Journal article
Mental health disorders mediate association of sexual minority identity with cardiovascular disease
Preventive medicine, v 108, pp 123-128
Mar 2018
PMID: 29330031
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Little is known about cardiovascular health disparities for lesbian, gay, or bisexual (LGB) persons and whether these disparities are mediated by mental health disorders due to sexual minority stress. We hypothesize LGB identity is associated with an increased risk of cardiovascular disease (CVD) and that major depressive disorder (MDD) and generalized anxiety disorders (GAD) may mediate this association.
The National Epidemiologic Survey on Alcohol and Related Conditions is a longitudinal, nationally-representative study of non-institutionalized U.S. adults. We cross-sectionally analyzed the second wave data (2004–2005) comparing 577 self-identified LGB persons to 33,598 heterosexuals. Multiple logistic regression modeling and mediation analysis (the product of coefficients approach) were performed.
LGB persons had significantly higher CVD prevalence [adjusted odds ratio (AOR): 1.5, 95% CI: 1.2–1.9], and were more likely to be diagnosed with MDD (AOR: 1.9, 1.8–2.1), GAD (AOR: 2.2, 1.9–2.4), or co-occurring MDD and GAD (AOR: 2.2, 2.0–2.5). MDD, GAD, and co-occurrence of MDD and GAD significantly mediated 14.3%, 22.2%, and 33.3% of the association of LGB status with increased CVD prevalence, respectively.
Our findings identified a 50% increased CVD prevalence among LGB persons and this increased risk was mediated in part by MDD and GAD, both being more prevalent in sexual minority adults.
•LGB persons had a 50% higher prevalence of CVD than heterosexuals.•Major depressive disorder was more prevalent among LGB persons.•Generalized anxiety disorders was more prevalent among LGB persons.•Both disorders mediate the association between LGB status and higher CVD risk.•Efforts to improve mental health may have cardiovascular benefit for LGB persons.
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Details
- Title
- Mental health disorders mediate association of sexual minority identity with cardiovascular disease
- Creators
- Lezhou Wu - Department of Epidemiology and Biostatistics, Drexel University Dornsife School of Public Health, 3215 Market St, Philadelphia, PA 19104, USARandall L Sell - Department of Community Health and Prevention, Drexel University Dornsife School of Public Health, 3215 Market St, Philadelphia, PA 19104, USAAlexis M Roth - Department of Community Health and Prevention, Drexel University Dornsife School of Public Health, 3215 Market St, Philadelphia, PA 19104, USASeth L Welles - Department of Epidemiology and Biostatistics, Drexel University Dornsife School of Public Health, 3215 Market St, Philadelphia, PA 19104, USA
- Publication Details
- Preventive medicine, v 108, pp 123-128
- Publisher
- Elsevier
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Epidemiology and Biostatistics; Community Health and Prevention
- Web of Science ID
- WOS:000426111900017
- Scopus ID
- 2-s2.0-85041564974
- Other Identifier
- 991014878219404721
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- Public, Environmental & Occupational Health