Adverse Childhood Experiences Related to Poor Adult Health among Lesbian, Gay, & Bisexual Individuals

OBJECTIVES:

We explored the association of sexual orientation with poor adult health outcomes before and after adjustment for exposure to adverse childhood experiences (ACEs).

METHODS:

Data were from the 2012 North Carolina, 2011 Washington, and 2011 and 2012 Wisconsin Behavioral Risk Factor Surveillance System (BRFSS) surveys regarding health risks, perceived poor health, and chronic conditions by sexual orientation and 8 categories of ACEs. There were 711 lesbian, gay, and bisexual (LGB) respondents and 29 690 heterosexual respondents.

RESULTS:

LGB individuals had a higher prevalence of all ACEs than heterosexuals, with odds ratios ranging from 1.4 to 3.1. After adjustment for cumulative exposure to ACEs, sexual orientation was no longer associated with poor physical health, current smoking, and binge drinking. Associations with poor mental health, activity limitation, HIV risk behaviors, current asthma, depression, and disability remained, but were attenuated.

CONCLUSIONS:

The higher prevalence of ACEs among LGB individuals may account for some of their excess risk for poor adult health outcomes. 

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By:   Austin A1, Herrick H1, Proescholdbell S1.

• 1At the time of the study, Anna Austin and Scott Proescholdbell were with the Injury Epidemiology and Surveillance Unit, Injury and Violence Prevention Branch, Chronic Disease and Injury Section, Division of Public Health, North Carolina Department of Health and Human Services, Raleigh. Harry Herrick was with the Behavioral Risk Factor Surveillance System, State Center for Health Statistics, Division of Public Health, North Carolina Department of Health and Human Services, Raleigh. 

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Neighborhood Characteristics Contribute to Urban Alcohol Availability: Accounting for Race/Ethnicity & Social Disorganization

This study examined the role that race/ethnicity and social disorganization play in alcohol availability in Milwaukee, Wisconsin, census block groups. 

This study estimated negative binomial regression models to examine separately the relationship between neighborhood racial/ethnic composition and social disorganization levels for (1) total, (2) on-premise, and (3) off-premise alcohol outlets. Results of this study suggest that proportion Hispanic was positively associated with total and with off-premise alcohol outlets. 

Second, proportion African American was negatively associated with on-premise alcohol outlets and positively associated with off-premise alcohol outlets. Proportion Asian was not associated with total, on-premise, or off-premise alcohol outlets. 

However, the effects of race/ethnicity on alcohol availability were either unrelated or negatively related to alcohol outlet availability once neighborhood social disorganization levels were taken into account, and social disorganization was positively and significantly associated with all alcohol outlet types. 

Neighborhood characteristics contribute to alcohol availability and must be considered in any efforts aimed toward prevention of alcohol-related negative health and social outcomes.

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By:  Snowden AJ1.

• 1 Department of Criminal Justice , University of Wisconsin Milwaukee , Milwaukee , Wisconsin.

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Peer Victimization and Sexual Risk Differences Between Lesbian, Gay, Bisexual, Transgender, or Questioning and Nontransgender Heterosexual Youths in Grades 7–12

Before and after accounting for peer victimization, we estimated sexual risk disparities between students who self-identified as lesbian, gay, bisexual, transgender, or questioning (LGBTQ) and students who self-identified as nontransgender heterosexual.

Students in grades 7 through 12 in Dane County, Wisconsin, were given the Web-administered Dane County Youth Assessment. One set of analyses was based on a sample that included 11 337 students. Subsequent analyses were based on a sample from which we screened out students who may not have been responding to survey items truthfully. Various multilevel-modeling and propensity-score-matching strategies ensured robustness of the results, examined disparities at lower and higher victimization rates, and explored heterogeneity among LGBTQ-identified youths. Finally, propensity-score-matching strategies estimated LGBTQ–heterosexual disparities in 2 matched samples: a sample that reported higher victimization and one that reported lower victimization.

Across 7 sexual risk outcomes, and in middle and high school, LGBTQ-identified youths reported engaging in riskier behavior than did heterosexual-identified youths after we accounted for peer victimization. Risk differentials were present in middle and high school. The LGBTQ group was heterogeneous, with lesbian/gay- and bisexual-identified youths generally appearing most risky, and questioning-identified youths least risky. In the matched sample with lower average victimization rates, LGBTQ-identified youths perceived a greater risk of sexually transmitted infections despite not engaging in sexually risky behavior at significantly higher rates; in the matched sample with higher average victimization rates, all outcomes were significantly different.

Demonstrated LGBTQ–heterosexual risk differentials in grades 7 through 8 suggest that interventions need to be implemented during middle school. These interventions should also be differentiated to address the unique risk patterns among LGBTQ subgroups. Finally, models of sexual risk disparities must expand beyond peer victimization.

Full article at: http://goo.gl/Rhrdfy

By: Joseph P. Robinson, PhD and Dorothy L. Espelage, PhD

Department of Educational Psychology, University of Illinois at Urbana-Champaign.

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