title: Disparities in long-term cardiovascular disease risk by sexual identity: The National Longitudinal Study of Adolescent to Adult Health.
abstract: OBJECTIVE
  To examine long-term cardiovascular disease (CVD) risk disparities by sexual identity using a nationally representative sample of young adults in the United States.
  
  
  METHODS
  Data include participants in wave 4 (2008/09; ages 24-34years) of the National Longitudinal Study of Adolescent to Adult Health (7087 females; 6340 males). Sexual identity was self-reported (heterosexual, mostly heterosexual, bisexual, mostly homosexual, homosexual) and a Framingham-based prediction model was used to estimate participants' risk of a CVD event over 30years. Differences in CVD risk by sexual identity, relative to heterosexuals, were calculated with linear regression models adjusted for age, race/ethnicity, education, and financial distress.
  
  
  RESULTS
  Average 30-year CVD risk was 17.2% (95% CI: 16.7, 17.7) in males and 9.0% (95% CI: 8.6, 9.3) in females. Compared to heterosexual females, mostly heterosexual (0.8%; 95% CI: 0.2, 1.4) and mostly homosexual females (2.8%; 95% CI: 0.8, 4.9) had higher CVD risk. Bisexual and homosexual females had higher but not statistically significant CVD risk compared to heterosexuals. Among males, differences in CVD risk by sexual identity were not statistically significant.
  
  
  CONCLUSIONS
  Sexual identity was associated with CVD risk in sexual minority subgroups. Population- and clinic-based prevention strategies are needed to minimize disparities in subsequent disease.
authors: Department of Medicine, Division of Epidemiology and Community Health, Program in Health Disparities Research, University of Minnesota, 717 Delaware Street, SE, Ste 166, Minneapolis, MN 55414, United States. Electronic address: cjclark@umn.edu.
authors: Cari Jo
authors: CJ
authors: Clark
authors: Division of General Pediatrics and Adolescent Health, Department of Pediatrics, University of Minnesota, 717 Delaware St., SE, Ste. 353, Minneapolis, MN 55414, United States. Electronic address: borow004@umn.edu.
authors: Iris W
authors: IW
authors: Borowsky
authors: Rainbow Health Initiative, 2021 E Hennepin Ave #220, Minneapolis, MN 55413, United States. Electronic address: john.salisbury@rainbowhealth.org.
authors: John
authors: J
authors: Salisbury
authors: Rainbow Health Initiative, 2021 E Hennepin Ave #220, Minneapolis, MN 55413, United States. Electronic address: Joann.usher@rainbowhealth.org.
authors: Joann
authors: J
authors: Usher
authors: Independent Researcher, Ponce de Leon Avenue, Atlanta, GA 30308, United States. Electronic address: ralennon@gmail.com.
authors: Rachael A
authors: RA
authors: Spencer
authors: Division of Health Policy & Management, 420 Delaware St. S.E., MMC 729, Minneapolis, MN 55455, United States. Electronic address: prze0009@umn.edu.
authors: Julia M
authors: JM
authors: Przedworski
authors: School of Social Work, University of Minnesota, 105 Peters Hall, 1404 Gortner Avenue, Saint Paul, MN 55108, United States. Electronic address: renn0042@umn.edu.
authors: Lynette M
authors: LM
authors: Renner
authors: School of Social Work, University of Minnesota, 105 Peters Hall, 1404 Gortner Avenue, Saint Paul, MN 55108, United States. Electronic address: cfisher@umn.edu.
authors: Colleen
authors: C
authors: Fisher
authors: Department of Medicine, Program in Health Disparities Research, 717 Delaware St SE, #166, Minneapolis, MN 55414, United States. Electronic address: saer@umn.edu.
authors: Susan A
authors: SA
authors: Everson-Rose
mesh_terms: D000328:Adult; D002318:Cardiovascular Diseases; D005260:Female; D006306:Health Surveys; D054625:Healthcare Disparities; D006801:Humans; D016014:Linear Models; D008137:Longitudinal Studies; D008297:Male; D008913:Minority Groups; D012307:Risk Factors; D012725:Sexual Behavior; D019529:Sexuality; D014481:United States
keywords: Cardiovascular diseases; Health status disparities; Homosexuality