Sexual Orientation, Socioeconomic Status, and Chronic Disease Risk

Health inequalities that disadvantage sexual and gender minorities (SGMs) have been widely documented, but research has largely ignored the key influence of socioeconomic status (SES). Preliminary analyses of data from the National Longitudinal Study of Adolescent to Adult Health (Add Health) indicate that sexual orientation is related to multiple indicators of young adult SES, including rates of home ownership, levels of self-reported financial strain, receipt of public assistance, and poverty. For each indicator, SGM respondents fare significantly worse. The scientific objective of Add Health Wave V is to understand the early life precursors of chronic disease by tracing the cumulative and integrated biological, behavioral, and psychosocial processes that are hypothesized to operate in all stages of the life course. This project contributes to achieving that broad objective by focusing on biopsychosocial processes, and their implications for chronic conditions, among SGMs in the Add Health sample. Because Wave V data are not yet available, data from Waves I (adolescence) and IV (young adulthood) of Add Health are being used to (1) test potential mediators (i.e., parent-child relationship quality and subsequent adolescent educational attainment) of the association between sexual orientation and young adult SES, and (2) test whether the impact on adult SES leads to economic strain that increases the likelihood of chronic disease risk. The Wave IV sample includes 15,561 members, not recruited on the basis of sexual orientation, who identify as LGB (n=588), mostly heterosexual (n=1,526), and completely heterosexual (n=13,447). Allostatic load and metabolic syndrome, measured via biomarker data collected at Wave IV, are used as indicators of chronic disease risk. Structural equation modeling will be used to test hypothesized pathways. Completion of these two aims will contribute to the public health literature and expand the contributions of the Add Health program project by offering insight into the precursors of chronic disease among the sexual minority sample in Add Health.

Principal Investigator: Kathleen Mullan Harris

Other Investigators: Shoshana Goldberg

Funding Source: NIH NICHD

Grant Number: P01HD031921

Funding Period: 5/1/2016 - 4/30/2019

Primary Research Area: Population Health

Affiliated Research Project:

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