Minority Stress and Cardiovascular Disease Risk Among Sexual Minorities: Mediating Effects of Sense of Mastery

Abstract

Background: Sexual minority adults are at greater risk for cardiovascular disease (CVD) risk factors than heterosexual adults. There is a dearth of research identifying factors that are associated with CVD risk among sexual minorities. This study examined the associations between distal and proximal minority stressors and CVD risk. We also tested a sense of mastery as one mechanism that might explain the link between minority stressors and CVD risk.

Methods: Participants were 670 sexual minority adults (53.6% male; 76% White), ages 18 to 76 years (M = 41.19, SD = 14.73), obtained from a non-probability sample. Using an online survey, participants self-reported family history of CVD risk, physiological conditions (diabetes mellitus, high cholesterol, hypertension), and health behaviors (e.g., tobacco use, diet, exercise) that confer or protect against CVD risk. A weighted CVD risk index was computed. Linear and logistic regressions were conducted to test the effects of minority stressors on the CVD risk index and its specific indicators and to examine mediation.

Results: Minority stressors were associated with a sense of mastery, and mastery was associated with lower CVD risk index scores. Proximal and distal minority stressors were not directly associated with the overall CVD risk index but were associated with some specific risk indicators. Mediation analyses revealed that both distal and proximal minority stressors were indirectly associated with the CVD risk index through mastery.

Conclusions: Research and interventions should aim to reduce CVD risk factors and target minority stressors and mastery to improve the cardiovascular health of sexual minorities.

Keywords: Cardiovascular disease risk; Internalized heterosexism; Minority stress; Sense of mastery; Sexual minorities.