Potential COVID-19 Vulnerabilities in Employment and Healthcare Access by Sexual Orientation

The 2019 coronavirus (COVID-19) pandemic has led to more than 235,000 deaths and 9 million reported positive cases in the United States. Most of the country implemented stay-at-home orders to prevent the spread of COVID-19, which has led to job losses and more than 40 million claims for unemployment insurance. The objective of this study was to estimate the potential impact of COVID-19-related closures in employment and healthcare access by sexual orientation. We used data from the 2015 to 2018 National Health Interview Survey and employment industry codes to describe the working adult population who may be vulnerable to COVID-19 job losses by sexual orientation. Multivariable logistic regression models identified the risk factors for working in a COVID-19-sensitive industry and differences in healthcare access by sexual orientation. We estimate that there may be approximately 1.7 million sexual minorities and 36.6 million heterosexual adults employed in industries that make them vulnerable to unemployment, uninsurance, and limited access to care. Nearly two-thirds of working adults—regardless of sexual orientation—are at risk of severe illness should they become infected with COVID-19. Almost half of the sexual minority and heterosexual adults in industries sensitive to COVID-19 may remain or become uninsured during the pandemic. Approximately 60% of sexual minorities and 40% of heterosexual adults in COVID-19-sensitive industries are renting their home or apartment (rather than owning their home). Because sexual minority adults vulnerable to the COVID-19 pandemic are renting or within family income ranges for premium tax credits in the individual insurance marketplaces, policymakers should consider expanding protections for renters and broadening special enrollment periods for people seeking coverage in the federal and state-based marketplaces.

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Do Socioeconomic Conditions Explain Ethnic Inequalities in Tooth Loss among US Adults?

Ethnicity & Disease ◽

10.18865/ed.28.3.201 ◽

2018 ◽

Vol 28 (3) ◽

pp. 201

Author(s):

Fatma W. Nazer ◽

Wael Sabbah

Keyword(s):

Ethnic Differences ◽

Tooth Loss ◽

Family Income ◽

The United States ◽

Outcome Variable ◽

Behavioral Risk ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Logistic Regression Models ◽

Ethnic Inequalities

Objective: To assess whether there are ethnic differences in tooth loss among adult Americans aged <40 years and whether socioeconomic position attenuates these differences if they exist.Methods: Data were from the 2014 Behavioral Risk Factor Surveillance System, a health-related telephone cross-sectional survey of a nationally representative sample of US adults. Tooth loss (one tooth or more) was used as the outcome variable. Ethnicity was the main explanatory variable. Family income, education and health insurance were also used in the analysis. Logistic regression models for tooth loss were constructed adjusting for demographic (age, sex, and ethnicity), socioeconomic indicators (income and education), health insurance, dental visits, smoking and diabetes.Results: A total of 76,273 participants were included in the analysis. The prevalence of tooth loss was highest among Blacks (33.7%). Hispanics and other ethnic groups had a higher prevalence of tooth loss than Whites, 29.1% (95%CI: 27.7-30.6), 22.0% (95%CI: 20.3-23.8), and 20.8% (95%CI: 20.2-21.4), respectively. Blacks had odds ratios (OR) 1.98 (95%CI: 1.81-2.16) for tooth loss compared with Whites. After adjusting for socioeconomic positions (SEP), the relationship attenuated but remained significant with OR 1.71 (95%CI: 1.55-1.90).Conclusions: Despite recent changes in the health care system in the United States, ethnic inequalities in tooth loss still exist. Income and education partially explained ethnic differences in tooth loss among Americans aged <40 years.Ethn Dis. 2018;28(3):201-206; doi:10.18865/ ed.28.3.201

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Prevalence and correlates of suicidal ideation and suicide attempts in preadolescent children: A US population-based study

Translational Psychiatry ◽

10.1038/s41398-021-01593-3 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Hannah R. Lawrence ◽

Taylor A. Burke ◽

Ana E. Sheehan ◽

Brianna Pastro ◽

Rachel Y. Levin ◽

...

Keyword(s):

Suicidal Ideation ◽

Sexual Minority ◽

Family Income ◽

Suicide Attempts ◽

Psychiatric Treatment ◽

The United States ◽

Minority Youth ◽

Sexual Minority Youth ◽

Treatment Utilization ◽

Preadolescent Children

AbstractThe present study evaluated sociodemographic and diagnostic predictors of suicidal ideation and attempts in a nationally representative sample of preadolescent youth enrolled in the Adolescent Brain Cognitive Development Study. Rates and predictors of psychiatric treatment utilization among suicidal youth also were examined. Eleven thousand eight hundred and seventy-five 9- and 10-year-old children residing in the United States were assessed. Children and their parents/guardians provided reports of children’s lifetime history of suicidal ideation, suicide attempts, and psychiatric disorders. Parents also reported on sociodemographic characteristics and mental health service utilization. Multivariate logistic regression analyses were employed to evaluate sociodemographic and diagnostic correlates of suicidal ideation, suicide attempts among youth with suicidal ideation, and treatment utilization among youth with suicidal ideation and suicide attempts. Lifetime prevalence rates were 14.33% for suicidal ideation and 1.26% for suicide attempts. Youth who identified as male, a sexual minority, or multiracial had greater odds of suicidal ideation, and sexual minority youth and youth with a low family income had greater odds of suicide attempts. Comorbid psychopathology was associated with higher odds of both suicidal ideation and suicide attempts. In youth, 34.59% who have suicidal ideation and 54.82% who had attempted suicide received psychiatric treatment. Treatment utilization among suicidal youth was lower among those who identified as female, Black, and Hispanic. Suicidal ideation and attempts among preadolescent children are concerningly high and targeted assessment and preventative efforts are needed, especially for males, racial, ethnic, and sexual minority youth, and those youth experiencing comorbidity.

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Proving it: experiences of sexual minorities in the Canadian refugee determination system

10.32920/ryerson.14656989.v1 ◽

2021 ◽

Author(s):

Casey Anderson

Keyword(s):

Sexual Orientation ◽

Gender Identity ◽

Sexual Minority ◽

Sexual Minorities ◽

Decision Makers ◽

Gender Identities ◽

Theoretical Concepts ◽

Canadian Immigration ◽

Determination System ◽

And Gender

This paper explores refugee claimant’s experiences negotiating the Canadian Immigration and Refugee Board (IRB). Focusing on claims based on sexual orientation and gender identity, this paper investigates how claimants are made to ‘prove’ their sexual orientation and gender identity. The IRB and its decision makers require that claimants prove their identity as a refugee as well as a member of a sexual minority. Through an analysis of the existing literature and by integrating queer and feminist theoretical concepts on gender, sex, performativity and representation, it is apparent that the Canadian IRB functions as a heteronormative system in which the understanding of sexual orientation and gender identities are essentialized.

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Proving it: experiences of sexual minorities in the Canadian refugee determination system

10.32920/ryerson.14656989 ◽

2021 ◽

Author(s):

Casey Anderson

Keyword(s):

Sexual Orientation ◽

Gender Identity ◽

Sexual Minority ◽

Sexual Minorities ◽

Decision Makers ◽

Gender Identities ◽

Theoretical Concepts ◽

Canadian Immigration ◽

Determination System ◽

And Gender

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Disparities in Subjective Cognitive Impairment by Sexual Orientation and Gender in a National Population Based Study of U.S. Adults, 2013–2018

Journal of Aging and Health ◽

10.1177/08982643211046466 ◽

2021 ◽

pp. 089826432110464

Author(s):

Karen I. Fredriksen-Goldsen ◽

Hailey Jung ◽

Hyun-Jun Kim ◽

Ryan Petros ◽

Charles Emlet

Keyword(s):

Cognitive Impairment ◽

Sexual Orientation ◽

Sexual Minority ◽

Sexual Minorities ◽

Population Based ◽

Population Based Study ◽

Subjective Cognitive Impairment ◽

Targeted Interventions ◽

National Population ◽

And Gender

Objectives: This is the first national population-based study to examine cognitive impairment disparities among sexual minority mid-life and older adults. Methods: Using the National Health Interview Survey (2013–2018), we compared weighted prevalence of subjective cognitive impairment by sexual orientation and gender, among those aged 45 plus, applying logistic regressions adjusting for age, income, education, race/ethnicity, and survey years. Results: Sexual minorities (24.5%) were more likely to have subjective cognitive impairment than heterosexuals (19.1%). Sexual minority women had higher odds of greater severity, frequency, and extent of subjective cognitive impairment. Sexual minorities were also more likely to report activity limitations resulting from cognitive impairment and were no more likely to attribute limitations to dementia or senility. Discussion: Cognitive health disparities are of particular concern in this historically and socially marginalized population. The investigation of explanatory factors is needed, and targeted interventions and policies are warranted to address cognitive challenges faced by sexual minorities.

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Sexual Orientation and Suicide Attempt Disparities Among US Adolescents: 2009–2017

10.1542/9781610025409-sexual_orientation ◽

2021 ◽

pp. 73-83

Author(s):

Julia Raifman ◽

Brittany M. Charlton ◽

Renata Arrington-Sanders ◽

Philip A. Chan ◽

Jack Rusley ◽

...

Keyword(s):

Sexual Orientation ◽

Sexual Minority ◽

Adolescent Suicide ◽

Suicide Attempts ◽

Same Sex ◽

Logistic Regression Models ◽

Sexual Orientation Identity ◽

Minority Adolescents ◽

Sexual Contacts ◽

Minority Sexual Orientation

BACKGROUND Sexual minority adolescents face mental health disparities relative to heterosexual adolescents. We evaluated temporal changes in US adolescent reported sexual orientation and suicide attempts by sexual orientation. METHODS We used Youth Risk Behavioral Surveillance data from 6 states that collected data on sexual orientation identity and 4 states that collected data on sex of sexual contacts continuously between 2009 and 2017. We estimated odds ratios using logistic regression models to evaluate changes in reported sexual orientation identity, sex of consensual sexual contacts, and suicide attempts over time and calculated marginal effects (MEs). RESULTS The proportion of adolescents reporting minority sexual orientation identity nearly doubled, from 7.3% in 2009 to 14.3% in 2017 (ME: 0.8 percentage points [pp] per year; 95% confidence interval [CI]: 0.6 to 0.9 pp). The proportion of adolescents reporting any same-sex sexual contact increased by 70%, from 7.7% in 2009 to 13.1% in 2017 (ME: 0.6 pp per year; 95% CI: 0.4 to 0.8 pp). Although suicide attempts declined among students identifying as sexual minorities (ME: –0.8 pp per year; 95% CI: –1.4 to –0.2 pp), these students remained >3 times more likely to attempt suicide relative to heterosexual students in 2017. Sexual minority adolescents accounted for an increasing proportion of all adolescent suicide attempts. CONCLUSIONS The proportion of adolescents reporting sexual minority identity and same-sex sexual contacts increased between 2009 and 2017. Disparities in suicide attempts persist. Developing and implementing approaches to reducing sexual minority youth suicide is critically important.

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The role of country-level structural stigma on sexual orientation disclosure and discrimination in health care settings among lesbian, gay, and bisexuals across Europe

European Journal of Public Health ◽

10.1093/eurpub/ckz185.467 ◽

2019 ◽

Vol 29 (Supplement_4) ◽

Author(s):

R Bränström ◽

J E Pachankis

Keyword(s):

Health Care ◽

Sexual Orientation ◽

Health Care Providers ◽

Sexual Minority ◽

Sexual Minorities ◽

Care Providers ◽

Health Care Settings ◽

Country Level ◽

Disclosure Of Sexual Orientation ◽

Sexual Orientation Disclosure

Abstract Background The national climate surrounding sexual minorities (i.e., those self-identifying as lesbian, gay, or bisexual [LGB]) varies greatly worldwide. Recent Cross-European studies have shown that country-level structural stigma is a strong determinant of sexual minority individuals health risk behaviors and mental health. The consequences of the significant country-level variation in structural stigma on sexual minorities’ experiences of health care discrimination and disclosure of sexual orientation to health care providers have not been previously investigated. Methods In 2012, 86 000 sexual minority individuals (aged 18 years and older) from all 28 European Union countries responded to questions concerning discrimination in health care settings and sexual orientation disclosure to health care providers (EU LGBT survey). Structural stigma was assessed using a combination of national laws and policies affecting sexual minorities and a measure of sexual minority acceptance among citizens of each country. Results Disclosure of sexual orientation to health care providers were much more common in low stigma coutries (e.g., the Netherlands, Sweden, UK) compared to high stigma coutries (e.g., Lithuania, Latvia, Slovakia). Experiences of discrimination in health care settings were more common among LGB indiviudals who were open about their sexual orientaiton and increased by degree of country-level structural stigma. Conclusions Disclosure of sexual orientation and experiences of discrimination in health care settings varies greatly among LGB individuals in Europe largely due to structural stigma surrounding sexual minorities. Main messages These findings highlight the importance of eliminating legislation, policies, and national attitudes that promote the unequal treatment of sexual minorities in currently unsupportive European countries.

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Black Sexual Minority Men’s Disclosure of Sexual Orientation Is Associated With Exposure to Homonegative Religious Messages

American Journal of Men s Health ◽

10.1177/1557988318806432 ◽

2018 ◽

Vol 13 (1) ◽

pp. 155798831880643 ◽

Cited By ~ 2

Author(s):

Jonathan Mathias Lassiter ◽

Russell Brewer ◽

Leo Wilton

Keyword(s):

Sexual Orientation ◽

Sexual Minority ◽

Clinical Work ◽

The United States ◽

Geographic Region ◽

Religious Communities ◽

Western Society ◽

Church Members ◽

Region Of Residence ◽

Sexual Orientation Disclosure

Previous research has highlighted the homonegative atmospheres of many religious communities in Western society and their harmful impact on Black sexual minority (SM) people’s mental and physical health. However, few studies have examined the relationship between sexual orientation disclosure to church members and exposure to homonegative religious messages in religious settings. This online quantitative study investigated this relationship among a sample of 320 Black SM men. The participants for this study were recruited nationally from across the United States and had a mean age of 34 years. Descriptive statistics and linear regression analyses were conducted. Findings indicated that sexual orientation disclosure to church members was significantly associated with exposure to homonegative religious messages, even when controlling for geographic region of residence and denominational affiliation. Black SM men who had higher levels of disclosure were exposed to fewer homonegative religious messages. The implications of these findings for health research and clinical work with Black SM men are discussed in detail.

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The Age at Leaving Home in the United States, 1850–1860

Social Science History ◽

10.1017/s0145553200017545 ◽

1996 ◽

Vol 20 (4) ◽

pp. 507-532 ◽

Cited By ~ 1

Author(s):

Richard H. Steckel

Keyword(s):

Family Income ◽

The United States ◽

Social Phenomenon ◽

Parental Home ◽

Leaving Home ◽

Decision To Leave ◽

History Of ◽

The Individual ◽

History Of Migration ◽

Departure Of Children

Historically, the departure of children from the parental home was an important economic and social phenomenon. Because it was equivalent to establishing a new residence, the decision to leave is relevant to our understanding of the history of migration. Leaving home was also a milestone in the life cycle that typically signaled a transition from semidependence to greater economic and social responsibility on the part of the individual, a change that affected labor force participation, family income, expenditures on housing, schooling or training, socialization, and interaction among siblings. In turn, couples considered these implications in formulating fertility goals and strategies.

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The Influence of Applicant Sexual Orientation, Applicant Gender, and Rater Gender on Ascribed Attributions and Hiring Recommendations of Personal Trainers

Journal of Sport Management ◽

10.1123/jsm.24.4.400 ◽

2010 ◽

Vol 24 (4) ◽

pp. 400-415 ◽

Cited By ~ 25

Author(s):

George B. Cunningham ◽

Melanie L. Sartore ◽

Brian P. McCullough

Keyword(s):

Sexual Orientation ◽

Analysis Of Variance ◽

Sexual Minority ◽

Sexual Minorities ◽

Job Applicants ◽

Future Directions ◽

Job Applicant ◽

Personal Trainers ◽

Organization Analysis ◽

Personal Trainer

The purpose of this study was to examine the influence of job applicant sexual orientation on subsequent evaluations and hiring recommendations. Data were gathered from 106 students (48 men, 57 women) who participated in a 2 (applicant sexual orientation: heterosexual, sexual minority) × 2 (rater gender: female, male) × 2 (applicant gender: female, male) experiment related to the hiring of a personal trainer for a fitness organization. Analysis of variance indicated that sexual minority job applicants received poorer evaluations than did heterosexuals. These effects were moderated by the rater gender, as men provided harsher ratings of sexual minorities than did women. Finally, applicant ratings were reliably related to hiring recommendations. Results are discussed in terms of contributions to the literature, limitations, and future directions.

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