title: Measuring Sexual Orientation: A Review and Critique of U.S. Data Collection Efforts and Implications for Health Policy.
abstract: The U.S. Department of Health and Human Services' (HHS) Healthy People 2020 goals sought to improve health outcomes among sexual minorities; HHS acknowledged that a dearth of sexual orientation items in federal and state health surveys obscured a broad understanding of sexual minority-related health disparities. The HHS 2011 data progression plan aimed to advance sexual orientation data collection efforts at the national level. Sexual orientation is a complex, multidimensional construct often composed of sexual identity, sexual attraction, and sexual behavior, thus posing challenges to its quantitative and practical measurement and analysis. In this review, we (a) present existing sexual orientation constructs; (b) evaluate current HHS sexual orientation data collection efforts; (c) review post-2011 data progression plan research on sexual minority health disparities, drawing on HHS survey data; (d) highlight the importance of and (e) identify obstacles to multidimensional sexual orientation measurement and analysis; and (f) discuss methods for multidimensional sexual orientation analysis and propose a matrix for addressing discordance/branchedness within these analyses. Multidimensional sexual orientation data collection and analysis would elucidate sexual minority-related health disparities, guide related health policies, and enhance population-based estimates of sexual minority individuals to steer health care practices.
authors.affiliation: a Department of Community Health and Social Science , CUNY Graduate School of Public Health and Health Policy.
authors.forename: Margaret
authors.initials: M
authors.lastname: Wolff
authors.affiliation: b Center for Human Sexuality Studies , Widener University.
authors.forename: Brooke
authors.initials: B
authors.lastname: Wells
authors.affiliation: a Department of Community Health and Social Science , CUNY Graduate School of Public Health and Health Policy.|c Department of Physician Assistant Studies , Hofstra University.
authors.forename: Christina
authors.initials: C
authors.lastname: Ventura-DiPersia
authors.affiliation: d Department of Epidemiology and Biostatistics , CUNY Graduate School of Public Health and Health Policy.
authors.forename: Audrey
authors.initials: A
authors.lastname: Renson
authors.affiliation: a Department of Community Health and Social Science , CUNY Graduate School of Public Health and Health Policy.
authors.forename: Christian
authors.initials: C
authors.lastname: Grov
mesh_terms: D003625:Data Collection / Q000379:methods / Q000592:standards*; D006801:Humans; D012725:Sexual Behavior / Q000706:statistics & numerical data*; D014481:United States