Contextual Determinants of Sexual Minority Health in the United States

美国性少数群体健康的背景决定因素

• 批准号: 10669754
• 负责人: Kara Joyner
• 金额: $ 30.02万
• 依托单位: UNIVERSITY OF TEXAS SAN ANTONIO
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-07-21 至 2025-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10669754
• 关键词: Adolescent; Adoption; Adult; Advisory Committees; Anxiety; Attitude; Biological Markers; Bisexual; Cardiovascular Diseases; Characteristics; Charge; Cities; Climate; County; Data; Databases; Demography; Discipline; Discrimination; Disparity; Economics; Employment; Ensure; Ethnic Origin; Exposure to; Face; Fostering; Gays; Gender; Gender Identity; Geography; Goals; Health; Health Insurance; Health Policy; Heterosexuals; High Prevalence; Individual; Institute of Medicine (U.S.); Intervention; Investigation; Laws; Legal; Lesbian; Lesbian Gay Bisexual; Life Cycle Stages; Link; Longitudinal Studies; Malignant Neoplasms; Measurement; Measures; Mental Depression; Modeling; National Longitudinal Survey of Adolescent to Adult Health; Neighborhoods; Outcome; Patient Self-Report; Persons; Physiological; Policies; Population; Population Heterogeneity; Positioning Attribute; Process; Productivity; Psychology; Public Health; Public Policy; Race; Research; Research Personnel; Respondent; Sample Size; Sampling; Sex Orientation; Sexual Health; Sexual and Gender Minorities; Social Environment; Societies; Socioeconomic Status; Sociology; Source; Statutes and Laws; Stigmatization; Structural Racism; Subgroup; Surveys; Testing; Time; United States; United States National Institutes of Health; Woman; adverse outcome; asexual; cohort; data sharing; database design; design; ethnic minority; ethnic minority population; experience; gender diversity; gender minority group; hate crimes; health care availability; health disparity; improved; innovation; interest; intersectionality; minority children; minority stress; obesity risk; population based; population health; psychosocial; racial minority; racial minority population; racism; response; sexual identity; sexual minority; sexual minority group; sexual minority health; sexual minority health disparity; social; social exclusion; social stigma; transgender

Contextual Determinants of Sexual Minority Health in the United States R01 Application Summary/Abstract Kara Joyner (PI) and Wendy Manning (Co-I) Researchers have long documented health disparities for sexual minority populations (or sexual diverse populations) and they are beginning to document them for gender minority populations (or gender diverse populations). These health disparities remain largely intractable because researchers have not been able to rigorously capture the putative mechanism behind them: stigma. The minority stress perspective posits that sexual minority populations, like racial/ethnic minority populations, experience a higher prevalence of adverse health outcomes than heterosexual populations due to their stigmatized status in society. Researchers testing this perspective have increasingly measured stigma at the societal level or “structural stigma,” a concept that captures both social climate (public attitudes towards sexual/gender minorities) and legal climate (laws and policies relevant to sexual/gender minorities). Researchers have been hampered in their ability to adequately assess the effects of structural stigma due to the design of most population-based surveys that include questions on sexual minority status and health. Few of these surveys permit researchers to measure stigma at multiple levels. Another limitation of these surveys is that they are cross-sectional, precluding a consideration of how exposure to structural stigma changes over the life course. The National Longitudinal Study of Adolescent to Adult Health (Add Health) has the necessary criteria to rigorously investigate the effects of structural stigma on the health outcomes of sexual minority respondents, including a formal and regulated mechanism for producing and disseminating contextual data. Add Health users interested in testing minority stress and intersectionality perspectives will have unprecedented opportunities to examine how various outcomes are associated with structural stigma for sexual minority respondents and how the associations differ across subgroups. Aim 1 of this project is to create a contextual database that researchers can use to better study the effects of structural stigma. Specifically, this database will include measures of social and legal climate relevant to sexual minorities that correspond to the tract, county, and state levels before or around the time of Waves 3, 4, and 5. This database will also include measures of structural racism since many sexual minorities are also racial/ethnic minorities. We will convene an advisory team to ensure we have the best measures of structural stigma and racism. Aim 2 will examine with this contextual database how state-level measures of legal climate are associated with self-rated health and health biomarkers among Add Health respondents and consider how these associations differ by key factors (e.g., gender, socioeconomic status, and race/ethnicity). This database will promote research on health disparities for sexual and racial minority populations that is both rigorous and innovative. Research made possible by the creation of this contextual database has the potential to inform policies and interventions that improve the health of sexual and racial minority populations, including subgroups of these populations, ensuring all populations have equal opportunities for long, healthy, and productive lives.

美国性少数群体健康的背景决定因素 R01 应用摘要/摘要 卡拉·乔伊纳 (PI) 和温迪·曼宁 (Co-I) 研究人员早就记录了性少数人群（或性别多样化人群）的健康差异 人口），并且他们开始记录性别少数人口（或性别多样化人口）的数据 这些健康差异在很大程度上仍然难以解决，因为研究人员还无法解决这一问题。 严格捕捉其背后的假定机制：少数派压力观点认为。 性少数群体，如种族/族裔少数群体，遭受不良影响的发生率较高 由于研究人员在社会上的污名化地位，他们的健康状况优于异性恋人群。 这种观点越来越多地衡量社会层面的耻辱或“结构性耻辱”，这一概念 捕捉社会氛围（公众对性/性别少数群体的态度）和法律氛围（法律和法规） 研究人员的能力受到阻碍。 评估由于大多数基于人口的调查（包括问题）的设计而造成的结构性耻辱的影响 这些调查很少允许研究人员衡量多重耻辱。 这些调查的另一个局限性是它们是横截面的，无法考虑如何进行。 一生中经历结构性耻辱变化的国家青少年纵向研究。 成人健康（Add Health）有必要的标准来严格调查结构性耻辱对 性少数受访者的健康结果，包括正式且规范的生产机制 添加对测试少数群体压力和交叉性感兴趣的健康用户。 观点将有前所未有的机会来研究各种结果如何与 性少数受访者的结构性耻辱以及不同亚群体的关联有何不同。 该项目旨在创建一个上下文数据库，研究人员可以使用该数据库更好地研究结构的影响 具体来说，该数据库将包括与性少数相关的社会和法律氛围的衡量标准。 对应于第 3、4 和 5 波之前或前后的地区、县和州级别。 数据库还将包括结构性种族主义的措施，因为许多性少数群体也是种族/族裔 我们将召集一个咨询小组，以确保我们有结构性耻辱和歧视的最佳措施。 目标 2 将利用该背景数据库来研究州级法律氛围的衡量标准。 与 Add Health 受访者中的自评健康和健康生物标志物相关，并考虑这些如何 协会因关键因素（例如性别、社会经济地位和种族/民族）而异。 促进对性别和种族少数群体健康差异的研究，该研究既严格又可靠 通过创建这个上下文数据库而实现的研究有可能提供信息。 改善性少数群体和种族少数群体（包括亚群体）健康的政策和干预措施 的人口，确保所有人口都有平等的机会过上长寿、健康和富有成效的生活。