Are sociodemographic, lifestyle, and psychosocial characteristics associated with sexual orientation group differences in mental health disparities? Results from a national population-based study

Abstract

Purpose: Sexual minority mental health disparities are well documented. However, distinct sexual minority subgroups are often collapsed into a single "lesbian, gay, or bisexual" (LGB) analytic group. While limited research has shown sexual minority subgroup differences in mental health, little is known about the factors underlying these differences. This study examines whether sociodemographic, lifestyle, and psychosocial characteristics are associated with sexual orientation subgroup differences in mental health.

Methods: Using the National Epidemiologic Survey on Alcohol and Related Conditions, Wave III, differences in various mental health measures, and sociodemographic, lifestyle, and psychosocial characteristics were assessed across three sexual minority subgroups [lesbians/gay men, bisexuals, and heterosexuals reporting same-sex attractions or behaviors ("heterosexual-identified sexual minorities, HSM")] and heterosexuals reporting only opposite-sex attractions and behaviors ("heterosexuals"). Sequential linear regressions evaluated the degrees to which different factors attenuated mental health (SF-12) disparities between heterosexuals and sexual minority subgroups. Analyses were sex-stratified.

Results: Several sociodemographic, lifestyle, and psychosocial characteristic differences existed between sexual orientation groups. Further, all sexual minority subgroups had lower SF-12 scores than heterosexuals, except lesbian women. Sociodemographic factors attenuated the disparity for bisexual men. Sociodemographic, lifestyle, plus psychosocial factors attenuated the disparity for HSM men. However, sociodemographic, lifestyle, and psychosocial factors partially, but did not fully, attenuate the disparity for gay men, bisexual women, or HSM women.

Conclusions: Different factors are associated with mental health disparities for sexual minority subgroups. To maximize health intervention efforts, additional research is needed to uncover the specific mechanisms contributing to health disparities across diverse sexual minority populations.

Keywords: Disparities; Mental health; Sexual orientation; Social epidemiology.