Lesbian, gay and bisexual women and men in England are more likely to suffer from poor health than the general population, according to a new study conducted by the RAND Corporation, the University of Cambridge and Boston Children's Hospital.
The study, published online by the Journal of General Internal Medicine, also found that lesbian, gay and bisexual populations are more likely to report unfavorable experiences with the health care they received in general practices in England's health care system, the National Health Service.
In one of the largest studies of sexual minority health and health care ever conducted, researchers analyzed data from more than 2 million respondents to the 2009/2010 English General Practice Patient Survey. The respondents included more than 27,000 people who described themselves as lesbian, gay or bisexual.
The findings confirm previous studies -- particularly from the United States -- that members of sexual minority groups are more likely than the general population to suffer from mental health problems, particularly depression, anxiety and substance abuse. Previous studies have typically been limited by their small sample sizes.
"Our results show that sexual minorities suffer poorer health and have worse experiences with health care," said Marc Elliott, the study's lead author and a principal researcher at RAND, a nonprofit research organization. "This suggests a need to develop programs tailored toward the health care needs of lesbian, gay and bisexual patients."
The study found that sexual minorities were two to three times more likely to report having a longstanding psychological or emotional problem than heterosexual counterparts.
In addition, researchers found that 25 percent of lesbians and 31 percent of bisexual women reported fair or poor general health, compared to 21 percent of heterosexual women. Among men, 22 percent of gay men and 26 percent of bisexual men reported fair or poor general health, compared to 20 percent of heterosexual men.
Lesbian, gay and bisexual women and men also were up to 50 percent more likely than heterosexuals to report negative experiences with primary care services, including trust and confidence with their primary care physicians, communication with both primary care physicians and nurses, and overall satisfaction.
"The results raise the possibility that the poorer health reported by sexual minority group members may be due in part to hostile and stressful social environments created by the stigma, prejudice and discrimination that they face," said Dr. Martin Roland, the study's senior author and project leader, and also the director of the Cambridge Centre for Health Services Research. "It is possible, too, that this hostile environment may carry over into the medical practice, leading to poor health care experiences."
Researchers say there have been no similar large studies of the health care experiences of sexual minorities in the United States.
"We do know that sexual minorities in the United States have health problems similar to those we see in England," Elliott said. "Stigma, prejudice and discrimination exist in the U.S. as well, so it is important to find out whether our health care system also tends to produce worse experiences of care for sexual minorities."
The study was funded by the English Department of Health. Other authors of the study are David E. Kanouse, Q Burkhart, Gary Abel, Georgios Lyratzopoulos, Megan K. Beckett and Mark A. Schuster.
RAND Health is the nation's largest independent health policy research program, with a broad research portfolio that focuses on health care costs, quality and public health preparedness, among other topics.
The Cambridge Centre for Health Services Research is a collaboration between the University of Cambridge and RAND Europe, RAND's European office, also based in Cambridge.
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