title: Health inequalities among sexual minority adults: evidence from ten U.S. states, 2010.
abstract: BACKGROUND
  Improving the health of lesbian, gay, and bisexual (LGB) individuals is a Healthy People 2020 goal; however, the IOM highlighted the paucity of information currently available about LGB populations.
  
  
  OBJECTIVE
  To compare health indicators by gender and sexual orientation statuses.
  
  
  METHODS
  Data are from Behavioral Risk Factor Surveillance System surveys conducted January-December of 2010 with population-based samples of non-institutionalized U.S. adults aged over 18 years (N=93,414) in ten states that asked about respondents' sexual orientation (response rates=41.1%-65.6%). Analyses were stratified by gender and sexual orientation to compare indicators of mental health, physical health, risk behaviors, preventive health behaviors, screening tests, health care utilization, and medical diagnoses. Analyses were conducted in March 2013.
  
  
  RESULTS
  Overall, 2.4% (95% CI=2.2, 2.7) of the sample identified as LGB. All sexual minority groups were more likely to be current smokers than their heterosexual peers. Compared with heterosexual women, lesbian women had more than 30% decreased odds of having an annual routine physical exam, and bisexual women had more than 2.5 times the odds of not seeking medical care owing to cost. Compared with heterosexual men, gay men were less likely to be overweight or obese, and bisexual men were twice as likely to report a lifetime asthma diagnosis.
  
  
  CONCLUSIONS
  This study represents one of the largest samples of LGB adults and finds important health inequalities, including that bisexual women bear particularly high burdens of health disparities. Further work is needed to identify causes of and intervention for these disparities.
authors.affiliation: Department of Psychiatry, School of Medicine & Dentistry, University of Rochester, Rochester, New York; Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania. Electronic address: john.blosnich@va.gov.
authors.forename: John R
authors.initials: JR
authors.lastname: Blosnich
authors.affiliation: Department of Epidemiology, College for Public Health & Social Justice, Saint Louis University, St. Louis, Missouri.
authors.forename: Grant W
authors.initials: GW
authors.lastname: Farmer
authors.affiliation: Department of Health Behavior, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
authors.forename: Joseph G L
authors.initials: JG
authors.lastname: Lee
authors.affiliation: Department of Psychiatry, School of Medicine & Dentistry, University of Rochester, Rochester, New York.
authors.forename: Vincent M B
authors.initials: VM
authors.lastname: Silenzio
authors.affiliation: Department of Community Health Sciences, School of Public Health, Boston University, Boston, Massachusetts.
authors.forename: Deborah J
authors.initials: DJ
authors.lastname: Bowen
mesh_terms: D000328:Adult; D040343:Behavioral Risk Factor Surveillance System; D055088:Early Detection of Cancer / Q000706:statistics & numerical data; D005260:Female; D015438:Health Behavior; D006296:Health Services / Q000706:statistics & numerical data; D054624:Health Status Disparities; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D008913:Minority Groups / Q000523:psychology / Q000706:statistics & numerical data*; D012309:Risk-Taking; D012737:Sex Factors; D019529:Sexuality / Q000523:psychology / Q000706:statistics & numerical data*