Cardiovascular Disease Disparities in Sexual Minority Adults: An Examination of the Behavioral Risk Factor Surveillance System (2014-2016)

• Published in: American journal of health promotion Vol. 33; no. 4; pp. 576 - 585
• Main Authors: Caceres, Billy A., Makarem, Nour, Hickey, Kathleen T., Hughes, Tonda L.
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01.05.2019; American Journal of Health Promotion
• Subjects: Adolescent; Adult; Aged; Alcoholism - epidemiology; Behavioral Risk Factor Surveillance System; Bisexuality; Cardiovascular disease; Cardiovascular diseases; Cardiovascular Diseases - epidemiology; Depression - epidemiology; Drinking behavior; Exercise; Female; Gays & lesbians; Health promotion; Health risk assessment; Health Status Disparities; Heterosexuality; Heterosexuality - statistics & numerical data; Homosexuality; Homosexuality, Female - statistics & numerical data; Homosexuality, Male - statistics & numerical data; Humans; Male; Mental depression; Middle Aged; Minority & ethnic groups; Minority groups; Myocardial Infarction - epidemiology; Obesity; Obesity - epidemiology; Prevention programs; Psychological distress; Risk behavior; Risk Factors; Risk reduction; Self report; Sexual orientation; Smoking; Smoking - epidemiology; Stress, Psychological - epidemiology; Stroke - epidemiology; Surveillance; Surveillance systems; United States - epidemiology; Young Adult; United States; disease prevention; sexual minorities; cardiovascular disease
• ISSN: 0890-1171; 2168-6602; 2168-6602
• DOI: 10.1177/0890117118810246

Purpose: Investigate sexual orientation differences in cardiovascular disease risk and cardiovascular disease. Design: Cross-sectional. Setting: The 2014 to 2016 Behavioral Risk Factor Surveillance System. Participants: A total of 395 154 participants. Measures: The exposure measure was sexual orientation. Self-report of cardiovascular disease risk factors and cardiovascular disease was assessed. Analysis: Sex-stratified logistic regression analyses to examine sexual orientation differences in cardiovascular disease risk and cardiovascular disease (heterosexuals = reference group). Results: Sexual minority men reported higher rates of mental distress (gay adjusted odds ratio [AOR]: 1.59; bisexual AOR: 1.88) and lifetime depression (gay AOR: 2.48; bisexual: AOR 2.67). Gay men reported higher rates of current smoking (AOR: 1.28), but lower rates of obesity (AOR: 0.82) compared to heterosexual men. Sexual minority women reported higher rates of several cardiovascular risk factors including mental distress (lesbian AOR: 1.37; bisexual AOR: 2.33), lifetime depression (lesbian AOR: 1.96; bisexual AOR: 3.26), current smoking (lesbian AOR: 1.65; bisexual AOR: 1.29), heavy drinking (lesbian AOR: 2.01; bisexual AOR: 2.04), and obesity (lesbian AOR: 1.50; bisexual AOR: 1.29), but were more likely to exercise than heterosexual women (lesbian AOR: 1.34; bisexual AOR: 1.24). Lesbian women reported lower rates of heart attack (AOR: 0.62), but bisexual women had higher rates of stroke than heterosexual women (AOR: 1.46). Conclusions: Findings can inform the development of prevention efforts to reduce cardiovascular disease risk in sexual minorities.