mean scores of resilience were lower among bisexual women compared to lesbian women (139.7 ± 33.4 vs. 147.5 ± 33.6, p = 0.024). Lesbian women had nearly 57.4% lower odds of having serious suicidal ideation and behavior as compared to bisexual women (adjusted odds ratio = 0.426; p = 0.023). Experiencing anxiety, depression, victimization distress, and family discrimination distress were positively associated with serious suicidal ideation and behavior, whereas personal resilience and family cohesion were negatively associated with serious suicidal ideation and behavior. Conclusions: Tackling structural inequities such as racism and homophobia remains vital to improving the mental health of SMW. Interventions to strengthen social and familial supports may be particularly impactful, especially at the family level.
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Affiliation(s)
- Emylia Terry
- Department of Environmental and Occupational Health, School of Public Health, University of Nevada, Las Vegas, Las Vegas, Nevada, USA
| | - Jennifer R Pharr
- Department of Environmental and Occupational Health, School of Public Health, University of Nevada, Las Vegas, Las Vegas, Nevada, USA
| | - Ravi Batra
- Department of Environmental and Occupational Health, School of Public Health, University of Nevada, Las Vegas, Las Vegas, Nevada, USA
| | - Kavita Batra
- Department of Medical Education, Kirk Kerkorian School of Medicine at UNLV, University of Nevada, Las Vegas, Las Vegas, Nevada, USA
- Office of Research, Kirk Kerkorian School of Medicine at UNLV, University of Nevada, Las Vegas, Las Vegas, Nevada, USA
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2
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Hsieh C, Charak R, Razo G, Tabler J, Schmitz RM. Associations between Sexual Minority Identities, Heterosexism, Identity Concealment, and Depression in Lesbian, Gay, and Bisexual Emerging Adults: Adjusting for the Effects of General Stressors. South Med J 2023; 116:923-929. [PMID: 38051164 DOI: 10.14423/smj.0000000000001625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2023]
Abstract
OBJECTIVES Lesbian, gay, and bisexual (LGB) individuals experience stressors distinctively tied to their sexual identities, such as externalized and internalized heterosexism and identity concealment, which are correlated with increased psychological distress, including depression. The present study examined the variance in depression scores resulting from heterosexism, LGB identity concealment, and minority sexual identities, after adjusting for race/ethnicity and interpersonal violence victimization experiences. METHODS Participants were 277 LGB emerging adults 18 to 29 years old (mean 25.39, standard deviation 2.77; 46 lesbian women, 71 gay men) recruited from an online platform. RESULTS Nearly 41% reported moderate to severe depression symptoms. A two-step hierarchical regression model examining the effect of sexual minority stressors, heterosexism, LGB identity concealment, and minority sexual identity on depression after controlling for childhood maltreatment and face-to-face intimate partner violence types was significant. Bisexual women (vs gay men), those with greater exposure to heterosexism, and those with a greater degree of identity concealment experienced significantly higher scores on depression. In addition, being a person of color (including identifying as Hispanic), exposure to childhood maltreatment, and experiencing psychological intimate partner violence significantly predicted increases in depression scores. CONCLUSIONS Findings emphasize the importance of assessing minority stressors and taking them into account when providing clinical interventions to LGB individuals.
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Affiliation(s)
- Claire Hsieh
- From the Department of Psychological Science, the University of Texas Rio Grande Valley, Edinburg
| | - Ruby Charak
- From the Department of Psychological Science, the University of Texas Rio Grande Valley, Edinburg
| | - Gisselle Razo
- From the Department of Psychological Science, the University of Texas Rio Grande Valley, Edinburg
| | - Jennifer Tabler
- Department of Criminal Justice and Sociology, University of Wyoming, Laramie
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3
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Sherman AD, Febres-Cordero S, Bonds Johnson K, Clark KD, Klepper M, Duroseau B, Lin Y, Zhang W, Coleman M, Prakash D, Daniel GA, Chand AT, Kalu U, Tarter R, Allgood S, Cohen S, Kelly U, Balthazar M. Intersectionality in nursing research: A scoping review. INTERNATIONAL JOURNAL OF NURSING STUDIES ADVANCES 2023; 5:100155. [PMID: 37982092 PMCID: PMC10655863 DOI: 10.1016/j.ijnsa.2023.100155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 09/21/2023] [Accepted: 09/25/2023] [Indexed: 11/21/2023] Open
Abstract
Background An intersectional approach to health research provides an analytical foundation to explain the multidimensionality of health status, resource accessibility, privilege, oppression, and current and historical context. The use of intersectionality in health research has known limitations. Its use in health-related fields too often focuses on outcomes, such as health disparities, rather than processes, such as power structures and social determinants. Objective This scoping review serves to examine how intersectionality has been implemented by nurses in the peer-reviewed literature. We offer insight into how it may be incorporated to inform future nursing research and healthcare provision. Design & Methods Systematic searches of PubMed (n = 257), SCOPUS (n = 807), EMBASE (n = 396), CINAHL (n = 224), and Health Source: Nursing and Academics (n = 491), published since the seminal publication on intersectionality (1989 - 2023), identified 131 research articles that met inclusion and exclusion criteria. Data extraction and synthesis were used to describe the breadth and depth of the literature specific to the application of intersectionality in nursing research. Results The included studies used intersectionality to examine the intersections of numerous identities, such as race, gender, and immigration status. However, most studies were descriptive/observational in nature, underreported their methods, and conducted deficit-based research instead of strength-based inquiries. Of note, the vast majority of included articles were published within the last five years. Conclusions Future researchers using intersectionality as a framework can improve their approach by reporting clear definitions and operationalization of intersectionality. Observational science dominated the included studies; future research should focus on intervention development and evaluation using an intersectional lens. Lastly, caution should be placed on research that focuses solely on deficits among marginalized communities, which places scientists at risk of perpetuating stereotypes or enhancing already-existing stigmas.
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Affiliation(s)
- Athena D. F. Sherman
- Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Road Office: 310, Atlanta, GA 30322, USA
| | - Sarah Febres-Cordero
- Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Road Office: 310, Atlanta, GA 30322, USA
| | - Kalisha Bonds Johnson
- Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Road Office: 310, Atlanta, GA 30322, USA
| | - Kristen D. Clark
- Department of Nursing, University of New Hampshire, Durham, NH, USA
| | | | | | - Yufen Lin
- Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Road Office: 310, Atlanta, GA 30322, USA
| | - Wenhui Zhang
- Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Road Office: 310, Atlanta, GA 30322, USA
| | - Mercy Coleman
- Ross and Carol Nese College of Nursing, Pennsylvania State University, University Park, PA, USA
| | - Diane Prakash
- Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Road Office: 310, Atlanta, GA 30322, USA
| | - Gaea A. Daniel
- Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Road Office: 310, Atlanta, GA 30322, USA
| | - Arzina Tabassum Chand
- Ross and Carol Nese College of Nursing, Pennsylvania State University, University Park, PA, USA
| | - Ugo Kalu
- Ross and Carol Nese College of Nursing, Pennsylvania State University, University Park, PA, USA
| | - Robin Tarter
- Oregon Health and Science University, Portland, OR, USA
| | | | - Sydney Cohen
- Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Road Office: 310, Atlanta, GA 30322, USA
| | - Ursula Kelly
- Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Road Office: 310, Atlanta, GA 30322, USA
- Atlanta VA Health Care System, Atlanta, Georgia, USA
| | - Monique Balthazar
- Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Road Office: 310, Atlanta, GA 30322, USA
- Ross and Carol Nese College of Nursing, Pennsylvania State University, University Park, PA, USA
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4
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Smith AU, Bostwick WB, Burke L, Hequembourg AL, Santuzzi A, Hughes TL. How deep is the cut? The influence of daily microaggressions on bisexual women's health. PSYCHOLOGY OF SEXUAL ORIENTATION AND GENDER DIVERSITY 2023; 10:535-548. [PMID: 38737574 PMCID: PMC11086984 DOI: 10.1037/sgd0000556] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2024]
Abstract
Bisexual women experience disproportionately poorer health outcomes in comparison to lesbian and gay groups, and the general population, including inequities related to mental and physical health. Although bisexual-specific health inequities are increasingly well-documented, research examining putative causes of such inequities, as well as research that accounts for differences within bisexual populations - particularly among racial minorities- remains limited. To address these gaps, this paper reports findings from the Women's Daily Experiences Study (WoDES), a multi-method study that explored the relationship between microaggressions and health outcomes among racially/ethnically diverse cisgender, bisexual women in Chicago. Data from 28-day daily e-diaries (N = 2,104 observations; 99 participants, 57% women of color) were analyzed using multilevel modeling to (1) measure the frequency of microaggressions among bisexual women; (2) examine the influence of sexual orientation, racial, and gender microaggressions on mental and physical health; and (3) investigate how race influences relationships between microaggressions and health. Participants reported an average of 8.1 microaggressions in the previous 28 days, and at least one microaggression was reported for more than 42% of days (n = 802). Microaggressions of any type were associated with increased same-day negative affect and somatic complaints. Latina bisexual women experienced worse health outcomes in comparison to Black bisexual women. This study demonstrated the detrimental impact of microaggressions on the health of bisexual women and highlights the critical need for strategies on broader structural changes that could improve the health and well-being of bisexual women.
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Affiliation(s)
- Ariel U Smith
- Ariel U. Smith, Assistant Professor, University of Illinois at Chicago, College of Nursing, Population Health Nursing Science
| | - Wendy B Bostwick
- Wendy B. Bostwick, Associate Professor, University of Illinois at Chicago, College of Nursing, Population Health Nursing Science
| | - Larisa Burke
- Larisa A. Burke, Visiting Research Specialist, University of Illinois at Chicago, College of Nursing, Office of Research Facilitation
| | - Amy L Hequembourg
- Amy L. Hequembourg, Associate Professor, State University of New York at Buffalo, School of Nursing
| | - Alecia Santuzzi
- Alecia Santuzzi, Professor, Northern Illinois University, College of Liberal Arts and Sciences, Department of Psychology
| | - Tonda L Hughes
- Tonda L. Hughes, Professor and Associate Dean, Columbia University, School of Nursing and Department of Psychiatry
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5
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Glynn SA, McLaren S, Goldie PD. Sexual Orientation Concealment, Hope, and Depressive Symptoms Among Sexual Minority Women: The Moderating Role of Sexual Orientation. JOURNAL OF HOMOSEXUALITY 2023:1-23. [PMID: 37682694 DOI: 10.1080/00918369.2023.2250500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/10/2023]
Abstract
Sexual minority women (SMW) experience higher levels of depression compared to heterosexual women, and bisexual women show higher levels than lesbian women. Sexual orientation concealment is a risk factor for depressive symptoms among SMW. Hope is protective against depressive symptoms in diverse samples, but limited research in this area has centered on SMW. This study examined the role of hope and its components, agency and pathways, as moderators of the relation between sexual orientation concealment and depressive symptoms, and whether the moderating effects were conditional on sexual orientation. An international sample of 218 lesbian women aged 18 to 69 (M = 32.93 years, SD = 12.75) and 230 bisexual women aged 18 to 67 (M = 27.83 years, SD = 7.52) completed an online survey. Hope, agency, and pathways did not moderate the relation between sexual orientation concealment and depressive symptoms. The significant negative relations between hope and depressive symptoms, and between agency and depressive symptoms, were moderated by sexual orientation: the relations were stronger among lesbian women than bisexual women. Results suggest that increasing levels of hope and agency through clinical intervention may reduce depressive symptoms for both groups of women, with more pronounced effects among lesbian women.
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Affiliation(s)
- Sophie Anne Glynn
- School of Psychology, Charles Sturt University, Port Macquarie, New South Wales, Australia
| | - Suzanne McLaren
- School of Psychology, Charles Sturt University, Port Macquarie, New South Wales, Australia
| | - Peter D Goldie
- Department of Psychology, Montclair State University, Montclair, New Jersey, USA
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6
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Xavier Hall CD, Harris R, Burns P, Girod C, Yount KM, Wong FY. Utilizing Latent Class Analysis to Assess the Association of Intersectional Stigma on Mental Health Outcomes Among Young Adult Black, Indigenous, and Sexual Minority Women of Color. LGBT Health 2023; 10:463-470. [PMID: 36951670 PMCID: PMC10468552 DOI: 10.1089/lgbt.2022.0083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/24/2023] Open
Abstract
Purpose: Discrimination has detrimental effects on mental health, particularly among Black, Indigenous, and people of color who are also sexual minority women (BIPOC SMW); however, measurement of multiple intersecting forms of discrimination (e.g., race, gender, and sexual identity discrimination among BIPOC SMW) poses methodological challenges. This analysis uses latent class analysis (LCA) to examine the influences of discrimination on mental health in a convenience sample of BIPOC SMW. Methods: Online survey data from BIPOC SMW aged 18-29 years (n = 324) were used to estimate latent classes for discrimination type (race, gender, and sexual identity). Data for this study were collected from July to October 2018. Adjusted linear regressions examined the influences of discrimination profiles on perceived stress and depressive symptoms. Results: Utilizing LCA, the following four classes emerged: (1) low discrimination; (2) mid-level discrimination; (3) high racial, medium gender, and low sexual identity discrimination; (4) high discrimination. Classes 3 and 4 were positively associated with perceived stress and depressive symptoms relative to Class 1 in adjusted models. Conclusion: This analysis highlights the importance of intersectionality and the adverse impact of multiple forms of discrimination on mental health outcomes for BIPOC SMW. Respondents reporting higher levels of racial or multiple forms of discrimination had poorer mental health outcomes. LCA is a promising analytical tool for investigating intersectional stigma and discrimination. There is an urgent need to develop tailored, culturally appropriate intersectional mental health interventions to address the multiple identities and oppressions faced by BIPOC SMW.
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Affiliation(s)
- Casey D. Xavier Hall
- Center of Population Sciences for Health Equity, College of Nursing, Florida State University, Tallahassee, Florida, USA
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, Illinois, USA
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Rachel Harris
- College of Social Work, Florida State University, Tallahassee, Florida, USA
| | - Paul Burns
- John D. Bower School of Population Health, Department of Population Health Science, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | | | - Kathryn M. Yount
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
- Department of Sociology, Emory University, Atlanta, Georgia, USA
| | - Frankie Y. Wong
- Center of Population Sciences for Health Equity, College of Nursing, Florida State University, Tallahassee, Florida, USA
- Department of Psychology, University of Hawai'i at Mānoa, Honolulu, Hawaii, USA
- Department of Epidemiology, Fudan University, Shanghai, China
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7
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Scheer JR, Helminen EC, Cascalheira CJ, Jaipuriyar V, Shaw TJ, Zabelski S, Behari K, Pirog S, Batchelder AW, Possemato K, Hughes TL, Sullivan TP. Probable PTSD, PTSD symptom severity, and comorbid PTSD and hazardous drinking among sexual minority women compared to heterosexual women: A meta-analysis. Clin Psychol Rev 2023; 102:102283. [PMID: 37150043 PMCID: PMC10205673 DOI: 10.1016/j.cpr.2023.102283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Revised: 01/24/2023] [Accepted: 04/20/2023] [Indexed: 05/09/2023]
Abstract
Posttraumatic stress disorder (PTSD) is more prevalent among sexual minority women (SMW) than among heterosexual women. PTSD risk varies among SMW, but no meta-analysis has clarified sexual identity-related disparities in probable PTSD among women or SMW's heterogeneity in PTSD risk. SMW are also at pronounced risk of comorbid PTSD and hazardous drinking (HD). However, the difference in comorbid PTSD/HD between SMW and heterosexual women is understudied. This meta-analysis aimed to provide a comprehensive understanding of differences between SMW and heterosexual women and among SMW across demographic characteristics. Peer-reviewed publications that were written in English and reported quantitative data on PTSD specific to SMW were included. Eligible publications (n = 45) were identified through a systematic search of 11 electronic databases, supplemented by a search of reference lists of relevant papers. We found that probable PTSD, PTSD symptom severity, and probable comorbid PTSD/HD are highly prevalent among SMW, with SMW of color, transgender and gender diverse people, and bi+ women (e.g., bisexual, pansexual, queer) being at greatest risk. These results emphasize the need to improve accurate assessment of trauma-related sequelae among SMW and to develop, disseminate, and implement culturally sensitive treatments to reduce PTSD and comorbid PTSD/HD among at-risk SMW.
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Affiliation(s)
- Jillian R Scheer
- Department of Psychology, Syracuse University, 414 Huntington Hall, Syracuse, NY 13244, USA.
| | - Emily C Helminen
- Department of Psychology, Syracuse University, 414 Huntington Hall, Syracuse, NY 13244, USA; College of Health Science and Technology, Rochester Institute of Technology, USA
| | - Cory J Cascalheira
- Department of Psychology, Syracuse University, 414 Huntington Hall, Syracuse, NY 13244, USA; Department of Counseling & Educational Psychology, New Mexico State University, Las Cruces, NM, USA
| | - Virinca Jaipuriyar
- Department of Psychology, Syracuse University, 414 Huntington Hall, Syracuse, NY 13244, USA
| | - Thomas J Shaw
- Department of Psychology, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA
| | - Sasha Zabelski
- Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, NC, USA
| | - Kriti Behari
- Department of Psychology, Syracuse University, 414 Huntington Hall, Syracuse, NY 13244, USA
| | - Sophia Pirog
- Department of Psychology, Syracuse University, 414 Huntington Hall, Syracuse, NY 13244, USA
| | - Abigail W Batchelder
- Harvard Medical School, Harvard University, Boston, MA, USA; Behavioral Medicine Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA; The Fenway Institute, Fenway Health, Boston, MA, USA
| | - Kyle Possemato
- VA Center for Integrated Healthcare, Syracuse Veterans Affairs Medical Center, Syracuse, NY, USA
| | - Tonda L Hughes
- School of Nursing and Department of Psychiatry, Columbia University, New York, NY, USA; Columbia University School of Nursing Center for Sexual and Gender Minority Research, New York, NY, USA
| | - Tami P Sullivan
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
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8
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Wu D, Zhong X, Deng R, Pan H, Gao Y, Lin B, Tang X, Dai J, Liang H, Huang A. Study on anxiety and depression of men who have sex with men: An application of group-based trajectory model. Front Psychol 2023; 13:857203. [PMID: 36660287 PMCID: PMC9842664 DOI: 10.3389/fpsyg.2022.857203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 06/30/2022] [Indexed: 01/04/2023] Open
Abstract
The prevalence of anxiety and depression is high among men who have sex with men (MSM), but limited studies focus on their development trends. This study examined the prevalence and influencing factors of anxiety and depression in HIV-negative MSM. In this study, 711 subjects were followed up every 24 weeks for 96 weeks. A group-based trajectory model was used to identify different development trends and a logistic regression model was used to explore the influencing factors of different trajectories. Low, moderate, and high anxiety groups accounted for 32.56, 56.12, and 11.32%; and low and high depression groups accounted for 73.90 and 26.10%. High anxiety was associated with a lower education degree, little HIV-related knowledge, and other characteristics (more agreed that "HIV is a threat to me/my family," had high frequency of seeking sexual partners via the Internet, had a history of sexually transmitted disease (STD), and a sense of discrimination by doctors). High depression was associated with a lower education degree, little HIV-related knowledge, being bisexual and the following characteristics: they felt that HIV infection rate of MSM around them was high, and more agreed that "HIV is a threat to me/my family," had a high frequency of seeking sexual partners through the Internet and alcohol drinking, had a history of STD, and felt being discriminated against by doctors and others. There is heterogeneity in the development trends of anxiety and depression. We need to improve intervention in the mental health of MSM, especially those with high anxiety and depression development trends. Clinical Trial Registration [http://www.chictr.org.cn/showproj.aspx?proj=5716], identifier [ChiCTR-TRC-13003849].
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Affiliation(s)
- Dan Wu
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, China,Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, China,Changzhou Center for Disease Control and Prevention, Changzhou, China
| | - Xiaoni Zhong
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, China,Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, China,*Correspondence: Xiaoni Zhong,
| | - Ruibin Deng
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, China,Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, China
| | - Hong Pan
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, China,Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, China
| | - Yuwen Gao
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, China,Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, China
| | - Bing Lin
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, China,Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, China
| | - Xian Tang
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, China,Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, China
| | - Jianghong Dai
- Department of Epidemiology and Health Statistics, School of Public Health, Xinjiang Medical University, Xinjiang, China
| | - Hao Liang
- Department of Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, Nanning, China
| | - Ailong Huang
- Key Laboratory of Molecular Biology, Ministry of Molecular Biology, Chongqing, China
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9
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López G, Yeater EA, Veldhuis CB, Venner KL, Verney SP, Hughes TL. Sexual Assault, Psychological Distress, and Protective Factors in a Community Sample of Black, Latinx, and White Lesbian and Bisexual Women. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:NP1239-NP1260. [PMID: 35459411 DOI: 10.1177/08862605221090570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
Intersectionality and minority stress frameworks were used to guide examination and comparisons of psychological distress (depression, anxiety, posttraumatic stress disorder symptoms) and protective factors (religiosity, spirituality, social support) among 673 Black, Latinx, and White lesbian and bisexual women with and without histories of sexual assault. Participants were from Wave 3 of the 21-year longitudinal Chicago Health and Life Experiences of Women (CHLEW) study. More than one-third (38%) of participants reported having experienced adolescent or adult sexual assault (i.e., rape or another form of sexual assault) since age 14. Confirmatory factor analysis, structural equation modeling, and multivariate analyses of covariance were used to analyze the data. Results revealed that levels of religiosity/spirituality and psychological distress varied by race/ethnicity and by sexual identity (i.e., Black lesbian, Black bisexual, Latinx lesbian, Latinx bisexual, White lesbian, White bisexual). Black lesbian women reported the highest level of religiosity/spirituality whereas White lesbian women reported the lowest level. White bisexual women reported the highest level of psychological distress whereas White lesbian women reported the lowest level. We found no significant differences in reports of sexual assault or in social support (i.e., significant other, family, friend, and total social support). However, White lesbian women had higher friend, significant other, and total social support relative to the other five groups of women with minoritized/marginalized sexual identities. Future work should examine whether religiosity, spirituality, and social support serve as protective factors that can be incorporated into mental health treatment for lesbian and bisexual who have experienced sexual assault to reduce psychological distress.
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Affiliation(s)
- Gabriela López
- Center for Alcohol and Addiction Studies, School of Public Health, Brown University, Providence, RI, USA
- Department of Psychology, 12289University of New Mexico, Albuquerque, NM, USA
| | - Elizabeth A Yeater
- Department of Psychology, 12289University of New Mexico, Albuquerque, NM, USA
| | - Cindy B Veldhuis
- School of Nursing and Department of Psychiatry, 5798Columbia University, New York, NY, USA
| | - Kamilla L Venner
- Department of Psychology, 12289University of New Mexico, Albuquerque, NM, USA
| | - Steven P Verney
- Department of Psychology, 12289University of New Mexico, Albuquerque, NM, USA
| | - Tonda L Hughes
- School of Nursing and Department of Psychiatry, 5798Columbia University, New York, NY, USA
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10
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Veldhuis CB, Juster RP, Corbeil T, Wall M, Poteat T, Hughes TL. Testing whether the combination of victimization and minority stressors exacerbate PTSD risks in a diverse community sample of sexual minority women. PSYCHOLOGY & SEXUALITY 2022; 14:252-278. [PMID: 38549608 PMCID: PMC10978045 DOI: 10.1080/19419899.2022.2106147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 07/19/2022] [Indexed: 10/16/2022]
Abstract
Informed by minority stress and intersectionality frameworks, we examined: 1) associations of sexual identity and race/ethnicity with probable diagnosis of post-traumatic stress disorder (PTSD-PD) among sexual minority women (SMW; e.g., lesbian, bisexual); and 2) potential additive and interactive associations of minority stressors (discrimination, stigma consciousness, and internalized homonegativity) and potentially traumatic childhood and adulthood events (PTEs) with PTSD-PD. Data come from a large and diverse community sample of SMW (N = 662; age range: 18-82; M = 40.0, SD = 14.0). The sample included 35.8% Black, 23.4% Latinx, and 37.2% White participants. Logistic regressions tested associations of sexual identity and race/ethnicity, minority stressors, and PTEs with PTSD-PD. More than one-third of SMW (37.2%) had PTSD-PD with significantly higher prevalence among bisexual, particularly White bisexual women, than lesbian women. Discrimination, stigma consciousness, and internalized homonegativity were each associated with higher odds of PTSD-PD, but only internalized homonegativity was additively associated with PTSD-PD in mutually adjusted models above and beyond effects of PTEs. No evidence for interactive effects between PTEs and minority stressors was found. In a diverse community sample of sexual minority women, PTSD is strongly associated with potentially traumatic childhood events and with minority stressors above and beyond the associations with other potentially traumatic events and stressors in adulthood. Our findings suggest a strong need for therapists to address the effects of stigma and homophobia in treatment for PTSD, as these minority stressors likely maintain and exacerbate the effects of past traumas.
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Affiliation(s)
| | | | - Thomas Corbeil
- Mental Health Data Science, New York State Psychiatric Institute
| | - Melanie Wall
- Mental Health Data Science, New York State Psychiatric Institute
| | - Tonia Poteat
- Department of Social Medicine, University of North Carolina School of Medicine, Chapel Hill
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11
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Guan A, Thomas M, Vittinghoff E, Bowleg L, Mangurian C, Wesson P. An investigation of quantitative methods for assessing intersectionality in health research: A systematic review. SSM Popul Health 2021; 16:100977. [PMID: 34869821 PMCID: PMC8626832 DOI: 10.1016/j.ssmph.2021.100977] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 11/16/2021] [Accepted: 11/19/2021] [Indexed: 11/16/2022] Open
Abstract
Intersectionality is a theoretical framework that investigates how interlocking systems of power and oppression at the societal level influence the lived experiences of historically and socially marginalized groups. Currently, there are no consistent or widely adopted quantitative methods to investigate research questions informed by intersectionality theory. The objective of this systematic review is to describe the current landscape of quantitative methods used to assess intersectionality and to provide recommendations on analytic best practices for future research. We searched PubMed, EMBASE, and the Web of Science in December 2019 to identify studies using analytic quantitative intersectionality approaches published up to December 2019 (PROSPERO CRD42020162686). To be included in the study, articles had to: (1) be empirical research, (2) use a quantitative statistical method, (3) be published in English, and (4) incorporate intersectionality. Our initial search yielded 1889 articles. After screening by title/abstract, methods, and full text review, our final analytic sample included 153 papers. Eight unique classes of quantitative methods were identified, with the majority of studies employing regression with an interaction term. We additionally identified several methods which appear to be at odds with the key tenets of intersectionality. As quantitative intersectionality continues to expand, careful attention is needed to avoid the dilution of the core tenets. Specifically, emphasis on social power is needed as methods continue to be adopted and developed. Additionally, clear explanation of the selection of statistical approaches is needed and, when using regression with interaction terms, researchers should opt for use of the additive scale. Finally, use of methods that are potentially at odds with the tenets of intersectionality should be avoided.
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Affiliation(s)
- Alice Guan
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
| | - Marilyn Thomas
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Eric Vittinghoff
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
| | - Lisa Bowleg
- Department of Psychological and Brain Sciences, The George Washington University, Washington, DC, USA
| | - Christina Mangurian
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA
- Center for Vulnerable Populations, University of California, San Francisco, San Francisco, CA, USA
| | - Paul Wesson
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
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12
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Heiden-Rootes KM, Coburn KO, Sandage SJ, Hall EL. Minority Stress & Mental Health for Sexual Minority Adults from Religious Families: the Role of Religious Coping. INTERNATIONAL JOURNAL OF SYSTEMIC THERAPY 2021. [DOI: 10.1080/2692398x.2021.1984125] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Katie M. Heiden-Rootes
- Medical Family Therapy Program, Department of Family & Community Medicine, Saint Louis University, St. Louis, Missouri, USA
| | - Katelyn O. Coburn
- Department of Applied Human Sciences, Kansas State University, Manhattan, Kansas, USA
| | - Steven J. Sandage
- School of Theology, Boston University, Boston, Massachusetts, USA
- Department of Psychological and Brain Sciences, Boston University, Boston, Massachusetts, USA
| | - Eugene L. Hall
- School of Theology, Boston University, Boston, Massachusetts, USA
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13
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Holm AKJ, Johnson AN, Clockston R, Oselinsky K, Lundeberg PJ, Rand K, Graham DJ. Intersectional health disparities: the relationships between sex, race/ethnicity, and sexual orientation and depressive symptoms. PSYCHOLOGY & SEXUALITY 2021. [DOI: 10.1080/19419899.2021.1982756] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Abby K. Johnson Holm
- Department of Psychology, Colorado State University, Fort Collins, CO, Larimer County, United States
| | - Ashlie N. Johnson
- Department of Psychology, Colorado State University, Fort Collins, CO, Larimer County, United States
| | - Raeven Clockston
- Department of Psychology, Colorado State University, Fort Collins, CO, Larimer County, United States
| | - Katrina Oselinsky
- Department of Psychology, Colorado State University, Fort Collins, CO, Larimer County, United States
| | - Pamela J. Lundeberg
- Department of Psychology, Aims Community College, Loveland, Co, Larimer County, United States
| | - Katelyn Rand
- Department of Psychology, Colorado State University, Fort Collins, CO, Larimer County, United States
| | - Daniel J. Graham
- Department of Psychology, Colorado State University, Fort Collins, CO, Larimer County, United States
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14
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Harari L, Lee C. Intersectionality in quantitative health disparities research: A systematic review of challenges and limitations in empirical studies. Soc Sci Med 2021; 277:113876. [PMID: 33866085 DOI: 10.1016/j.socscimed.2021.113876] [Citation(s) in RCA: 55] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 03/11/2021] [Accepted: 03/19/2021] [Indexed: 01/12/2023]
Abstract
RATIONALE Quantitative health disparities research has increasingly employed intersectionality as a theoretical tool to investigate how social characteristics intersect to generate health inequality. Yet, intersectionality was not designed to quantify, predict, or identify health disparities, and, as a result, multiple criticisms against its misapplication in health disparities research have been made. As such, there is an emerging need to evaluate the growing body of quantitative research that aims to investigate health disparities through an intersectional lens. METHODS We conducted a systematic review from earliest records to January 2020 to (i) describe the scope of limitations when applying intersectionality to quantitative health disparities research, and (ii) identify recommendations to improve the future integration of intersectionality with this scholarship. We identified relevant publications with electronic searches in PubMed and CA Web of Science. Studies eligible for inclusion were English-language publications that used quantitative methodologies to investigate health disparities among adults in the U.S. while explicitly claiming to adopt an intersectional perspective. Out of 1279 articles reviewed, 65 were eligible for inclusion. RESULTS Our review found that, while the value of intersectionality to the study of health disparities is evident, the existing research struggles with meeting intersectionality's fundamental assumptions. In particular, four limitations were found to be widespread: narrowing the measurements of intersectionality, intersectional groups, and health outcomes; placing primacy on the study of certain intersectional groups to the neglect of others; overlooking underlying explanatory mechanisms that contribute to the health disparities experienced by intersectional groups; and, lacking in the use of life-course perspectives to show how health disparities vary across different life stages. CONCLUSION If the goal of health equality is to be achieved among diverse intersectional groups, future research must be assisted by the collection and examination of data that overcomes these limitations.
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Affiliation(s)
- Lexi Harari
- Department of Sociology, University of California-Riverside, Riverside, CA, USA
| | - Chioun Lee
- Department of Sociology, University of California-Riverside, Riverside, CA, USA.
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15
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Norris A, Rich C, Kaplan C, Krieger N, Carey KB, Carey MP. Intersections between Young Women's Racial/Ethnic Identities and Sexual Orientation on Rates of Sexual Violence and Substance Use. PSYCHOLOGY & SEXUALITY 2021; 12:141-161. [PMID: 33738042 DOI: 10.1080/19419899.2020.1729848] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Background Little is known about whether there are differences in rates of sexual violence and its association with substance use based on women's identities, specifically the intersection of their race/ethnicity and sexual orientation. Method Women (N = 546; 18 to 29 years of age) recruited from a reproductive healthcare clinic reported their race, ethnicity, sexual orientation, sexual violence history and substance use. Five logistic regressions examined (a) rates of sexual violence, and (b) the strength of the associations between sexual violence and four substance use outcomes (heavy alcohol use, marijuana use, cigarette use, number of cigarettes used) based on sexual orientation. Subsequent logistic regressions examined race/ethnicity as a moderator of the associations between sexual orientation and (a) rates of sexual violence and (b) substance use. Results Most women surveyed were heterosexual (64%), and 35% of all women reported unwanted sex. Sexual minority women (SMW) reported higher rates of sexual violence and substance use than heterosexual women. Sexual violence was more strongly associated with heavy alcohol use, but not with marijuana or cigarette use, for SMW than heterosexual women. Rates of sexual violence varied based on the intersection of sexual orientation and race/ethnicity. Although SMW were more likely to report sexual violence than heterosexual women, this association was weaker for Black/Latinx women than for non-Hispanic White women (aOR = 0.39, 95%CI [0.18, 0.82]). Race/ethnicity did not moderate the strength of associations between sexual violence and substance use. Conclusions SMW exhibit increased risk for sexual violence and substance use, and victimization was associated with heavy alcohol use. Few racial/ethnic differences emerged as a function of sexual orientation, so SMW are a group with unique needs around sexual violence experiences and substance use, regardless of race/ethnicity. Healthcare providers should be aware of the link between substance use and prior victimization when treating SMW.
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Affiliation(s)
- Alyssa Norris
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, 164 Summit Avenue, Providence RI 02903.,Department of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University, Providence, RI 02903
| | - Carla Rich
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, 164 Summit Avenue, Providence RI 02903
| | - Clair Kaplan
- Department of Clinical Research, Planned Parenthood of Southern New England, 345 Whitney 15 Avenue, New Haven, CT, 06511.,Center for Interdisciplinary Research on AIDS, Yale University, 135 College Street, Suite 200, New Haven, CT 06510
| | - Naomi Krieger
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, 164 Summit Avenue, Providence RI 02903
| | - Kate B Carey
- Department of Behavioral and Social Science, School of Public Health, Brown University, Providence RI 02903.,Center for Alcohol and Addiction Studies, Brown University, Providence RI 02903
| | - Michael P Carey
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, 164 Summit Avenue, Providence RI 02903.,Department of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University, Providence, RI 02903.,Department of Behavioral and Social Science, School of Public Health, Brown University, Providence RI 02903
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16
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Smith AU, Reidy D, Norris AE. Teen Dating Violence and Suicide Risk Among Bisexual Adolescents. J Adolesc Health 2020; 67:685-691. [PMID: 32571755 DOI: 10.1016/j.jadohealth.2020.04.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 04/01/2020] [Accepted: 04/06/2020] [Indexed: 12/28/2022]
Abstract
PURPOSE Suicide is a public health problem that disproportionately affects bisexual youth more than heterosexual, lesbian/gay, and other sexual minority youth. Teen dating violence (TDV) consists of physically, emotionally, and/or psychologically aggressive behavior in adolescent relationships and has been linked to increased suicidality among sexual minority youth. Although biological sex differences in suicide and TDV have been noted, limited research currently exists regarding the importance of these differences in bisexual youth. METHODS This study employed a cross-sectional descriptive design to investigate the relationship between biological sex, TDV, and suicide risk among bisexual youth in grades 9-12. This study used structural equation modeling to conduct a secondary analysis of pooled 2015 and 2017 national Youth Risk Behavior Surveillance Survey data that examined whether TDV mediated the relationship between biological sex and suicide risk among bisexual youth. RESULTS Results indicated that TDV did not mediate the relationship between biological sex and suicide risk among bisexual youth. Biological sex was a significant predictor of suicide risk with male youth reporting lower suicide risk than female youth, when controlling for dating history, TDV, age, and race. TDV predicted suicide risk, with youth reporting TDV having higher suicide risk, when controlling for dating history, biological sex, age, and race. In addition, black and Hispanic youth reported lower suicide risk compared to white youth. CONCLUSION There is a dire need for research that addresses issues of TDV and suicide among bisexual youth. Understanding factors influencing suicide risk following TDV experiences among bisexual youth will inform interventions to mitigate negative mental health outcomes.
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Affiliation(s)
- Ariel U Smith
- College of Nursing - Health Systems Science, University of Illinois at Chicago, Chicago, Illinois.
| | - Dennis Reidy
- School of Public Health, Georgia State University, Atlanta, Georgia
| | - Anne E Norris
- School of Nursing and Health Studies, & Senior Research Scientist, REAL Prevention, LLC, University of Miami, Coral Gables, Florida
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17
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McCann E, Brown MJ. The views and experiences of lesbians regarding their mental health needs and concerns: Qualitative findings from a mixed-methods study. Perspect Psychiatr Care 2020; 56:827-836. [PMID: 32175605 DOI: 10.1111/ppc.12498] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 02/26/2020] [Accepted: 03/07/2020] [Indexed: 11/26/2022] Open
Abstract
PURPOSE The aim of this paper is to report the specific views and experiences of lesbians and identify their distinct mental health issues and concerns. DESIGN AND METHODS A mixed-methods design with surveys and individual interviews was utilized. The data were thematically analyzed. FINDINGS The key themes were (a) enabling service access, (b) person-centered support, (c) models of care, (d) community presence and participation, and (e) future aspirations for mental health services. PRACTICE IMPLICATIONS The study results inform and develops the understanding of the issues that impact upon the mental health and well-being of lesbians. The implications for mental health practice are discussed.
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Affiliation(s)
- Edward McCann
- Faculty of Health Sciences, School of Nursing and Midwifery, Dublin, Republic of Ireland
| | - Michael J Brown
- Faculty of Medicine, Health and Life Sciences, School of Nursing and Midwifery, Belfast, Northern Ireland
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18
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Veldhuis CB, Hughes TL, Drabble L, Wilsnack S, Matthews A. Do relationships provide the same levels of protection against heavy drinking for lesbian and bisexual women? An intersectional approach. PSYCHOLOGY OF SEXUAL ORIENTATION AND GENDER DIVERSITY 2020; 7:337-352. [PMID: 34485591 PMCID: PMC8411928 DOI: 10.1037/sgd0000383] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
PURPOSE Sexual minority women (SMW; e.g., lesbian, bisexual) are more likely than heterosexual women to be heavy drinkers, with bisexual women showing the highest risk. There is ample literature demonstrating that intimate relationships protect against stress-related health risk behaviors in the general population. However, very little research has focused on SMW's relationships and far less is known about the relationships of SMW of color. Using intersectionality theory as our framework, we tested two competing models to determine whether the effects of minority sexual identity (lesbian, bisexual) and race/ethnicity (African American, Latinx, White) are: 1) additive, or 2) multiplicative in the associations between relationship status and heavy drinking. METHODS Data are from a diverse sample of cisgender sexual minority women (N = 641) interviewed in Wave 3 of the CHLEW study, a 20-year longitudinal study of SMW's health. RESULTS Findings from two- and three-way interactions provide mixed evidence for both the additive and multiplicative hypotheses; support for each varied by sexual identity and race/ethnicity. Overall, we found that Latinx SMW, particularly single and bisexual Latinx SMW report the highest rates of heavy drinking compared to their cohabiting and lesbian counterparts, respectively. African American single SMW reported significantly higher rates of heavy drinking compared to their cohabiting counterparts. CONCLUSION Our findings suggest that the protective qualities of SMW's intimate relationships vary based on sexual identity and race/ethnicity-and the intersections between them. These results highlight that research among SMW that does not take into account multiple marginalized identities may obscure differences. PUBLIC SIGNIFICANCE Little research has focused on health within sexual minority women's relationships, particularly among sexual minority women of color. Given the potential additive or multiplicative effects of multiple sources of oppression such as heterosexism, racism, and sexism, understanding the potential protective effects of relationships is important. Our findings demonstrate that the protective qualities of intimate relationships among SMW vary based on sexual identity and race/ethnicity - and the intersections between them.
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Affiliation(s)
| | - Tonda L Hughes
- School of Nursing, Columbia University
- College of Nursing, University of Illinois at Chicago
| | | | - Sharon Wilsnack
- School of Medicine & Health Sciences, University of North Dakota
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19
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Caceres BA, Veldhuis CB, Hughes TL. Racial/Ethnic Differences in Cardiometabolic Risk in a Community Sample of Sexual Minority Women. Health Equity 2019; 3:350-359. [PMID: 31312782 PMCID: PMC6626969 DOI: 10.1089/heq.2019.0024] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Purpose: To examine the intersection of sexual identity and race/ethnicity on self-reported cardiometabolic risk in sexual minority women (SMW). Methods: Data from the Chicago Health and Life Experiences of Women study were analyzed. Logistic regression models examined racial/ethnic differences in cardiometabolic risk (including obesity, hypertension, and diabetes) in SMW, accounting for psychosocial and behavioral factors. A variable accounting for the intersection of sexual identity and race/ethnicity was added to regression models (White lesbian women were the reference group). Results: The analytic sample included 601 SMW (237 White, 219 Black, 145 Latina). Black (adjusted odds ratio [AOR] 2.96, 95% confidence interval [CI]=1.48-5.94) and Latina (AOR 2.30, 95% CI=1.18-4.48) SMW had higher rates of lifetime trauma than White SMW. Black SMW reported higher rates of obesity (AOR 3.05, 95% CI=1.91-4.88), hypertension (AOR 1.99, 95% CI=1.08-3.66), and diabetes (AOR 3.77, 95% CI=1.46-9.74) relative to White SMW. Intersectional analyses revealed that Black lesbian (AOR 2.94, 95% CI=1.74-4.97) and Black bisexual (AOR 3.43, 95% CI=1.69-6.96) women were more likely to be obese than White lesbian women. Black lesbian women also reported higher rates of hypertension (AOR 2.09, 95% CI=1.08-4.04) and diabetes (AOR 3.31, 95% CI=1.26-8.67) than White lesbian women. No differences in cardiometabolic risk were found between Latina and White SMW. Conclusion: This study extends previous research on racial/ethnic differences in cardiometabolic risk among SMW. Prevention strategies are needed to reduce cardiometabolic risk in Black SMW. Findings highlight the need for cardiovascular disease research in SMW that incorporates longitudinal designs and objective measures.
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Are Black Sexual Minority Adults More Likely to Report Higher Levels of Psychological Distress than White Sexual Minority Adults? Findings from the 2013–2017 National Health Interview Survey. SOCIAL SCIENCES-BASEL 2019. [DOI: 10.3390/socsci8010014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study examined whether the association between sexual minority status and psychological distress is different between Black adults and White adults. The intersectionality framework suggests that Black sexual minority adults are more likely to report psychological distress than White sexual minority adults. Using data from the 2013–2017 National Health Interview Survey, multinomial logistic regression was conducted to examine the associations among race, sexual orientation identity, and psychological distress in a large representative U.S. sample that included a large number of Black sexual minority adults and White sexual minority adults. Results indicated that the association between sexual minority status and psychological distress was not significantly different between Black adults and White adults. Future research should examine resources that may buffer risk for psychological distress among Black sexual minority adults.
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