Abstract
Objectives
Previous large-scale population studies have reported that gay and bisexual men may be at increased risk for health disparities. This study was conducted to determine whether health status and health risk behaviours of Canadian men vary based on sexual orientation identity.
Methods
Utilizing the Canadian Community Health Survey data (Cycle 2.1, 2003; n=49,901), we conducted multivariable logistic regression to assess the independent effects of sexual orientation on health status and health risk behaviours. For all multivariate models, we calculated odds ratios, p-values, standard errors, and 95% confidence intervals (CIs) using the bootstrap re-sampling procedure recommended by Statistics Canada.
Results
When compared to heterosexual men, gay and bisexual men did not report more respiratory conditions; had lower rates of obesity and overweight BMI; and reported more mood/anxiety disorders, and a history of lifetime suicidality. Gay and bisexual men did not report higher rates of daily smoking or risky drinking, however, gay men reported an almost six-fold increase in STD diagnoses when compared to heterosexual men.
Conclusion
This study represents the largest-known population-based data analysis on health risks and behaviours among men of varying sexual orientations. These findings raise important concerns regarding the impact of sexual orientation on mental and sexual health. Limitations of this data set, including those associated with measurement of sexual orientation, are discussed. Further research is required to understand the mechanisms that influence these health resiliencies and disparities.
Key words: Health disparities, homosexuality, gay men, bisexual men, health behaviors, general population sample, sexual identity
Résumé
Objectifs
Selon des études démographiques à grande échelle menées antérieurement, les hommes homosexuels et bisexuels pourraient courir un risque accru d’afficher des disparités dans leur état de santé. Nous avons voulu déterminer si l’état de santé des Canadiens de sexe masculin et leurs comportements présentant un risque pour la santé varient selon leur orientation sexuelle.
Méthode
À l’aide des données de l’Enquête sur la santé dans les collectivités canadiennes (Cycle 2.1, 2003; n=49 901), nous avons effectué une analyse de régression logistique multivariée pour déterminer les effets indépendants de l’orientation sexuelle sur l’état de santé et sur les comportements qui présentent un risque pour la santé. Dans tous nos modèles multivariés, nous avons calculé les rapports de cotes, les valeurs P, les erreurs-types et les intervalles de confiance (IC) de 95 % par la méthode de rééchantillonnage bootstrap recommandée par Statistique Canada.
Résultats
Comparativement aux hommes hétérosexuels, les hommes homosexuels et bisexuels ne déclaraient pas plus de troubles respiratoires; leurs taux d’obésité et d’IMC en surpoids étaient plus faibles; mais ils déclaraient davantage de troubles de l’humeur et de troubles anxieux, et des antécédents de suicidabilité sur la vie entière. Les hommes homosexuels et bisexuels ne déclaraient pas de taux de tabagisme quotidien ni d’abus d’alcool plus élevés; cependant, les homosexuels faisaient état de diagnostics de MTS presque six fois plus élevés que les hétérosexuels.
Conclusion
Cette étude est la plus vaste analyse connue de données représentatives sur les risques pour la santé et les comportements d’hommes de diverses orientations sexuelles. Nos constatations soulèvent des préoccupations importantes quant à l’incidence de l’orientation sexuelle sur la santé mentale et sexuelle. Nous expliquons les contraintes de ce jeu de données, dont celles associées à la mesure de l’orientation sexuelle. Il faudrait pousser la recherche pour comprendre les mécanismes qui influencent la résilience et les disparités sur le plan de la santé que nous avons mises en évidence.
Mots clés: disparités d’état sanitaire, homosexualité, homosexualité masculine, bisexualité masculine, comportements liés à la santé, échantillon issu de la population générale, identité sexuelle
Footnotes
Acknowledgements: This research was supported by grants from the Institute of Gender and Health (IGH), Canadian Institutes of Health Research (CIHR 2005-11-HOA-1988721), the Fonds Québécois de Recherche sur la Société et la Culture (FQRSC 111796) awarded to the research team SVR (www.svr.uqam.ca) and a Janus Grant from the College of Family Physicians of Canada. Dr. Steele is funded as a career scientist by the Ontario Ministry of Health and Long-Term Care. Dr. Ross is supported as a New Investigator by the Canadian Institutes of Health Research and Ontario Women’s Health Council (Award NOW-84656).
Conflict of Interest: None to declare.
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