IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v244y2020ics0277953619304575.html
   My bibliography  Save this article

Structural stigma and all-cause mortality among sexual minorities: Differences by sexual behavior?

Author

Listed:
  • Hatzenbuehler, Mark L.
  • Rutherford, Caroline
  • McKetta, Sarah
  • Prins, Seth J.
  • Keyes, Katherine M.

Abstract

Using updated data from the General Social Survey/National Death Index (GSS/NDI) study, we examined whether the relationship between structural stigma—measured by aggregating 4 items assessing prejudice towards homosexuality to the community level—and all-cause mortality is present among gay men/lesbian women. Our hypothesis is based on emerging evidence that indicators of structural stigma specific to homosexuality, such as those used in the GSS/NDI, uniquely predict health outcomes among this group. Because the GSS/NDI lacked an identity-based measure of sexual orientation, we tested our hypothesis by employing a strategy that has a relatively high degree of sensitivity and specificity for ascertaining individuals most likely to identify as gay or lesbian: restricting analyses to individuals who reported same-sex sexual partners in the past year. We compared this approach against an alternative strategy, which has weaker specificity for identifying gay men/lesbian women: restricting analyses to individuals who reported any lifetime same-sex sexual behaviors. After controlling for 6 individual-level factors and fixed effects of survey year, structural stigma was associated with mortality among individuals who reported past-year same-sex sexual partners (HR = 1.95, 95% CI: 1.14, 3.31). Further, there was a dose-response relationship with mortality in this group, such that those residing in communities in the highest quartile of structural stigma had the greatest mortality risk, controlling for these same factors (HR = 2.12, 95% CI: 1.03, 4.38). In sensitivity analyses, the effect size for structural stigma ranged from 1.54 to 2.30, indicating a consistent, but small-to-moderate, effect. In contrast, no association between structural stigma and mortality was observed among respondents who reported lifetime same-sex sexual partners, nor among those reporting only opposite-sex sexual partners. This analysis therefore delimits potential boundary conditions of the association between structural stigma related to same-sex sexuality and all-cause mortality, highlighting the conditions under which this association is (and is not) observed.

Suggested Citation

  • Hatzenbuehler, Mark L. & Rutherford, Caroline & McKetta, Sarah & Prins, Seth J. & Keyes, Katherine M., 2020. "Structural stigma and all-cause mortality among sexual minorities: Differences by sexual behavior?," Social Science & Medicine, Elsevier, vol. 244(C).
    • Handle: RePEc:eee:socmed:v:244:y:2020:i:c:s0277953619304575
    DOI: 10.1016/j.socscimed.2019.112463
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277953619304575
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.socscimed.2019.112463?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Morey, Brittany N. & Gee, Gilbert C. & Muennig, Peter & Hatzenbuehler, Mark L., 2018. "Community-level prejudice and mortality among immigrant groups," Social Science & Medicine, Elsevier, vol. 199(C), pages 56-66.
    2. Bostwick, W.B. & Boyd, C.J. & Hughes, T.L. & McCabe, S.E., 2010. "Dimensions of sexual orientation and the prevalence of mood and anxiety disorders in the United States," American Journal of Public Health, American Public Health Association, vol. 100(3), pages 468-475.
    3. Diane Lauderdale, 2006. "Birth outcomes for Arabic-named women in California before and after September 11," Demography, Springer;Population Association of America (PAA), vol. 43(1), pages 185-201, February.
    4. Hatzenbuehler, Mark L. & Bellatorre, Anna & Lee, Yeonjin & Finch, Brian K. & Muennig, Peter & Fiscella, Kevin, 2014. "Structural stigma and all-cause mortality in sexual minority populations," Social Science & Medicine, Elsevier, vol. 103(C), pages 33-41.
    5. Lee, Y. & Muennig, P. & Kawachi, I. & Hatzenbuehler, M.L., 2015. "Effects of racial prejudice on the health of communities: A multilevel survival analysis," American Journal of Public Health, American Public Health Association, vol. 105(11), pages 2349-2355.
    6. Berg, Rigmor C. & Ross, Michael W. & Weatherburn, Peter & Schmidt, Axel J., 2013. "Structural and environmental factors are associated with internalised homonegativity in men who have sex with men: Findings from the European MSM Internet Survey (EMIS) in 38 countries," Social Science & Medicine, Elsevier, vol. 78(C), pages 61-69.
    7. Ross, L.E. & Dobinson, C. & Eady, A., 2010. "Perceived determinants of mental health for bisexual people: A qualitative examination," American Journal of Public Health, American Public Health Association, vol. 100(3), pages 496-502.
    8. Regnerus, Mark, 2017. "Is structural stigma's effect on the mortality of sexual minorities robust? A failure to replicate the results of a published study," Social Science & Medicine, Elsevier, vol. 188(C), pages 157-165.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Jennifer R. Pharr & Lung-Chang Chien & Maxim Gakh & Jason D. Flatt & Krystal Kittle & Emylia Terry, 2022. "Moderating Effect of Community and Individual Resilience on Structural Stigma and Suicidal Ideation among Sexual and Gender Minority Adults in the United States," IJERPH, MDPI, vol. 19(21), pages 1-13, November.
    2. Everett, Bethany G. & Wall, Melanie & Shea, Eileen & Hughes, Tonda L., 2021. "Mortality risk among a sample of sexual minority women: A focus on the role of sexual identity disclosure," Social Science & Medicine, Elsevier, vol. 272(C).

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Morey, Brittany N. & Gee, Gilbert C. & Muennig, Peter & Hatzenbuehler, Mark L., 2018. "Community-level prejudice and mortality among immigrant groups," Social Science & Medicine, Elsevier, vol. 199(C), pages 56-66.
    2. Brown, Dustin C, 2019. "Comparability of Mortality Estimates from Social Surveys and Vital Statistics Data in the United States," SocArXiv x9f5y, Center for Open Science.
    3. Dustin C. Brown & Joseph T. Lariscy & Lucie Kalousová, 2019. "Comparability of Mortality Estimates from Social Surveys and Vital Statistics Data in the United States," Population Research and Policy Review, Springer;Southern Demographic Association (SDA), vol. 38(3), pages 371-401, June.
    4. Morey, Brittany N. & García, San Juanita & Nieri, Tanya & Bruckner, Tim A. & Link, Bruce G., 2021. "Symbolic disempowerment and Donald Trump's 2016 presidential election: Mental health responses among Latinx and white populations," Social Science & Medicine, Elsevier, vol. 289(C).
    5. Hatzenbuehler, Mark L. & Bellatorre, Anna & Lee, Yeonjin & Finch, Brian K. & Muennig, Peter & Fiscella, Kevin, 2014. "Structural stigma and all-cause mortality in sexual minority populations," Social Science & Medicine, Elsevier, vol. 103(C), pages 33-41.
    6. Thu T. Nguyen & Shaniece Criss & Amani M. Allen & M. Maria Glymour & Lynn Phan & Ryan Trevino & Shrikha Dasari & Quynh C. Nguyen, 2019. "Pride, Love, and Twitter Rants: Combining Machine Learning and Qualitative Techniques to Understand What Our Tweets Reveal about Race in the US," IJERPH, MDPI, vol. 16(10), pages 1-19, May.
    7. Persson, Tonje J. & Pfaus, James G. & Ryder, Andrew G., 2015. "Explaining mental health disparities for non-monosexual women: Abuse history and risky sex, or the burdens of non-disclosure?," Social Science & Medicine, Elsevier, vol. 128(C), pages 366-373.
    8. Francisco Perales, 2016. "The Costs of Being “Different”: Sexual Identity and Subjective Wellbeing over the Life Course," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 127(2), pages 827-849, June.
    9. Perales, Francisco & Todd, Abram, 2018. "Structural stigma and the health and wellbeing of Australian LGB populations: Exploiting geographic variation in the results of the 2017 same-sex marriage plebiscite," Social Science & Medicine, Elsevier, vol. 208(C), pages 190-199.
    10. Diane Coffey & Ashwini Deshpande & Jeffrey Hammer & Dean Spears, 2019. "Local Social Inequality, Economic Inequality, and Disparities in Child Height in India," Demography, Springer;Population Association of America (PAA), vol. 56(4), pages 1427-1452, August.
    11. Johnston, David W. & Lordan, Grace, 2012. "Discrimination makes me sick! An examination of the discrimination–health relationship," Journal of Health Economics, Elsevier, vol. 31(1), pages 99-111.
    12. Winskell, Kate & Sabben, Gaëlle, 2016. "Sexual stigma and symbolic violence experienced, enacted, and counteracted in young Africans’ writing about same-sex attraction," Social Science & Medicine, Elsevier, vol. 161(C), pages 143-150.
    13. Petra Persson & Maya Rossin-Slater, 2018. "Family Ruptures, Stress, and the Mental Health of the Next Generation," American Economic Review, American Economic Association, vol. 108(4-5), pages 1214-1252, April.
    14. Samari, Goleen & Catalano, Ralph & Alcalá, Héctor E. & Gemmill, Alison, 2020. "The Muslim Ban and preterm birth: Analysis of U.S. vital statistics data from 2009 to 2018," Social Science & Medicine, Elsevier, vol. 265(C).
    15. Nobles, Jenna & Brown, Ryan & Catalano, Ralph, 2010. "National independence, women's political participation, and life expectancy in Norway," Social Science & Medicine, Elsevier, vol. 70(9), pages 1350-1357, May.
    16. Daniel Ramirez & Steven A. Haas, 2022. "Windows of Vulnerability: Consequences of Exposure Timing during the Dutch Hunger Winter," Population and Development Review, The Population Council, Inc., vol. 48(4), pages 959-989, December.
    17. Carlson, Kyle, 2015. "Fear itself: The effects of distressing economic news on birth outcomes," Journal of Health Economics, Elsevier, vol. 41(C), pages 117-132.
    18. Slaughter-Acey, Jaime C. & Brown, Tony N. & Keith, Verna M. & Dailey, Rhonda & Misra, Dawn P., 2020. "A tale of two generations: Maternal skin color and adverse birth outcomes in Black/African American women," Social Science & Medicine, Elsevier, vol. 265(C).
    19. Christopher S. Carpenter & Gilbert Gonzales Jr. & Tara McKay & Dario Sansone, 2020. "Effects of the Affordable Care Act Dependent Coverage Mandate on Health Insurance Coverage for Individuals in Same-Sex Couples," NBER Working Papers 26978, National Bureau of Economic Research, Inc.
    20. Stearns, Jenna, 2015. "The effects of paid maternity leave: Evidence from Temporary Disability Insurance," Journal of Health Economics, Elsevier, vol. 43(C), pages 85-102.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:244:y:2020:i:c:s0277953619304575. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.