Stewart Landers

A Population-Based Study of Sexual Orientation Identity and Gender Differences in Adult Health

OBJECTIVES We provide estimates of several leading US adult health indicators by sexual orientation identity and gender to fill gaps in the current literature. METHODS We aggregated data from the 2001-2008 Massachusetts Behavioral Risk Factor Surveillance surveys (N = 67,359) to examine patterns in self-reported health by sexual orientation identity and gender, using multivariable logistic regression. RESULTS Compared with heterosexuals, sexual minorities (i.e., gays/lesbians, 2% of sample; bisexuals, 1%) were more likely to report activity limitation, tension or worry, smoking, drug use, asthma, lifetime sexual victimization, and HIV testing, but did not differ on 3-year Papanicolaou tests, lifetime mammography, diabetes, or heart disease. Compared with heterosexuals, bisexuals reported more barriers to health care, current sadness, past-year suicidal ideation, and cardiovascular disease risk. Gay men were less likely to be overweight or obese and to obtain prostate-specific antigen tests, and lesbians were more likely to be obese and to report multiple risks for cardiovascular disease. Binge drinking and lifetime physical intimate partner victimization were more common among bisexual women. CONCLUSIONS Sexual orientation disparities in chronic disease risk, victimization, health care access, mental health, and smoking merit increased attention. More research on heterogeneity in health and health determinants among sexual minorities is needed.

Sexual and Gender Minority Health: What We Know and What Needs to Be Done

We describe the emergence of lesbian, gay, bisexual, and transgender (LGBT) health as a key area of study and practice for clinicians and public health professionals. We discuss the specific needs of LGBT populations on the basis of the most recent epidemiological and clinical investigations, methods for defining and measuring LGBT populations, and the barriers they face in obtaining appropriate care and services. We then discuss how clinicians and public health professionals can improve research methods, clinical outcomes, and service delivery for lesbian, gay, bisexual, and transgender people.

Transgender Health in Massachusetts: Results From a Household Probability Sample of Adults

Despite higher rates of unemployment and poverty among transgender adults (n = 131; 0.5% weighted) than among nontransgender adults (n = 28,045) in our population-based Massachusetts household sample, few health differences were observed between transgender and nontransgender adults. Transgender adults who are stably housed and participated in a telephone health survey may represent the healthiest segment of the transgender population. Our findings demonstrate a need for diverse sampling approaches to monitor transgender health, including adding transgender measures to population-based surveys, and further highlight economic inequities that warrant intervention.

An Invisible Population: Older Lesbian, Gay, Bisexual, and Transgender Individuals

The US census reported that persons 65 years or older numbered 35 million in year 2000 (1). This number represents 12.4% of the US population, or approximately one in every eight Americans. By the year 2030 when the baby boomer generation (45–65 years of age) reaches 65 years of age, the numbers of older adults are projected to double to approximately 70 million older adults, representing about 20% of the overall population (2).

Sex and Gender in the US Health Surveillance System: A Call to Action

Youth Risk Behavior Survey (YRBS) data have exposed significant sexual orientation disparities in health. Interest in examining the health of transgender youths, whose gender identities or expressions are not fully congruent with their assigned sex at birth, highlights limitations of the YRBS and the broader US health surveillance system. In 2009, we conducted the mixed-methods Massachusetts Gender Measures Project to develop and cognitively test measures for adolescent health surveillance surveys. A promising measure of transgender status emerged through this work. Further research is needed to produce accurate measures of assigned sex at birth and several dimensions of gender to further our understanding of determinants of gender disparities in health and enable strategic responses to address them.

Effect of changing patterns of care and duration of survival on the cost of treating the acquired immunodeficiency syndrome (AIDS).

We performed a two-year cost of illness study of 240 AIDS patients (55 percent of all Massachusetts cases) diagnosed and treated at five hospitals from March 1984 through February 1986. Sociodemographic and clinical data as well as information on medical utilization were obtained from review of inpatient and outpatient hospital records. The yearly inpatient cost per patient decreased by 28 percent from

Reporting Guidelines and the American Journal of Public Health’s Adoption of Preferred Reporting Items for Systematic Reviews and Meta-Analyses

38,369 in year one to

The Open Door Project Task Force: A Qualitative Study on LGBT Aging

27,714 in year two. These changes were related to shorter lengths of stay (from 20.6 days to 16.8 days per hospitalization, mean difference of 3.8 days, 95% CI of the difference -.2, 7.8), and less costly hospitalizations (from

Sexual Orientation Differences in Asthma Correlates in a Population-Based Sample of Adults

12,463 to

Interdisciplinary HIV care in a changing healthcare environment in the USA

9,957, mean difference of