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Sexual orientation disparities in mental health: the moderating role of educational attainment.
Soc Psychiatry Psychiatr Epidemiol. 2014 Sep; 49(9):1447-54.SP

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.

Authors+Show Affiliations

Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, 10032, USA, dmb23@columbia.edu.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

24570204

Citation

Barnes, David M., et al. "Sexual Orientation Disparities in Mental Health: the Moderating Role of Educational Attainment." Social Psychiatry and Psychiatric Epidemiology, vol. 49, no. 9, 2014, pp. 1447-54.
Barnes DM, Hatzenbuehler ML, Hamilton AD, et al. Sexual orientation disparities in mental health: the moderating role of educational attainment. Soc Psychiatry Psychiatr Epidemiol. 2014;49(9):1447-54.
Barnes, D. M., Hatzenbuehler, M. L., Hamilton, A. D., & Keyes, K. M. (2014). Sexual orientation disparities in mental health: the moderating role of educational attainment. Social Psychiatry and Psychiatric Epidemiology, 49(9), 1447-54. https://doi.org/10.1007/s00127-014-0849-5
Barnes DM, et al. Sexual Orientation Disparities in Mental Health: the Moderating Role of Educational Attainment. Soc Psychiatry Psychiatr Epidemiol. 2014;49(9):1447-54. PubMed PMID: 24570204.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Sexual orientation disparities in mental health: the moderating role of educational attainment. AU - Barnes,David M, AU - Hatzenbuehler,Mark L, AU - Hamilton,Ava D, AU - Keyes,Katherine M, Y1 - 2014/02/26/ PY - 2013/08/05/received PY - 2014/02/10/accepted PY - 2014/2/27/entrez PY - 2014/2/27/pubmed PY - 2015/5/20/medline SP - 1447 EP - 54 JF - Social psychiatry and psychiatric epidemiology JO - Soc Psychiatry Psychiatr Epidemiol VL - 49 IS - 9 N2 - 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. SN - 1433-9285 UR - https://www.unboundmedicine.com/medline/citation/24570204/Sexual_orientation_disparities_in_mental_health:_the_moderating_role_of_educational_attainment_ L2 - https://dx.doi.org/10.1007/s00127-014-0849-5 DB - PRIME DP - Unbound Medicine ER -