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State-level policies and psychiatric morbidity in lesbian, gay, and bisexual populations

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  • Hatzenbuehler, M.L.
  • Keyes, K.M.
  • Hasin, D.S.

Abstract

Objectives. We investigated the modifying effect of state-level policies on the association between lesbian, gay, or bisexual status and the prevalence of psychiatric disorders. Methods. Data were from wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), a nationally representative study of noninstitutionalized US adults (N=34653). States were coded for policies extending protections against hate crimes and employment discrimination based on sexual orientation. Results. Compared with living in states with policies extending protections, living in states without these policies predicted a significantly stronger association between lesbian, gay, or bisexual status and psychiatric disorders in the past 12 months, including generalized anxiety disorder (F=3.87; df=2; P=.02), post-traumatic stress disorder (F=3.42; df =2; P=.04), and dysthymia (F=5.20; df =2; P=.02). Living in states with policies that did not extend protections also predicted a stronger relation between lesbian, gay, or bisexual status and psychiatric comorbidity (F=2.47; df =2; P=.04). Conclusions. State-level protective policies modify the effect of lesbian, gay, or bisexual status on psychiatric disorders. Policies that reduce discrimination against gays and lesbians are urgently needed to protect the health and well-being of this population.

Suggested Citation

  • Hatzenbuehler, M.L. & Keyes, K.M. & Hasin, D.S., 2009. "State-level policies and psychiatric morbidity in lesbian, gay, and bisexual populations," American Journal of Public Health, American Public Health Association, vol. 99(12), pages 2275-2281.
    • Handle: RePEc:aph:ajpbhl:10.2105/ajph.2008.153510_6
    DOI: 10.2105/AJPH.2008.153510
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    Cited by:

    1. Ludwing Flórez-Salamanca & Edwin Herazo & Heidi Celina Oviedo & Adalberto Campo-Arias, 2014. "Prevalence and Predictors of High Sexual Prejudice Among Medical Students From Two Colombian Cities," SAGE Open, , vol. 4(2), pages 21582440145, June.
    2. Wendy D. Manning & Susan L. Brown & J. Bart Stykes, 2016. "Same-Sex and Different-Sex Cohabiting Couple Relationship Stability," Demography, Springer;Population Association of America (PAA), vol. 53(4), pages 937-953, August.
    3. Sansone, Dario, 2019. "Pink work: Same-sex marriage, employment and discrimination," Journal of Public Economics, Elsevier, vol. 180(C).
    4. 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.
    5. Giorgia Lorenzi & Marina Miscioscia & Lucia Ronconi & Caterina Elisa Pasquali & Alessandra Simonelli, 2015. "Internalized Stigma and Psychological Well-Being in Gay Men and Lesbians in Italy and Belgium," Social Sciences, MDPI, vol. 4(4), pages 1-14, December.
    6. Marius Baranauskas & Ingrida Kupčiūnaitė & Rimantas Stukas, 2022. "Psychoactive Substance Effect on Mental Health and Well-Being Focusing on Student-Aged Lithuanian Cohort of Sexual Minorities," Sustainability, MDPI, vol. 14(20), pages 1-16, October.
    7. Pachankis, John E. & Hatzenbuehler, Mark L. & Starks, Tyrel J., 2014. "The influence of structural stigma and rejection sensitivity on young sexual minority men's daily tobacco and alcohol use," Social Science & Medicine, Elsevier, vol. 103(C), pages 67-75.
    8. Thomeer, Mieke Beth & Reczek, Corinne & Umberson, Debra, 2015. "Relationship dynamics around depression in gay and lesbian couples," Social Science & Medicine, Elsevier, vol. 147(C), pages 38-46.
    9. Russell Spiker, 2021. "Same-Sex, Same Health? Health Concordance Among Same-Sex and Different-Sex Couples," Population Research and Policy Review, Springer;Southern Demographic Association (SDA), vol. 40(6), pages 1313-1340, December.
    10. White Hughto, Jaclyn M. & Reisner, Sari L. & Pachankis, John E., 2015. "Transgender stigma and health: A critical review of stigma determinants, mechanisms, and interventions," Social Science & Medicine, Elsevier, vol. 147(C), pages 222-231.
    11. Egemen Hanimoglu, 2019. "Stigmatization and Suicide Vulnerability in LGBT Students: Inquiry and Recommendations," Journal of Education and e-Learning Research, Asian Online Journal Publishing Group, vol. 6(2), pages 45-51.
    12. Ethan C Cicero & Sari L Reisner & Elizabeth I Merwin & Janice C Humphreys & Susan G Silva, 2020. "The health status of transgender and gender nonbinary adults in the United States," PLOS ONE, Public Library of Science, vol. 15(2), pages 1-20, February.
    13. Diederik Boertien & Fabrizio Bernardi, 2019. "Same-Sex Parents and Children’s School Progress: An Association That Disappeared Over Time," Demography, Springer;Population Association of America (PAA), vol. 56(2), pages 477-501, April.
    14. Solazzo, Alexa & Brown, Tony N. & Gorman, Bridget K., 2018. "State-level climate, anti-discrimination law, and sexual minority health status: An ecological study," Social Science & Medicine, Elsevier, vol. 196(C), pages 158-165.
    15. 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.
    16. Diederik Boertien & Daniele Vignoli, 2019. "Legalizing Same-Sex Marriage Matters for the Subjective Well-being of Individuals in Same-Sex Unions," Demography, Springer;Population Association of America (PAA), vol. 56(6), pages 2109-2121, December.
    17. Everett, Bethany G. & Hatzenbuehler, Mark L. & Hughes, Tonda L., 2016. "The impact of civil union legislation on minority stress, depression, and hazardous drinking in a diverse sample of sexual-minority women: A quasi-natural experiment," Social Science & Medicine, Elsevier, vol. 169(C), pages 180-190.
    18. Lukachko, Alicia & Hatzenbuehler, Mark L. & Keyes, Katherine M., 2014. "Structural racism and myocardial infarction in the United States," Social Science & Medicine, Elsevier, vol. 103(C), pages 42-50.
    19. Hatzenbuehler, Mark L. & Prins, Seth J. & Flake, Morgan & Philbin, Morgan & Frazer, M. Somjen & Hagen, Daniel & Hirsch, Jennifer, 2017. "Immigration policies and mental health morbidity among Latinos: A state-level analysis," Social Science & Medicine, Elsevier, vol. 174(C), pages 169-178.
    20. Michael Chaiton & Rebecca Billington & Ilana Copeland & Luc Grey & Alex Abramovich, 2022. "Mental Health and Addiction Services Exclusive to LGBTQ2S+ during COVID-19: An Environmental Scan," IJERPH, MDPI, vol. 19(10), pages 1-16, May.
    21. Reid, Allecia E. & Dovidio, John F. & Ballester, Estrellita & Johnson, Blair T., 2014. "HIV prevention interventions to reduce sexual risk for African Americans: The influence of community-level stigma and psychological processes," Social Science & Medicine, Elsevier, vol. 103(C), pages 118-125.
    22. Barbara F. Prince & Kara Joyner & Wendy D. Manning, 2020. "Sexual Minorities, Social Context, and Union Formation," Population Research and Policy Review, Springer;Southern Demographic Association (SDA), vol. 39(1), pages 23-45, February.
    23. Melissa M. Barnhill & Joseph G. L. Lee & Ann P. Rafferty, 2017. "Health Inequities among Lesbian, Gay, and Bisexual Adults in North Carolina, 2011–2014," IJERPH, MDPI, vol. 14(8), pages 1-10, July.
    24. Gilbert Gonzales & Jesse M. Ehrenfeld, 2018. "The Association between State Policy Environments and Self-Rated Health Disparities for Sexual Minorities in the United States," IJERPH, MDPI, vol. 15(6), pages 1-11, June.

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