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Wang C, Butler G, Szczepanowski MRJ, Betancourt MT, Roberts KC. Physical activity, organized sport participation and active transportation to school among Canadian youth by gender identity and sexual attraction. Health Promot Chronic Dis Prev Can 2024; 44:47-55. [PMID: 38353939 PMCID: PMC11013025 DOI: 10.24095/hpcdp.44.2.02] [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: 02/16/2024]
Abstract
INTRODUCTION Regular physical activity is associated with a wide range of health benefits in youth. While previous studies have identified disparities in physical activity among youth by gender identity and sexual attraction, these have seldom been explored in Canadian youth. METHODS Data from the 2019 Canadian Health Survey on Children and Youth were used to assess prevalence of and time spent in organized sports participation, total physical activity and active transportation by gender identity (non-cisgender vs. cisgender) among youth aged 12 to 17, and by sexual attraction (nonheterosexual attraction vs. heterosexual attraction) among youth aged 15 to 17. RESULTS There was no difference in average minutes of total physical activity per week between non-cisgender and cisgender Canadian youth. Non-cisgender youth (which represent 0.5% of the population) averaged significantly fewer minutes of organized sports per week than their cisgender counterparts. There was some evidence of increased active transportation to school among non-cisgender youth, but insufficient power to detect significant differences. Canadian youth reporting any nonheterosexual attraction (which represent 21.2% of the population, including mostly heterosexual youth) were less likely to be regularly physically active and participate in organized sports than youth reporting exclusive heterosexual attraction. Differences were larger among males than females. Males reporting nonheterosexual attraction were more likely to use active transportation to get to school than their heterosexual counterparts. CONCLUSION Non-cisgender youth and youth reporting nonheterosexual attraction tended to participate less in organized sports than their counterparts, but may have engaged in more active transportation. Mitigating the barriers associated with sport participation could increase physical activity among these groups.
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Affiliation(s)
- Chinchin Wang
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, Ontario, Canada
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Quebec, Canada
- Centre for Clinical Epidemiology, Lady Davis Institute for Medical Research, Montréal, Quebec, Canada
| | - Gregory Butler
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - McKenna R J Szczepanowski
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, Ontario, Canada
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Marisol T Betancourt
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - Karen C Roberts
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, Ontario, Canada
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Wang CH, Peiper N. Association Between Physical Activity and Sedentary Behavior With Depressive Symptoms Among US High School Students, 2019. Prev Chronic Dis 2022; 19:E76. [PMID: 36395000 PMCID: PMC9673959 DOI: 10.5888/pcd19.220003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2024] Open
Abstract
INTRODUCTION The prevalence of depression among US adolescents has increased during the past decade. Previous studies found relationships among physical activity, sedentary behavior, and depression, but more recent information is needed to inform research and practice. We used national surveillance data to assess the association of physical activity and sedentary behavior with depressive symptoms among US high school students. METHODS This study included 13,526 high school students from the 2019 Youth Risk Behavior Survey. The dependent variable was the presence of depressive symptoms in the past year that lasted almost every day for at least 2 weeks in a row and interfered with usual activities. The independent variables were physical activity (overall activity, muscle-strengthening exercises, participation on sports teams) and sedentary behavior (watching television, using a computer or digital device). We used weighted multivariable logistic regression to evaluate the association of physical activity and sedentary behavior variables with depressive symptoms, while controlling for demographic characteristics and other health behaviors. RESULTS The prevalence of depressive symptoms was 36.7%. Participating in physical activity 5 or more days in the past 7 days (adjusted odds ratio [aOR], 0.81; 95% CI, 0.68-0.97) and participating on 1 or more sports teams in the past year (aOR, 0.66; 95% CI, 0.55-0.78) were associated with reduced odds of depressive symptoms. Using a computer or digital device for 3 or more hours per school night was associated with higher odds of reporting depressive symptoms (aOR, 1.61; 95% CI, 1.41-1.85). CONCLUSION Inadequate physical activity and excessive sedentary behavior are associated with depressive symptoms among US high school students. Interventions targeting physical activity and sedentary behavior may be a public health strategy to reduce depressive symptoms in this population.
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Affiliation(s)
- Charles H Wang
- Noble and Greenough School, 10 Campus Dr, Dedham, MA 02026.
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Abstract
It is widely assumed that LGBT+ people may feel insecure and unwelcome in sports settings, which are often characterized by a binary gender order and a culture of heteronormativity. Previous research also suggests that LGBT+ individuals experience homophobia in the context of sport. Despite these findings, reliable quantitative data on the sports participation levels of sexual minority groups are scarce. The paper addresses this academic void by analyzing sports activity data of sexual minority groups. The 2019 wave of the German Socio-Economic Panel (SOEP) study is analyzed, which includes a novel LGBT+ boost sample of respondents who self-identify as lesbian, gay, bisexual, transgender, or non-binary with regard to gender. The analysis of this sample shows that sports activity levels (with regard to frequency and duration) of homo- and bisexual individuals are comparable to the heterosexual majority. Although findings show that a high share of homo- and bisexual individuals experience sexual discrimination, discrimination is not associated with lower participation rates in sports. We thus conclude that the domain of sport—although by no means free of discrimination—offers sufficient participation opportunities for LGBT+ people.
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An R, Li D, Cole M, Park K, Lyon AR, White NH. Implementation of School Diabetes Care in the United States: A Scoping Review. J Sch Nurs 2022; 38:61-73. [PMID: 34184953 PMCID: PMC9924139 DOI: 10.1177/10598405211026328] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Diabetes management at school demands close collaboration of multiple stakeholders, including students with diabetes and parents, school nurses, teachers/staff, and local health care providers. This scoping review identified and synthesized evidence concerning factors that contributed to the quality and effectiveness of diabetes care implementation in U.S. K-12 schools. Forty-six studies met the eligibility criteria and were included. Five common factors emerged surrounding training and experiences, communications, parent engagement, resource allocations, and school environment. Complex interactions between multiple stakeholders jointly determined the quality of school diabetes care. A conceptual model was established to elucidate the complex interactions between multiple stakeholders and the relevant facilitators and barriers. Future research should improve sample representativeness, contrast school diabetes care practices to the national guidelines, and assess the impact of the social, economic, and political environment at federal, state, local/district levels on school diabetes care implementation.
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Affiliation(s)
- Ruopeng An
- Brown School, 7548Washington University, St. Louis, MO, USA
| | - Danyi Li
- Brown School, 7548Washington University, St. Louis, MO, USA
| | - Marjorie Cole
- Missouri Department of Health & Senior Services, Jefferson City, MO, USA
| | | | - Aaron R Lyon
- Department of Psychiatry and Behavioral Sciences, 7284University of Washington, Seattle, WA, USA
| | - Neil H White
- School of Medicine, Washington University, St. Louis, MO, USA
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Sexual and Gender Minorities and Risk Behaviours among University Students in Italy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111724. [PMID: 34770238 PMCID: PMC8583234 DOI: 10.3390/ijerph182111724] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 10/26/2021] [Accepted: 11/04/2021] [Indexed: 12/15/2022]
Abstract
Sexual and gender minorities (SGM) may experience stigma, discrimination and show higher prevalence of behavioural risk factors than heterosexual counterparts. In Italy, the information on SGM is scarce and outdated. The present cross-sectional study aims to provide a more up-to-date estimate of the SGM proportion in young adults and to assess differences in the adoption of risk behaviours compared to their heterosexual counterparts. The study involved university students aged 18-25. Information on socio-demographic and behavioural characteristics were collected. The effect of sexual orientation on risk behaviours was assessed with a multinomial single-step logistic regression analysis. A total of 9988 participants were included. Overall, 518 students (5.2%) self-identified as SGM. While lesbians showed significantly higher odds of only non-regular use of protective barriers (AOR: 11.16), bisexuals showed higher odds for frequent drinking (AOR: 2.67), smoking (AOR: 1.85), multiple sexual partnerships (AOR: 1.78) and non-regular use of protective barriers (AOR: 1.90) compared with heterosexual women. Gay men showed higher odds of multiple sexual partnerships compared with heterosexual males (AOR: 5.52). SGM accounted for 5.2% of the sample, slightly more than the proportion found in the general population, but substantially in line with similarly aged populations abroad. Our findings confirm that unhealthy risk behaviours are more frequent among LGBTQ+, in particular among bisexual women. Rather than targeting specific subpopulations, our study aims to show the need for health promotion interventions that aim at the empowerment of all students regardless of sexual orientation, being aware that SGMs can benefit to a relatively greater extent.
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Curry CW, Felt D, Kan K, Ruprecht M, Wang X, Phillips G, Beach LB. Asthma Remission Disparities Among US Youth by Sexual Identity and Race/Ethnicity, 2009-2017. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2021; 9:3396-3406. [PMID: 33964511 PMCID: PMC8434969 DOI: 10.1016/j.jaip.2021.04.046] [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] [Received: 11/11/2020] [Revised: 04/13/2021] [Accepted: 04/18/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Sexual minority and racial/ethnic minority youth experience a higher burden of asthma. The frameworks of minority stress theory and intersectionality suggest that sexual minority and racial/ethnic minority youth may experience disparities in nonremitting asthma. OBJECTIVE To examine adjusted odds of nonremitting asthma by sexual identity, race/ethnicity, and their intersections, along with their relationship with traditional nonremitting asthma risk factors (weight status and smoking) and victimization (bullying, cyberbullying, and forced sex). METHODS We used data from the Youth Risk Behavior Survey pooled across 41 jurisdiction-years (biennially, 2009-2017), resulting in a sample of 21,789 US youth. The prevalence of nonremitting asthma was examined by sexual identity, race/ethnicity, and their intersections, stratified by sex. Bivariate associations and backward logistic regression models, stratified by sex, were built to examine nonremitting asthma disparities and the effects of selected traditional correlates and victimization variables. RESULTS At the intersections, 8 sexual minority and racial/ethnic minority subpopulations were significantly more likely to have nonremitting asthma compared with White heterosexual sex-matched peers. White gay males and Black lesbian females had the highest odds of nonremitting asthma. Traditional risks of nonremitting asthma and victimization were associated with attenuated odds of nonremitting asthma. CONCLUSIONS Many sexual minority and racial/ethnic youth subpopulations are more likely to have nonremitting asthma. Evidence suggests that traditional nonremitting asthma risk factors and victimization may partly explain disparities in nonremitting asthma. Asthma management guidelines should be updated to include population health disparities of sexual and racial/ethnic minorities.
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Affiliation(s)
- Caleb W. Curry
- Evaluation, Data Integration, and Technical Assistance (EDIT) Research Program, Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
- College of Arts and Sciences, Case Western Reserve University, Cleveland, OH
| | - Dylan Felt
- Evaluation, Data Integration, and Technical Assistance (EDIT) Research Program, Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Kristin Kan
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL
- Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL
| | - Megan Ruprecht
- Evaluation, Data Integration, and Technical Assistance (EDIT) Research Program, Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Xinzi Wang
- Evaluation, Data Integration, and Technical Assistance (EDIT) Research Program, Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Gregory Phillips
- Evaluation, Data Integration, and Technical Assistance (EDIT) Research Program, Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Lauren B. Beach
- Evaluation, Data Integration, and Technical Assistance (EDIT) Research Program, Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
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Ancheta AJ, Caceres BA, Jackman KB, Kreuze E, Hughes TL. Sexual Identity Differences in Health Behaviors and Weight Status among Urban High School Students. Behav Med 2021; 47:259-271. [PMID: 34719340 PMCID: PMC8560978 DOI: 10.1080/08964289.2020.1763903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Revised: 04/16/2020] [Accepted: 04/24/2020] [Indexed: 10/24/2022]
Abstract
Although racial/ethnic disparities in childhood obesity are well documented in the United States (U.S.), fewer studies have investigated elevated body mass index (BMI) and related health behaviors among sexual minority youth (SMY; gay/lesbian, bisexual, not sure). We examined pooled data from the 2009-2017 Youth Risk Behavior Surveys, which included high school students from 12 urban U.S. school districts. We used sex-stratified logistic regression models to estimate the association of sexual identity with health behaviors and elevated BMI (reference = heterosexual participants). A total of 133,615 participants were included. Sexual minority boys were more likely to report physical inactivity than heterosexual boys. Gay and not sure boys were also less likely to consume the recommended daily intake of fruit. Bisexual girls were more likely than heterosexual girls to report watching television ≥ 3 hours on a school day and to consume sugar-sweetened beverages (AOR 1.30, 95% CI= 1.18-1.43). All SMY reported higher rates of current tobacco use than their heterosexual peers. Sexual minority girls and bisexual boys had significantly higher rates of obesity than their heterosexual counterparts. These findings can inform tailored health promotion initiatives to reduce obesity risk in SMY.
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Affiliation(s)
- April J Ancheta
- Columbia University School of Nursing, New York, New York, USA
| | - Billy A Caceres
- Columbia University School of Nursing, New York, New York, USA
| | - Kasey B Jackman
- Columbia University School of Nursing, New York, New York, USA
| | | | - Tonda L Hughes
- Henrik H. Bendixen Professor of International Nursing (in Psychiatry), Columbia University School of Nursing, New York, New York, USA
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Charlton BM, Farland LV, Boehmer U, Tamimi RM, Collins LC, VanKim NA, Bertone-Johnson ER, Potter J, Sarda V, Austin SB. Sexual orientation and benign breast disease in a cohort of U.S. women. Cancer Causes Control 2020; 31:173-179. [PMID: 31894493 DOI: 10.1007/s10552-019-01258-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Accepted: 12/10/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE Several studies indicate that sexual minority (e.g., bisexual, lesbian) women may be at an increased risk for breast cancer. However, we know little about how risk factors, such as benign breast disease (BBD)-which can confer nearly a fourfold breast cancer risk increase-may vary across sexual orientation groups. METHODS Among Nurses' Health Study II participants followed from 1989 to 2013 (n = 99,656), we investigated whether bisexual and lesbian women were more likely than heterosexual women to have breast cancer risk factors including a BBD diagnosis (self-reported biopsy or aspiration confirmed, n = 11,021). Cox proportional hazard models were used to calculate hazard ratios (HR) and 95% confidence intervals (CI). RESULTS Compared to heterosexuals, sexual minority participants more commonly reported certain breast cancer risk factors including increased alcohol intake and nulliparity. However, sexual minority participants were more likely than heterosexuals to have certain protective factors including higher body mass index and less oral contraceptive use. When evaluating age- and family history-adjusted rates of BBD diagnoses across sexual orientation groups, bisexual (HR 1.04, 95% CI [0.78, 1.38]) and lesbian (0.99 [0.81, 1.21]) women were just as likely as heterosexuals to have a BBD diagnosis. Results were similar after adjusting for other known breast cancer risk factors. CONCLUSIONS In this cohort of women across the U.S., sexual minorities were more likely than heterosexuals to have some breast cancer risk factors-including modifiable risk factors such as alcohol intake. Heterosexual, bisexual, and lesbian women were equally as likely to have a BBD diagnosis.
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Affiliation(s)
- Brittany M Charlton
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA. .,Harvard Medical School, 25 Shattuck Street, Boston, MA, 02115, USA. .,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, 181 Longwood Avenue, Boston, MA, 02115, USA. .,Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA.
| | - Leslie V Farland
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 North Martin Avenue, Tucson, Az, 85724, USA
| | - Ulrike Boehmer
- Department of Community Health Sciences, Boston University School of Public Health, 715 Albany St, Boston, MA, 02118, USA
| | - Rulla M Tamimi
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, 181 Longwood Avenue, Boston, MA, 02115, USA.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA
| | - Laura C Collins
- Harvard Medical School, 25 Shattuck Street, Boston, MA, 02115, USA.,Department of Pathology, Beth Israel Deaconess Medical Center and Harvard Medical School, 330 Brookline Avenue, Boston, MA, 02215, USA
| | - Nicole A VanKim
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts Amherst, 715 North Pleasant Street, Amherst, MA, 01003, USA
| | - Elizabeth R Bertone-Johnson
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts Amherst, 715 North Pleasant Street, Amherst, MA, 01003, USA
| | - Jennifer Potter
- Harvard Medical School, 25 Shattuck Street, Boston, MA, 02115, USA.,Division of General Internal Medicine, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA, 02215, USA.,The Fenway Institute, 1340 Boylston Street, Boston, MA, 02215, USA
| | - Vishnudas Sarda
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA
| | - S Bryn Austin
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA.,Harvard Medical School, 25 Shattuck Street, Boston, MA, 02115, USA.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, 181 Longwood Avenue, Boston, MA, 02115, USA.,Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA
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Grammer AC, Byrne ME, Pearlman AT, Klein DA, Schvey NA. Overweight and obesity in sexual and gender minority adolescents: A systematic review. Obes Rev 2019; 20:1350-1366. [PMID: 31334601 DOI: 10.1111/obr.12906] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 05/14/2019] [Accepted: 05/15/2019] [Indexed: 12/21/2022]
Abstract
Population data indicate that sexual and gender minority adolescents may be at increased risk for excess weight gain compared with cisgender, heterosexual youth. However, no studies, to our knowledge, have systematically reviewed the literature on weight disparities in this population nor explored risk for overweight and obesity by sexual and gender minority subgroup across studies. The current systematic review, therefore, identified 21 studies that assessed the relationship between sexual and gender minority status and weight among adolescents. Results indicated an overall greater prevalence of overweight and obesity among sexual and gender minority adolescents compared with cisgender, heterosexual youth. However, cisgender sexual minority males demonstrated lower or no added risk for overweight and obesity, whereas cisgender sexual minority females demonstrated greater risk for overweight and obesity. Findings were mixed among gender minority adolescents. This study highlights weight disparities in sexual and gender minority youth, although important subgroup differences exist. Additional research is needed to elucidate the mechanisms that may contribute to differential weight trajectories in this population and to develop tailored approaches for prevention and treatment.
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Affiliation(s)
- Anne Claire Grammer
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, 63110
| | - Meghan E Byrne
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USU), Bethesda, Maryland, 20814.,Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, Bethesda, Maryland, 20892
| | - Arielle T Pearlman
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USU), Bethesda, Maryland, 20814
| | - David A Klein
- Department of Family Medicine, Fort Belvoir Community Hospital (FBCH), Fort Belvoir, Virginia, 22032.,Department of Family Medicine, Uniformed Services University of the Health Sciences (USU), Bethesda, Maryland, 20814.,Department of Pediatrics, Uniformed Services University of the Health Sciences (USU), Bethesda, Maryland, 20814
| | - Natasha A Schvey
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USU), Bethesda, Maryland, 20814.,Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, Bethesda, Maryland, 20892
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McDowell A, Progovac AM, Cook BL, Rose S. Estimating the Health Status of Privately Insured Gender Minority Children and Adults. LGBT Health 2019; 6:289-296. [PMID: 31314674 DOI: 10.1089/lgbt.2018.0238] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Purpose: The purpose of this study was to characterize the health status of privately insured gender minority individuals. Methods: We created a diagnosis-based algorithm to identify gender minority children and adults in the 2009-2015 IBM® MarketScan® Commercial Database. We compared the age-adjusted health status among individuals with and without gender minority-related diagnosis codes. Results: The percentage of the privately insured population with gender minority-related diagnosis codes increased from 0.004% in 2009 to 0.026% in 2015. Age-adjusted analyses demonstrated that individuals with gender minority-related diagnosis codes were more likely to have diagnoses for mental health disorders (odds ratio [OR] = 8.5; 95% confidence interval [CI] = 8.1-9.0), substance use disorders (OR = 3.4; 95% CI = 2.9-3.9), and diabetes (OR = 1.4; 95% CI = 1.2-1.6), driven by high prevalence of these conditions among individuals younger than 18 years. Conclusions: Our findings highlight a markedly greater prevalence of mental health and substance use disorder diagnoses among privately insured gender minority individuals. These results establish a reference point for evaluating the impact of federal- and state-level policies that ban health insurance discrimination based on gender identity on the health and health care use of gender minority individuals.
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Affiliation(s)
- Alex McDowell
- PhD Program in Health Policy, Harvard University, Cambridge, Massachusetts.,Department of Health Care Policy and Harvard Medical School, Boston, Massachusetts
| | - Ana M Progovac
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts.,Health Equity Research Lab, Department of Psychiatry, Cambridge Health Alliance, Cambridge, Massachusetts
| | - Benjamin Lê Cook
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts.,Health Equity Research Lab, Department of Psychiatry, Cambridge Health Alliance, Cambridge, Massachusetts
| | - Sherri Rose
- Department of Health Care Policy and Harvard Medical School, Boston, Massachusetts
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