Substance Use, Mental Well-being, and Suicide Ideation by Sexual Orientation among US Adults

Abstract

Purpose: In the current work, we provide a portrait of heavy alcohol use, cigarette smoking, mental health, and suicide ideation by sexual orientation among a large sample of US adults aged 25 years and older.

Design/methodology/approach: We produce a repository of information on sexual orientation, substance use, mental well-being, and suicide ideation for adults aged 25 years and older using Behavioral Risk Factor Surveillance System (BRFSS) surveys for nine US states from 2011 to 2018. We establish baseline differences on these outcomes for gay, lesbian, and bisexual (GLB), relative to heterosexual, adults and then use regression techniques to adjust the estimates for important sociodemographic, socioeconomic, and relationship status variables.

Findings: Disparities by sexual orientation across substance use, mental health, and suicide ideation are concerning, some alarmingly so. Bisexuals, particularly women, face pronounced challenges across outcomes. Sexual minority men and women report significantly more poor mental health days and much higher odds of suicide ideation. To illustrate, gay men, lesbians, and bisexual men and women, relative to their heterosexual counterparts, have odds of seriously contemplating taking their own lives that are two to four times higher even after adjusting for relevant controls.

Originality/value: Existing knowledge connecting GLB identity and mental well-being has focused largely on adolescent and young adults. We provide a representative study on older adult differences across four different behavioral health outcomes by sexual orientation. The scale of the disparities we report here, and their implications for overall well-being across groups, deserves national attention and action.

Citation

Denney, J.T., Zhang, Z., Gorman, B.K. and Cooley, C. (2021), "Substance Use, Mental Well-being, and Suicide Ideation by Sexual Orientation among US Adults", LeBlanc, A.J. and Perry, B.L. (Ed.) Sexual and Gender Minority Health (Advances in Medical Sociology, Vol. 21), Emerald Publishing Limited, Leeds, pp. 39-63. https://doi.org/10.1108/S1057-629020210000021008