Table 2.
Unadjusted and Adjusted Models Measuring Disparities in Health-Related Quality of Life among Women Surviving Cancer by Self-Reported Sexual Orientation: National Health Interview Survey, 2013–2018 (n = 11,066)
| Heterosexual |
Lesbian |
χ2 |
pa |
Bisexual |
χ2 |
pa |
Lesbian |
Bisexual |
|
|---|---|---|---|---|---|---|---|---|---|
| Weighted % (95% CI) | Weighted % (95% CI) | aORb(95% CI) | aORb(95% CI) | ||||||
| Heterosexual vs. lesbian | Heterosexual vs. bisexual | ||||||||
| Mental health | |||||||||
| Psychological distress | 24.9 | <0.001 | 337.9 | <0.001 | |||||
| Low distress | 77.2 (76.8–77.6) | 70.4 (67.3–73.40) | 48.5 (44.6–52.4) | Ref. | Ref. | ||||
| Moderate distress | 18.8 (18.4–19.2) | 24.1 (21.2–27.0) | 39.0 (35.3–42.7) | 1.55 (0.98–2.46) | 1.38 (0.73–2.64) | ||||
| Severe distress | 4.0 (3.8–4.2) | 5.5 (4.2–6.8) | 12.5 (10.1–14.9) | 0.98 (0.41–2.36) | 3.03 (1.36–6.76) | ||||
| Functional limitation due to mental health | 15.6 (14.6–16.1) | 31.5 (23.5–39.5) | 25.9 | <0.001 | 47.5 (40.3–54.7) | 142.4 | <0.001 | 1.41 (0.66–3.01) | 1.58 (0.63–4.03) |
| Physical health | |||||||||
| Fair/Poor self-rated health | 13.3 (13.0–13.6) | 13.8 (11.3–16.3) | 0.2 | 0.678 | 14.2 (11.6–16.7) | 0.5 | 0.481 | 1.68 (1.02–2.78) | 0.73 (0.40–1.34) |
| Chronic condition | |||||||||
| Asthma | 14.4 (14.1–14.7) | 21.6 (18.8–24.2) | 35.3 | <0.001 | 24.7 (21.4–28.0) | 55.6 | <0.001 | 1.45 (0.89–2.37) | 1.40 (0.74–2.66) |
| COPD | 3.3 (3.2–3.5) | 2.7 (1.8–3.7) | 1.2 | 0.273 | 2.0 (1.2–2.9) | 5.2 | 0.023 | 1.98 (1.09–3.56) | 1.44 (0.64–3.25) |
| Diabetes | 9.3 (9.0–9.5) | 8.7 (6.8–10.7) | 0.3 | 0.590 | 6.8 (4.7–8.9) | 3.9 | 0.049 | 0.97 (0.47–2.00) | 0.73 (0.30–1.74) |
| Heart condition | 7.8 (7.6–8.1) | 7.3 (5.6–9.0) | 0.4 | 0.541 | 7.6 (5.8–9.5) | 0.05 | 0.821 | 1.90 (1.16–3.12) | 1.98 (1.12–3.53) |
| Hypertension | 30.2 (29.7–30.6) | 22.6 (19.9–25.3) | 25.1 | <0.001 | 18.8 (15.9–21.6) | 44.9 | <0.001 | 0.93 (0.62–1.41) | 1.41 (0.86–2.30) |
| Stroke | 2.9 (2.7–3.0) | 2.9 (1.8–4.0) | 0.003 | 0.956 | 1.4 (0.7–2.1) | 8.6 | 0.004 | 2.19 (0.94–5.09) | 1.16 (0.78–2.84) |
| Requires routine assistance | 5.4 (5.2–5.5) | 5.4 (3.7–7.1) | 0.001 | 0.983 | 4.0 (2.8–5.2) | 3.7 | 0.054 | 1.42 (0.70–2.88) | 1.07 (0.48–2.36) |
| No. of bed days past year | 11.1 (10.8–11.4) | 14.8 (12.1–17.4) | 8.8 | 0.003 | 17.5 (14.9–20.0) | 33.9 | <0.001 | 1.41 (0.81–2.46) | 1.13 (0.66–1.96) |
| Unable to work due to health problem | 8.5 (8.3–8.8) | 11.0 (8.7–13.3) | 5.5 | 0.019 | 10.9 (8.7–13.2) | 5.5 | 0.019 | 1.55 (0.88–2.71) | 0.66 (0.36–1.20) |
| BMIc | 29.8 | <0.001 | 22.9 | <0.001 | |||||
| Healthy weight | 39.0 (38.6–39.5) | 32.9 (29.5–36.4) | 36.4 (32.6–41.1) | Ref. | Ref. | ||||
| Overweight | 28.7 (28.3–29.1) | 25.4 (22.3–28.5) | 22.2 (19.2–25.3) | 1.20 (0.69–2.10) | 0.97 (0.50–1.89) | ||||
| Obese | 29.7 (29.3–30.2) | 39.2 (35.7–42.7) | 38.9 (35.0–42.9) | 1.62 (0.97–2.71) | 1.25 (0.62–2.52) | ||||
| Financial health | |||||||||
| Worry—monthly bills | 56.2 (55.6–56.8) | 60.0 (56.3–63.6) | 4.1 | 0.044 | 66.6 (63.2–69.9) | 32.7 | <0.001 | 1.02 (0.68–1.53) | 1.22 (0.74–2.00) |
| Worry—housing payment | 48.3 (47.7–50.0) | 50.6 (47.1–54.2) | 1.6 | 0.205 | 55.6 (51.8–59.3) | 13.8 | <0.001 | 1.03 (0.67–1.58) | 1.11 (0.68–1.82) |
| Worry—retirement | 71.5 (71.0–72.0) | 75.6 (72.2–78.9) | 5.1 | 0.025 | 77.9 (74.5–81.3) | 11.6 | <0.001 | 1.23 (0.81–1.87) | 1.56 (0.96–2.53) |
| Worry—costs of illness/accident | 68.7 (68.2–69.2) | 72.4 (68.9–75.9) | 3.9 | 0.049 | 76.9 (73.8–80.0) | 22.5 | <0.001 | 1.23 (0.82–1.85) | 1.00 (0.61–1.63) |
| Worry—costs of health care | 57.0 (56.4–57.6) | 60.0 (56.4–63.7) | 2.6 | 0.108 | 62.2 (58.6–65.8) | 7.6 | 0.006 | 1.12 (0.78–1.62) | 1.01 (0.58–1.77) |
| Food insecurity | 10.0 (9.7–10.3) | 12.0 (10.0–14.0) | 4.2 | 0.040 | 21.7 (18.8–24.6) | 113.9 | <0.001 | 1.43 (0.70–2.90) | 2.89 (1.29–6.50) |
| Severe food insecurity | 4.2 (4.0–4.4) | 6.4 (4.9–8.0) | 12.2 | <0.001 | 11.6 (9.3–13.9) | 103.0 | <0.001 | 2.24 (0.99–5.04) | 2.59 (1.05–6.38) |
| Social health | |||||||||
| Difficulty participating in social activities | 6.6 (6.4–6.8) | 8.3 (6.1–10.4) | 2.7 | 0.099 | 10.4 (8.2–12.6) | 16.5 | <0.001 | 1.89 (0.86–4.14) | 1.01 (0.40–2.56) |
| Difficulty going to events | 8.2 (8.0–8.5) | 9.3 (7.0–11.6) | 1.1 | 0.306 | 7.2 (5.3–9.1) | 1.0 | 0.328 | 1.41 (0.65–3.07) | 0.94 (0.42–2.11) |
Significant (p ≤ 0.05) results are bolded. Heterosexual women served as the reference group in all analyses. Regression models were adjusted for differences in age, race/ethnicity, education level, insurance type, cancer site (breast, gynecologic, and other), and survey year.
a
p Value for Rao-Scott Chi-square test for the difference.
b
Regression models estimate aORs using logistic and multinomial regression models.
c
Estimates comparing underweight BMI with healthy weight were suppressed due to unreliability.
aOR, adjusted odds ratio; BMI, body mass index; CI, confidence interval; COPD, chronic obstructive pulmonary disease.