Abstract
Objective: Black and Hispanic persons who identify as lesbian, gay, or bisexual (LGB) experience health disparities relative to non-Hispanic White and heterosexual groups respectively, including higher rates of suicidal ideation (SI) and substance use disorder (SUD). To elucidate intersectional risk, we used a large national sample to examine rates of SI, SUD, and their co-occurrence (SI + SUD) at the intersection of sexual identity and race/ethnicity. Method: Data were from five years (2015–2019) of the National Survey of Drug Use and Heath (unweighted N = 189,127). Multinomial logistic regressions with persons without SI and SUD as references were stratified by gender and controlled for survey year, age, education, marital status, and income. Results: Compared to same-race and same-gender heterosexual adults, White, Black, and Hispanic LGB men and women showed higher odds of SI (AOR = 2.86–4.45), SUD (AOR = 1.23–3.01), and SI + SUD (AOR = 2.72–6.85). Compared to same-gender White heterosexual adults, Black and Latinx heterosexual men and women showed lower odds of SI (AORs = .54–.65), SUD (AORs = .52–.78) and SI + SUD (AORs = .41–.57). Compared to same-gender White LGB adults, Black and Hispanic women, but not men, showed lower SI odds (AORs = .58–.72). Compared to same-gender White heterosexual adults, Black and Hispanic LGB men and women showed higher odds of SI (AORs = 1.71–2.51) and SI + SUD (AORs = 1.91–2.97). Conclusions: Consistent with research showing effects of multiple minority stress on behavioral health, adults with intersecting racial/ethnic and sexual minority identities showed increased odds of SI, SUD, and SI + SUD relative to Non-Hispanic White heterosexual peers. Black, Hispanic, and White LGB adults may benefit from screening and intervention for SI and SUD.
| Original language | English (US) |
|---|---|
| Article number | 108848 |
| Journal | Drug and Alcohol Dependence |
| Volume | 226 |
| DOIs | |
| State | Published - Sep 1 2021 |
Funding
Time spent preparing this manuscript for publication was supported by T32 (PI:Bauer; Alessi) from the National Institute on Alcohol and Alcoholism which supported the time of Dr. Kelly. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Publicly available data from five years (2015–2019) of the National Survey of Drug Use and Heath (NSDUH) were used. Computer-assisted face-to-face interviews were conducted by trained assessors and administered to community-dwelling residents in the United States. For detailed NSDUH methods, see the Substance Abuse and Mental Health Data Archive ( SAMHDA, 2021 ). In 2015, SUD items changed and sexual identity items were added; thus, prior years were not included. The 2015–2019 sampling and survey methods were identical, so data across years were collapsed to maximize statistical power. NSDUH data collection is funded by SAMHSA, with oversight by the Institutional Review Board of RTI International. These secondary analyses of de-identified data were deemed exempt human subjects’ research. The dataset was restricted to adults aged 18 and older (unweighted N = 189,127). Time spent preparing this manuscript for publication was supported by T32 (PI:Bauer; Alessi) from the National Institute on Alcohol and Alcoholism which supported the time of Dr. Kelly. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Keywords
- Ethnicity
- Intersectionality
- Race
- Sexual identity
- Substance use disorder
- Suicidal ideation
ASJC Scopus subject areas
- Psychiatry and Mental health
- Pharmacology (medical)
- Toxicology
- Pharmacology
