The Socioecology of Sexual Minority Stigma: Data Harmonization to Address Confounding Bias and Investigate Cross-Level MentalHealth Effects

性少数耻辱的社会生态学：数据协调以解决混杂偏见并调查跨层面的心理健康影响

• 批准号: 10728261
• 负责人: Arjan van der Star
• 金额: $ 47.19万
• 依托单位: SAN DIEGO STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-06-16 至 2026-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10728261
• 关键词: Address; Advocacy; Age; Attitude; Automobile Driving; Climate; Complex; Country; County; Data; Data Pooling; Data Set; Development; Disparity; District of Columbia; European; Exposure to; Feeling suicidal; Gender; Generations; Geography; Health Surveys; Heterosexuals; Individual; Inequity; Institutionalization; Laws; Legal; Libido; Life Cycle Stages; Link; Marriage; Measures; Mediating; Mental Depression; Mental Health; Modeling; National Longitudinal Survey of Adolescent to Adult Health; Neighborhoods; Outcome; Personal Satisfaction; Persons; Policies; Politics; Population; Prevalence; Public Health; Random Allocation; Reporting; Research; Risk; Sample Size; Schools; Sex Orientation; Sexuality; Shapes; Societies; Stigmatization; Suicide attempt; System; Testing; Therapeutic Intervention; US State; Urbanization; Victimization; combat; data harmonization; data integration; depressive symptoms; evidence base; gender diversity; hate crimes; health disparity; health equity; health inequalities; improved; indexing; internalized stigma; lifetime risk; multilevel analysis; novel; preventive intervention; same-sex marriage; sexual minority; sexual minority group; social stigma; structural determinants; suicidal; suicidal behavior; theories

PROJECT SUMMARY/ABSTRACT Sexual minorities (i.e., individuals who do not identify as heterosexual, or who are attracted to, have romantic relationships with, or have sexual contact with, people of the same or diverse genders) in the US are at a near three-fold increased odds for depression and a two to seven-fold increased risk for lifetime report of suicide attempts, compared with heterosexual individuals. Structural sexual minority stigma exposure across various levels (e.g., macro and exo levels) has been purported as a cause underlying and driving these sexual orientation-based disparities in mental health. While structural forms of sexual minority stigma, including discriminatory laws, inequitable policies, and negative population attitudes, have been associated with adverse sexual minority mental health, evidence from US-based studies, depending on single stand-alone indicators of structural stigma, has been hampered by risks for confounding bias through common causes from other 1) higher-level and 2) same-level structural stigma-related factors, as well as 3) often-overlooked structural factors outside of the stigma paradigm. Large existing US public health surveys do not independently allow for analyses that can fully account for such confounding bias. But data harmonization and integration across datasets (i.e., NHIS, Add Health, YRBS, and ABCD) will enable complex models with newly developed comprehensive macro- (i.e., state) and exo-level (i.e., county) structural sexual minority stigma predictors of individual-level mental health outcomes, sufficient clusters, and large-enough mean cluster sizes. With data collected during a transformational period for sexual minorities in the US (from 2001 to 2021; e.g., changes in population attitudes and the step-wise introduction of same-gender marriage), the NHIS, Add Health, YRBS, and ABCD, together, provide a once-in-a-generation and timely opportunity to harmonize and integrate these datasets to enable complex multilevel models that account for the risks of confounding bias and aid to further strengthen causal inferencing. Therefore, this proposed study will 1) harmonize and pool high-quality data from up to 42,000 sexual minority and 1.4 million heterosexual individuals, 2) comprehensively quantify the level of structural sexual minority stigma exposure in US states and counties between 2001 and 2021, and 3) examine the cross-sectional and longitudinal associations between cross-level (i.e., macro to exo) effects of structural sexual minority stigma and depressive symptoms and suicidality outcomes (namely, suicidal ideation and suicidal behaviors). Findings from the proposed study may have direct theoretical and applied implications as it addresses important confounding issues currently distorting findings on how macro- and exo-level structural sexual minority stigma shape sexual minorities’ mental health. Results may further contribute to health equity by facilitating targeted advocacy and therapeutic interventions to improve structural climates for sexual minorities and combat systemic effects, not only in the US, but similarly across the globe.

项目摘要/摘要 性少数群体（即，没有认同为异性恋或被吸引的个人有浪漫 在美国，与同一或潜水员的人的关系或与潜水员的人发生性接触） 抑郁症的几率增加了三倍，自杀报告的风险增加了两到七倍 与异性恋者相比尝试。各种结构性少数族裔污名 级别（例如，宏观和EXO水平）被认为是原因并驱动这些性的原因 基于方向的心理健康差异。而性少数民族污名的结构形式，包括 歧视性法律，不平等的政策和负面人群与逆境有关 性少数民族心理健康，美国研究的证据，具体取决于单一独立指标 结构性污名受到通过其他共同原因的混淆偏见的风险的阻碍。 更高级别和2）相同级别的结构性污名相关因素，以及3）经常被忽略的结构因子 在污名范式之外。大型现有的美国公共卫生调查不允许进行分析 这可以充分说明这种混杂的偏见。但是数据集的数据协调和集成（即 NHIS，Add Health，YRB和ABCD）将使复杂的模型具有新开发的全面宏观 - （即状态）和EXO级别（即县）结构性少数族裔污名预测，个人级别的精神 健康结果，足够的集群和大端平均簇尺寸。在A期间收集的数据 美国性少数群体的变革时期（从2001年到2021年；例如，人口态度的变化 以及同性婚姻的逐步介绍），NHI，添加健康，YRB和ABCD，一起 提供曾经一代和及时的机会来协调和集成这些数据集以启用 复杂的多层次模型，这些模型构成了混淆偏见和援助以进一步加强因果关系的风险 推论。因此，这项拟议的研究将1）从最高42,000个性数据协调和汇总高质量的数据 少数族裔和140万个异性恋人，2）全面量化结构性的水平 2001年至2021年之间，美国和县的少数族裔污名暴露，3）检查横截面 结构性少数族裔污名的跨层次（即宏至EXO）之间的纵向关联 以及抑郁症状和自杀性结果（即自杀思想和自杀行为）。发现 从拟议的研究中可能具有直接的理论和应用含义，因为它解决了重要的 当前令人困惑的问题扭曲了有关宏观和外观级别的结构性少数污名的发现 塑造性少数群体的心理健康。结果可能会通过促进目标进一步促进健康公平 倡导和治疗干预措施，以改善性少数群体的结构气候和战斗 影响不仅在美国，而且在全球范围内类似。