title: Is structural stigma's effect on the mortality of sexual minorities robust? A failure to replicate the results of a published study.
abstract: The study of stigma's influence on health has surged in recent years. Hatzenbuehler et al.'s (2014) study of structural stigma's effect on mortality revealed an average of 12 years' shorter life expectancy for sexual minorities who resided in communities thought to exhibit high levels of anti-gay prejudice, using data from the 1988-2002 administrations of the US General Social Survey linked to mortality outcome data in the 2008 National Death Index.
  
  
  
  In the original study, the key predictor variable (structural stigma) led to results suggesting the profound negative influence of structural stigma on the mortality of sexual minorities. Attempts to replicate the study, in order to explore alternative hypotheses, repeatedly failed to generate the original study's key finding on structural stigma. Efforts to discern the source of the disparity in results revealed complications in the multiple imputation process for missing values of the components of structural stigma. This prompted efforts at replication using 10 different imputation approaches.
  
  
  
  Efforts to replicate Hatzenbuehler et al.'s (2014) key finding on structural stigma's notable influence on the premature mortality of sexual minorities, including a more refined imputation strategy than described in the original study, failed. No data imputation approach yielded parameters that supported the original study's conclusions. Alternative hypotheses, which originally motivated the present study, revealed little new information.
  
  
  
  Ten different approaches to multiple imputation of missing data yielded none in which the effect of structural stigma on the mortality of sexual minorities was statistically significant. Minimally, the original study's structural stigma variable (and hence its key result) is so sensitive to subjective measurement decisions as to be rendered unreliable.
authors.affiliation: Department of Sociology, University of Texas at Austin, 305 E 23rd St, A1700, Austin, TX 78712-1086, USA; Austin Institute for the Study of Family and Culture, 2021 Guadalupe St., Suite 260, Austin, TX 78705, USA. Electronic address: regnerus@prc.utexas.edu.
authors.forename: Mark
authors.initials: M
authors.lastname: Regnerus
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality; D012107:Research Design / Q000592:standards*; D012307:Risk Factors; D000072339:Sexual and Gender Minorities; D064890:Social Determinants of Health / Q000639:trends*; D063508:Social Discrimination; D057545:Social Stigma
keywords: Data imputation; Mortality; Prejudice; Replication; Scientific transparency; Sexual orientation; Stigma; United States