Sexual Orientation Disparities in Healthcare Utilization: Differences in Informal and Formal Care

• In Event: 3-038 - Mental Healthcare for Sexual and Gender Minority Adolescents: Access, Utilization, and Effectiveness

Integrative Statement

Introduction: Research on health disparities shows that sexual minority youth report more mental health problems compared to heterosexual youth (Russell & Fish, 2016). However, research on (mental) healthcare utilization among sexual minority individuals is mixed in its findings: while some work shows that sexual minority individuals are less likely to utilize healthcare (Buchmueller et al., 2010), others show that sexual minority adolescents are more likely to visit health professionals (Lucassen et al., 2011). In the current study we examined differences in healthcare utilization by sexual orientation among college students.
Method: Data from the National Research Consortium of Counseling Centers in Higher Education were utilized. The sample included 25,844 college students (mean age = 25.52, SD = 7.89); most self-identified as heterosexual (93.15%), 2.49% as lesbian/gay, 3.37% as bisexual, and 0.99% as questioning. Measures assessed received services, resources to which students would turn, and who affected their ability to cope. Survey-adjusted, sex-stratified, regression analyses were conducted to examine differences between sexual minority and heterosexual students, controlling for age, race/ethnicity, suicidal ideation, and mental health history.

Results: The results showed differences in mental healthcare utilization across sexual orientation groups. Gay males (B=0.17, p=.002) received more services than heterosexual males. Bisexual females (B=0.11, p=.006) and lesbian/gay females (B=0.22, p<0.001) also received more services. Although differences were small, gay males (OR=0.66, 95%CI: 0.44-0.99), and bisexual females (OR=0.66, 95%CI: 0.46-0.92) were less likely to receive services from clergy.
Students were asked from whom they would seek help when faced with a combination of problems. Bisexual males and females, questioning females, and lesbian/gay females were less likely to seek help from a parent or family member (B=-0.04, p=.021; B=-.06, p<0.001; B=-0.11, p<0.001; B=-0.13, p<0.001), compared with heterosexuals. Gay males were more likely, while questioning females were less likely, to seek help from a friend or roommate (B=0.16, p<0.001; B=-0.05, p=.017). Lesbian/gay females (B=0.05, p=.002) were more likely, while questioning males females were less likely, to seek help from a romantic partner (B=-0.05, p=.045; B=-0.05, p=.005).
Last, students were asked what improved their ability to cope during a stressful period. Compared with heterosexual females, lesbian/gay and bisexual females were more likely to report that religion (B=-0.42, p<0.001; B=-0.38, p<0.001) reduced their ability to cope during a stressful period. Gay males were more likely to report that friends improved their ability to cope (B=0.27, p<0.001), whereas they were more likely to report that religion reduced their ability to cope (B=-0.22, p=.001). Lesbian/gay, bisexual, and questioning females were more likely to report that family reduced their ability to cope (B=-0.40, p<0.001; B=-0.23, p<0.001; B=-0.30, p=.003). Questioning males and females were more likely to report that friends (B=-0.30, p=.017; B=-0.27, p<0.001) and religion (B=-0.22, p=.003; B=-0.30, p<0.001) reduced their ability to cope.
Conclusion: Although sexual minority college students received more services from mental healthcare professionals than heterosexual students, they were less likely to receive support from informal sources. Future research should focus on perceived acceptance of healthcare providers and effectiveness of mental healthcare for sexual minority youth.

Authors

• Laura Baams, University of Groningen
  Presenting Author

• Susan De Luca, University of Texas at Austin
  Non-Presenting Author

• Chris Brownson, University of Texas at Austin
  Non-Presenting Author