Sexual orientation disparities in mental health: the moderating role of educational attainment

David Barnes, Mark L. Hatzenbuehler, Ava D. Hamilton, Katherine M. Keyes

Research output: Contribution to journalArticle

Abstract

PURPOSE: Mental health disparities between sexual minorities and heterosexuals remain inadequately understood, especially across levels of educational attainment. The purpose of the present study was to test whether education modifies the association between sexual orientation and mental disorder.

METHODS: We compared the odds of past 12-month and lifetime psychiatric disorder prevalence (any Axis-I, any mood, any anxiety, any substance use, and comorbidity) between lesbian, gay, and bisexual (LGB) and heterosexual individuals by educational attainment (those with and without a bachelor's degree), adjusting for covariates, and tested for interaction between sexual orientation and educational attainment. Data are drawn from the National Epidemiologic Survey on Alcohol and Related Conditions, a nationally representative survey of non-institutionalized US adults (N = 34,653; 577 LGB).

RESULTS: Sexual orientation disparities in mental health are smaller among those with a college education. Specifically, the disparity in those with versus those without a bachelor's degree was attenuated by 100 % for any current mood disorder, 82 % for any current Axis-I disorder, 76 % for any current anxiety disorder, and 67 % for both any current substance use disorder and any current comorbidity. Further, the interaction between sexual orientation and education was statistically significant for any current Axis-I disorder, any current mood disorder, and any current anxiety disorder. Our findings for lifetime outcomes were similar.

CONCLUSIONS: The attenuated mental health disparity at higher education levels underscores the particular risk for disorder among LGBs with less education. Future studies should consider selection versus causal factors to explain the attenuated disparity we found at higher education levels.

Original languageEnglish (US)
Pages (from-to)1447-1454
Number of pages8
JournalSocial Psychiatry and Psychiatric Epidemiology
Volume49
Issue number9
DOIs
StatePublished - Sep 1 2014

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sexual orientation
Sexual Behavior
Mental Health
mental health
Education
mood
education
comorbidity
bachelor
anxiety
Heterosexuality
Anxiety Disorders
Mood Disorders
Comorbidity
mental disorder
interaction
Sexual Minorities
Mental Disorders
Substance-Related Disorders
Psychiatry

ASJC Scopus subject areas

  • Epidemiology
  • Health(social science)
  • Social Psychology
  • Psychiatry and Mental health

Cite this

Sexual orientation disparities in mental health : the moderating role of educational attainment. / Barnes, David; Hatzenbuehler, Mark L.; Hamilton, Ava D.; Keyes, Katherine M.

In: Social Psychiatry and Psychiatric Epidemiology, Vol. 49, No. 9, 01.09.2014, p. 1447-1454.

Research output: Contribution to journalArticle

Barnes, David ; Hatzenbuehler, Mark L. ; Hamilton, Ava D. ; Keyes, Katherine M. / Sexual orientation disparities in mental health : the moderating role of educational attainment. In: Social Psychiatry and Psychiatric Epidemiology. 2014 ; Vol. 49, No. 9. pp. 1447-1454.
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