AGE-RELATED DIFFERENCES IN ASSOCIATIONS BETWEEN SEXUAL ORIENTATION AND HEALTH BEHAVIORS AND OUTCOMES

Abstract

Sexual minorities, such as lesbians, gays, and bisexuals (LGB), face increased marginalization later in life as a function of being in multiple minority status categories, leading to decreased health. Such marginalization may increase with age, yet little is known about how LGB older adults differ from younger adults with respect to health behaviors and outcomes. This study aimed to evaluate age differences in the associations between sexual orientation and health behaviors and outcomes. Data were abstracted from the 2016 Behavioral Risk Factor Surveillance System (N = 198,935) and weighted multivariate logistic regression analysis was used to assess associations between sexual orientation (gay/lesbian and bisexual versus heterosexual) and seven health behaviors and outcomes by 10-year age group. For all age groups, gays/lesbians and bisexuals were significantly more likely to engage in risky behaviors (e.g. smoking, unprotected sex, illicit drug use, etc.) than heterosexuals and the magnitude increased with age (p = 0.006 for trend). The association between depression and sexual orientation was significant for all age groups, but strongest in the 65+ population: (AOR=3.1, 95% CI 2.6–3.7 for gays/lesbians and AOR=1.9 95% CI 1.5–2.3 for bisexuals). Bisexuals were significantly more likely to have poor or fair self-reported health in all age groups except those 55–64. These results underscore key age differences in health behaviors and outcomes among LGB individuals that should be taken into account in tailoring programs and policies to promote health equity in this vulnerable population.