scholarly journals Untethered lives: Barriers to societal integration as predictors of the sexual orientation disparity in suicidality

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
R Bränström ◽  
A van der Star ◽  
J E Pachankis
Keyword(s):  
Risk Factors ◽  
Sexual Orientation ◽  
Sexual Minorities ◽  
Social Institutions ◽  
Cross Sectional ◽  
National Public Health ◽  
Public Health Survey ◽  
And Bisexual ◽  
Orientation Disparity

Abstract Background Despite increasing legal protections and supportive attitudes toward sexual minorities (e.g., those who identify as lesbian, gay, and bisexual [LGB]) in recent decades, suicidality remains more common among this population than among heterosexuals. While barriers to societal integration have been widely theorized as determinants of suicidality for the general population, they have not been comprehensively explored to explain the sexual orientation disparity in suicidality and/or compared to more established contributors. Methods Data come from the cross-sectional Swedish National Public Health Survey, which randomly collected data from individuals (16-84 years of age) annually from 2010 to 2015 (1,281 (2.2%) self-identified as LGB). Analyses examined sexual orientation differences in suicidality (i.e., past-12-month ideation and attempts), and explored the role of barriers to societal integration (i.e., not living with a partner or children, unemployment, and lack of societal trust) in explaining this disparity over-and-above more commonly explored psychological (e.g., depression, substance use) and interpersonal (e.g., discrimination, victimization, lack of social support) suicidality risk factors. Results Compared to heterosexuals, suicidal ideation and attempts were more common among both gay men/lesbians (AORideation: 2.51; AORattempts: 4.66), and bisexuals (AORideation: 3.76; AORattempts: 6.06). Barriers to societal integration mediated the association between sexual orientation and suicidality even in models adjusting for established risk factors for suicidality. Conclusions The disproportionate barriers to societal integration that LGB individuals experience seem important contributors to the elevated risk of suicidality among sexual minorities. Preventive interventions should consider innovative ways to foster societal integration within sexual minority populations and to adjust hetero-centric social institutions to better include sexual minorities.

scholarly journals Teen Pregnancy Risk Factors Among Young Women of Diverse Sexual Orientations

2021 ◽  
pp. 49-58
Author(s):  
Brittany M. Charlton ◽  
Andrea L. Roberts ◽  
Margaret Rosario ◽  
Sabra L. Katz-Wise ◽  
Jerel P. Calzo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Sexual Orientation ◽  
Young Women ◽  
Sexual Minority ◽  
Teen Pregnancy ◽  
Childhood Maltreatment ◽  
Sexual Minorities ◽  
Developmental Milestones ◽  
Pregnancy Risk ◽  
And Bisexual

OBJECTIVES Young women who are sexual minorities (eg, bisexual and lesbian) are approximately twice as likely as those who are heterosexual to have a teen pregnancy. Therefore, we hypothesized that risk factors for teen pregnancy would vary across sexual orientation groups and that other potential risk factors exist that are unique to sexual minorities. METHODS We used multivariable log-binomial models gathered from 7120 young women in the longitudinal cohort known as the Growing Up Today Study to examine the following potential teen pregnancy risk factors: childhood maltreatment, bullying victimization and perpetration, and gender nonconformity. Among sexual minorities, we also examined the following: sexual minority developmental milestones, sexual orientation–related stress, sexual minority outness, and lesbian, gay, and bisexual social activity involvement. RESULTS Childhood maltreatment and bullying were significant teen pregnancy risk factors among all participants. After adjusting for childhood maltreatment and bullying, the sexual orientation–related teen pregnancy disparities were attenuated; these risk factors explained 45% of the disparity. Among sexual minorities, reaching sexual minority developmental milestones earlier was also associated with an increased teen pregnancy risk. CONCLUSIONS The higher teen pregnancy prevalence among sexual minorities compared with heterosexuals in this cohort was partially explained by childhood maltreatment and bullying, which may, in part, stem from sexual orientation–related discrimination. Teen pregnancy prevention efforts that are focused on risk factors more common among young women who are sexual minorities (eg, childhood maltreatment, bullying) can help to reduce the existing sexual orientation–related teen pregnancy disparity.

Psychological Resilience Provides No Independent Protection From Suicidal Risk

Crisis ◽  
2016 ◽  
Vol 37 (2) ◽  
pp. 130-139 ◽  
Author(s):  
Danica W. Y. Liu ◽  
A. Kate Fairweather-Schmidt ◽  
Richard Burns ◽  
Rachel M. Roberts ◽  
Kaarin J. Anstey
Keyword(s):  
Risk Factors ◽  
Well Being ◽  
Current Status ◽  
Psychological Resilience ◽  
Cross Sectional ◽  
Life Project ◽  
Resilience Factors ◽  
First Time

Abstract. Background: Little is known about the role of resilience in the likelihood of suicidal ideation (SI) over time. Aims: We examined the association between resilience and SI in a young-adult cohort over 4 years. Our objectives were to determine whether resilience was associated with SI at follow-up or, conversely, whether SI was associated with lowered resilience at follow-up. Method: Participants were selected from the Personality and Total Health (PATH) Through Life Project from Canberra and Queanbeyan, Australia, aged 28–32 years at the first time point and 32–36 at the second. Multinomial, linear, and binary regression analyses explored the association between resilience and SI over two time points. Models were adjusted for suicidality risk factors. Results: While unadjusted analyses identified associations between resilience and SI, these effects were fully explained by the inclusion of other suicidality risk factors. Conclusion: Despite strong cross-sectional associations, resilience and SI appear to be unrelated in a longitudinal context, once risk/resilience factors are controlled for. As independent indicators of psychological well-being, suicidality and resilience are essential if current status is to be captured. However, the addition of other factors (e.g., support, mastery) makes this association tenuous. Consequently, resilience per se may not be protective of SI.

scholarly journals Revisiting Konzo Risk Factors in Three Areas Differently Affected by Spastic Paraparesis in Eastern Democratic Republic of the Congo Discloses a Prominent Role of the Nutritional Status—A Comparative Cross-Sectional Study

Nutrients ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 2628
Author(s):  
Marius Baguma ◽  
Espoir Bwenge Malembaka ◽  
Esto Bahizire ◽  
Germain Zabaday Mudumbi ◽  
Dieudonné Bahati Shamamba ◽  
...  
Keyword(s):  
Risk Factors ◽  
Nutritional Status ◽  
Democratic Republic ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cyanide Poisoning ◽  
Cross Sectional ◽  
High Prevalence ◽  
Republic Of The Congo

This comparative cross-sectional study aimed to better understand the respective contributions of protein malnutrition and cassava-derived cyanide poisoning in the development of konzo. We compared data on nutritional status and cyanide exposure of school-age adolescent konzo-diseased patients to those of non-konzo subjects of similar age from three areas in the Eastern Democratic Republic of the Congo. Our results show that konzo patients had a high prevalence of both wasting (54.5%) and stunting (72.7%), as well as of cyanide poisoning (81.8%). Controls from Burhinyi and those from Idjwi showed a similar profile with a low prevalence of wasting (3.3% and 6.5%, respectively) and intermediate prevalence of stunting (26.7% and 23.9%, respectively). They both had a high prevalence of cyanide poisoning (50.0% and 63.0%, respectively), similar to konzo-patients. On the other hand, controls from Bukavu showed the lowest prevalence of both risk factors, namely chronic malnutrition (12.1%) and cyanide poisoning (27.6%). In conclusion, cassava-derived cyanide poisoning does not necessarily coexist with konzo outbreaks. The only factor differentiating konzo patients from healthy individuals exposed to cyanide poisoning appeared to be their worse nutritional status. This further suggests that, besides the known role of cyanide poisoning in the pathogenesis of konzo, malnutrition may be a key factor for the disease occurrence.

scholarly journals AB0407 CARDIOVASCULAR BURDEN IN SYSTEMIC SCLEROSIS: QRISK3 VERSUS FRAMINGHAM FOR RISK ESTIMATION

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1232.1-1232
Author(s):  
M. Di Battista ◽  
S. Barsotti ◽  
A. Della Rossa ◽  
M. Mosca
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Systemic Sclerosis ◽  
High Risk ◽  
General Population ◽  
Risk Score ◽  
Predictive Accuracy ◽  
Risk Estimation ◽  
Cross Sectional

Background:Cardiovascular (CV) diseases, namely myocardial infarction and stroke, are not among the most known and frequent complications of systemic sclerosis (SSc), but there is growing evidence that SSc patients have a higher prevalence of CV diseases than the general population [1].Objectives:To compare two algorithms for CV risk estimation in a cohort of patients with SSc, finding any correlation with clinical characteristics of the disease.Methods:SSc patients without previous myocardial infarction or stroke were enrolled. Traditional CV risk factors, SSc-specific characteristics and ongoing therapies were assessed. Framingham and QRISK3 algorithms were then used to estimate the risk of develop a CV disease over the next 10 years.Results:Fifty-six SSc patients were enrolled. Framingham reported a median risk score of 9.6% (IQR 8.5), classifying 24 (42.9%) subjects at high risk, with a two-fold increase of the mean relative risk in comparison to general population. QRISK3 showed a median risk score of 15.8% (IQR 19.4), with 36 (64.3%) patients considered at high-risk. Both algorithms revealed a significant role of some traditional risk factors and a noteworthy potential protective role of endothelin receptor antagonists (p=0.003). QRISK3 was also significantly influenced by some SSc-specific characteristics, as limited cutaneous subset (p=0.01), interstitial lung disease (p=0.04) and non-ischemic heart involvement (p=0.03), with the first two that maintain statistically significance in the multivariate analysis (p=0.02 for both).Conclusion:QRISK3 classifies more SSc patients at high-risk to develop CV diseases than Framingham, and it seems to be influenced by some SSc-specific characteristics. If its predictive accuracy were prospectively verified, the use of QRISK3 as a tool in the early detection of SSc patients at high CV risk should be recommended.References:[1]Ngian GS, Sahhar J, Proudman SM, Stevens W, Wicks IP, Van Doornum S. Prevalence of coronary heart disease and cardiovascular risk factors in a national cross-sectional cohort study of systemic sclerosis. Ann Rheum Dis. 2012;71:1980-3.Disclosure of Interests:None declared

Abstract P001: LGB Health Disparities: Examining the Status of Ideal Cardiovascular Health From the 2011-2012 NHANES Survey

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Anshul Saxena ◽  
Muni Rubens ◽  
Sankalp Das ◽  
Tanuja Rajan ◽  
Gowtham Grandhi ◽  
...  
Keyword(s):  
Sexual Orientation ◽  
Cardiovascular Health ◽  
Cross Sectional Study ◽  
Minority Populations ◽  
Sectional Study ◽  
Cross Sectional ◽  
Ideal Cardiovascular Health ◽  
The Status ◽  
Nationally Representative ◽  
And Bisexual

Objectives: Extensive data suggests that lesbian, gay and bisexual (LGB) adults are more likely to experience adverse cardiovascular outcomes relative to heterosexuals. However, evidence regarding cardiovascular health (CVH) disparities and sexual orientation is scarce. The aim of this study was to examine the distribution of CVH metrics in a US nationally representative population of heterosexual (HT), and LGB adults. Methods: This cross-sectional study analyzed 2445 participants (representing 115 million) adults aged 18 or over years in the 2011-2012 NHANES survey. The CVH factors of smoking, body mass index (BMI), physical activity (PA), diet, blood pressure (BP), total cholesterol (TC) and glucose (GLU) were measured. Each CVH factor was then classified as ideal; intermediate; or poor. Ideal CVH was defined as presence of >=5 ideal CVH metrics. Results: 95.1% of the weighted sample self-identified as HT (95% CI: 93.5%, 96.6%) compared to 4.9% (95%: 3.3%, 6.5%) LGB. The figure illustrates the distribution of each of the 7 CVH categories according to sexual orientation. In age, gender, and race adjusted analysis, LGB individuals were 36% (AOR: 0.64; 95%: 0.29, 1.4; p > 0.05) less likely to have ideal CVH compared to HT. These proportions go higher after adjusting for age. Conclusions: The results suggest that LGB individuals face a higher risk of being in the category for poor cardiovascular health compared to heterosexuals. Evidence suggests that there are sexual orientation disparities among adults. If confirmed in other studies, results point towards disproportionately higher risk for cardiovascular disease among sexual-minority populations. Figure

scholarly journals Coming Out to Parents in Lesbian and Bisexual Women: The Role of Internalized Sexual Stigma and Positive LB Identity

2020 ◽  
Vol 11 ◽  
Author(s):  
Roberto Baiocco ◽  
Jessica Pistella ◽  
Mara Morelli
Keyword(s):  
Sexual Orientation ◽  
Coming Out ◽  
Future Research ◽  
Lesbian Women ◽  
Bisexual Women ◽  
Sexual Stigma ◽  
Positive Identity ◽  
And Bisexual ◽  
Internalized Sexual Stigma

The experience of “coming out” (CO) to parents is often a crucial event in the lives of lesbian and bisexual (LB) women, associated with lower internalized sexual stigma (ISS) and higher positive LB identity. Few studies have compared the experiences of LB women in the CO process. Rather, most prior research has either: (1) not addressed bisexuality or eliminated bisexual individuals from the analysis; (2) combined bisexual women and bisexual men in the same sexual orientation group; or (3) examined bisexual participants alongside lesbian women and gay men, using a single monolithic measure. Thus, the present research aimed at investigating the role of ISS and positive LB identity in inhibiting or encouraging CO to parents in a sample of 241 lesbian women (Mage = 27.61, SD = 7.19) and 186 bisexual women (Mage = 25.23, SD = 5.81), aged 18–40 years. Most participants reported that they had already revealed their sexual orientation to their mother (69%) and their father (52%). More lesbian women had CO to both their mother and their father than had bisexual women. These lesbian women reported lower levels of ISS and higher levels of LB positive identity relative to bisexual women. On average, CO to mothers occurred at age 20 (SD = 5.54), while CO to fathers occurred at age 22 (SD = 5.63). LB women did not differ in the average age of CO to mothers or fathers, or in parental reactions to CO. Finally, ISS was found to affect the process of CO to both parents via positive identity (bootstrapping estimate = −0.26, SE = 0.08, 95% CI = −0.43, 0.11), whereas sexual orientation was not found to moderate the path from ISS to CO to both parents. The present study contributes to our understanding of the differences between LB women when developing their sexual orientation, highlighting the relevance of a positive LB identity for CO to parents. Research and clinical implications and directions for future research are discussed.

scholarly journals Sexual orientation identity and tobacco and hazardous alcohol use: findings from a cross-sectional English population survey

BMJ Open ◽  
2017 ◽  
Vol 7 (10) ◽  
pp. e015058 ◽  
Author(s):  
Lion Shahab ◽  
Jamie Brown ◽  
Gareth Hagger-Johnson ◽  
Susan Michie ◽  
Joanna Semlyen ◽  
...  
Keyword(s):  
Sexual Orientation ◽  
Alcohol Use ◽  
Tobacco Use ◽  
Sexual Minority ◽  
Omnibus Test ◽  
Hazardous Alcohol Use ◽  
Cross Sectional ◽  
Sexual Minority Men ◽  
Hazardous Alcohol ◽  
And Bisexual

ObjectivesTo assess the association between tobacco and hazardous alcohol use and sexual orientation and whether such an association could be explained by other sociodemographic characteristics.DesignCross-sectional household survey conducted in 2014–2016.SettingEngland, UK.ParticipantsRepresentative English population sample (pooled n=43 866).Main outcomesSexual orientation identity (lesbian/gay, bisexual, heterosexual, prefer-not-to-say); current tobacco and hazardous alcohol use (defined as Alcohol Use Disorders Identification Test Score ≥8). All outcomes were self-reported.ResultsDue to interactions between sexual orientation and gender for substance use, analyses were stratified by gender. Tobacco use prevalence was significantly higher among lesbian/gay (women: 24.9%, 95% CI 19.2% to 32.6%; men: 25.9%, 95% CI 21.3% to 31.0%) and bisexual participants (women: 32.4%, 95% CI 25.9% to 39.6%; men: 30.7%, 95% CI 23.7% to 30.7%) and significantly lower for prefer-not-to-say participants in women (15.5%, 95% CI 13.5% to 17.8%) but not men (22.7%, 95% CI 20.3% to 25.3%) compared with heterosexual participants (women: 17.5%, 95% CI 17.0% to 18.0%; men: 20.4%, 95% CI 19.9% to 21.0%; p<0.001 for omnibus test). Similarly, hazardous alcohol use was significantly more prevalent for lesbian/gay (women: 19.0%, 95% CI 14.0% to 25.3%; men: 30.0%, 25.2%–35.3%) and bisexual participants (women: 24.4%, 95% CI 18.7% to 31.3%; men: 24.3%, 95% CI 17.9% to 32.1%) and lower for prefer-not-to-say participants (women: 4.1%, 95% CI 3.0% to 5.4%; men: 13.7%; 95% CI 11.8% to 16.0%) compared with heterosexuals (women: 8.3%, 95% CI 7.9% to 8.7%; men: 18.4%, 95% CI 17.9% to 18.9%; p<0.001 for omnibus test). However, after adjusting for sociodemographic confounders, tobacco use was similar across all sexual orientation groups among both women and men. By contrast, sexual orientation differences in hazardous alcohol use remained even after adjustment among women but not for bisexual and gay men.ConclusionsIn England, higher rates of tobacco use among sexual minority men and women appear to be attributable to other sociodemographic factors. Higher rates of hazardous alcohol use among sexual minority men may also be attributable to these factors, whereas this is not the case for sexual minority women.

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