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Commonwealth of Massachusetts Department of Public Health

A Health Profile of Massachusetts Adults by Sexual Orientation Identity: Results from the 2001-2006 Behavioral Risk Factor Surveillance System Surveys

Prepared by K.J. Conron, ScD1, MPH, M.J. Mimiaga2,3, ScD, MPH, S.J. Landers4,5, JD, MCP
for the Massachusetts Department of Public Health

SUMMARY

A growing body of research indicates that health disparities exist between
gay/lesbian/bisexuals and heterosexuals. For the first time, population-based estimates
of sexual orientation differences in adult health are available in the Commonwealth of
Massachusetts. This report used data collected for the 2001-2006 Massachusetts
Behavioral Risk Factor Surveillance System surveys to compare self-reported health
behavior and status among (n=38,910) heterosexual/straight, gay/lesbian/homosexual,
and bisexual adults ages 18-64. Most (97.1%) self-identified as heterosexual or straight,
while 1.9% identified as gay, lesbian or homosexual, and 1.0% as bisexual.

Results suggest that sexual orientation differences exist with respect to access to
health care, overall health status, cancer screening, chronic health conditions, mental
health, substance use including tobacco smoking, sexual health, and violence
victimization. While gay/lesbian/homosexual adults evidenced poorer health and greater
risk than straight/heterosexuals across several health domains, poorer health was
observed most often for bisexuals. The health profile of gay/lesbian/homosexual
residents was poorer than that of heterosexual/straight residents on: self-reported
health; disability-related activity limitation; asthma; current and past tobacco smoking;
anxious mood; 30-day binge drinking and substance use; and lifetime sexual assault
victimization. In addition, lesbian/homosexual women were more likely to be obese than
their heterosexual/straight female peers. Bisexual residents faired worse than
heterosexual/straight residents in terms of: access to health insurance, as well as
medical and dental providers; heart disease; anxious and depressed moods, 12-month
suicidal ideation; current tobacco smoking, and lifetime and 12-month sexual assault
victimization. In addition, bisexual women were more likely to report disability-related
activity limitation, 30-day illicit drug use, and lifetime intimate partner violence
victimization than heterosexual/straight women.

In several areas (prostate-specific antigen testing; lifetime mammography and 3-
year cervical cancer screening; diabetes; and 12-month intimate partner violence
victimization), no statistically significant sexual orientation differences were observed. In
a few domains, gay/bisexual/homosexuals were engaged in more health protective
behavior than straight/heterosexuals. Gay/lesbian/homosexuals and bisexuals were
more likely than heterosexuals to have been ever tested for HIV than their
straight/heterosexual counterparts. In addition, gay/homosexual men were less likely to
be obese or overweight compared to straight/heterosexual men. They were also more
likely to obtain lifetime colorectal cancer screening and to report recent condom use.

Information on health disparities can inform how public health resources are
allocated to improve health, including identifying areas for intervention development and
future research. As research continues, Massachusetts’ public health programs should
begin to address the sexual orientation-related disparities identified in this report. An
emphasis on the health needs of bisexuals in the Commonwealth is indicated by our
findings.