俄亥俄州性少数和性别少数成年人的健康差异

Hannah E. Albrechta, M. Katz, Megan E. Roberts
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摘要

背景:许多与健康行为和获得卫生保健相关的文献差异影响性和性别少数群体(SGM)的健康结果。目前的研究旨在深入了解生活在俄亥俄州的SGM成年人所经历的健康差异,以获得数据来规划未来的健康相关项目。方法:利用2018年俄亥俄州行为风险因素监测系统(BRFSS)数据进行二次数据分析。通过性取向(n=11 301)和性别认同(n=11 426)对健康行为、卫生保健获取和健康结果进行分析,以确定性少数男性、性少数女性和变性者面临的健康差异。结果:俄亥俄州显著的SGM健康差异与物质使用(即酗酒、当前吸烟状况、电子烟使用和大麻使用)有关;身心健康状况不佳;缺乏医疗保险;慢性阻塞性肺病、肺气肿或慢性支气管炎(均p < 0.001)。此外,与异性恋女性相比,少数性取向女性在推荐的乳腺癌筛查指南范围内的报告较少(p < 0.05)。结论:俄亥俄州的性和性别少数成年人报告了与几种健康行为和获得卫生保健相关的差异。这些发现可能是由于患者层面(例如,经历少数民族压力)、提供者层面(例如,隐性偏见)、系统层面(例如,歧视)和/或社会层面(例如,缺乏法律保护)的因素造成的。研究结果将用于计划针对SGM成人和提供者的健康运动和方案,以实现俄亥俄州SGM人口的健康平等。
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Health Disparities Among Sexual and Gender Minority Adults in Ohio
Background: Many documented disparities associated with health behaviors and access to health care impact the health outcomes of sexual and gender minorities (SGM). The current study aimed to gain insight into the health dispari-ties experienced by SGM adults living in Ohio to obtain data to plan future health-related programs. Methods: A secondary data analysis was conducted using 2018 Ohio Behavior Risk Factor Surveillance System (BRFSS) data. Health behaviors, health care access, and health outcomes were analyzed by sexual orientation (n=11 301) and gender identity (n=11 426) to determine health disparities faced by sexual minority males, sexual minority females and transgender individuals. Results: Significant SGM health disparities in Ohio are related to substance use (ie, binge drinking, current smoking status, e-cigarette use, and marijuana use); poor physical and mental health status; lack of health care coverage; and experiencing COPD, emphysema, or chronic bronchitis (all p < 0.001). In addition, fewer sexual minority females reported being within recommended breast cancer screening guidelines than heterosexual females (p < 0.05). Conclusion: Sexual and gender minority adults in Ohio report disparities associated with several health behaviors and access to health care. These findings may be due to factors at the patient level (eg, experiencing minority stress), provider level (eg, implicit bias), system level (eg, discrimination), and/or society level (eg, lack of legal protections). Study results will be used to plan health campaigns and programs targeted to SGM adults and providers to achieve health equity for the SGM population in Ohio.
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