A new study based on surveys and demographic data compiled over 14 years has found that gay people living in high-prejudice areas are at greater risk of dying prematurely than those living in more accepting communities. The effects were independent of other risk factors for premature death including household income, education, gender, ethnicity and age.
In the last decade, several studies have shown that lesbian, gay, bisexual and transgender individuals are at greater risk for mental and physical health problems than heterosexuals, but the reasons for these disparities aren't well understood. Previous research focused on interpersonal events but few studies have looked to communities and institutions that encourage and endorse anti-gay sentiment and policies.
Dr. Mark Hatzenbuehler, a sociomedical sciences professor at the Mailman School of Public Health – Columbia University and his colleagues sought to find out if an intolerant environment, the place where people “live, work and play,” was tied to premature death among LGBT individuals. What they found was that the life spans of“sexual minorities” (LGBT individuals) were shorter by about 12 years, when they lived in “high-prejudice communities.
“The results from the current study provide important social science evidence demonstrating that sexual minorities living in communities with high levels of anti-gay prejudice have increased risk of mortality, compared to those living in low-prejudice communities,” Hatzenbuehler says.
The difference, he says, is comparable to life expectancy differences between people with a high school education and those without one.
Hatzenbuehler and his colleagues at Columbia University as well as University of Nebraska–Lincoln, University of Pennsylvania, University of Rochester and the Rand Corporation used data from the General Social Survey from 1988 to 2002 to assess 20,001 people from 170 urban and rural “life spaces.” The lowest number of respondents in any sampling area or community was 42. The GSS is also tied to the National Death Index.
The year 1988 was chosen as a starting point because it was the first year respondents were asked about the number and gender of their sexual partners. Those who had sexual partners of the same sex in the preceding 12 months, 5 years or since they were 18 years old were classified as “sexual minorities.”
To measure anti-gay sentiment in a population sample the researchers looked at four specific questions, including: “If some people in your community suggested that a book in favor of homosexuality should be taken out of your public library, would you favor removing this book, or not?” and “Suppose a man who admits that he is a homosexual wanted to make a speech in your community. Should he be allowed to speak or not?”
The answers were rated, tallied and summed into a single value. The lowest number of respondents in any sampling area or community was 42. On average, those living in high prejudice areas responded to almost half (1.77) of the four anti-gay survey questions in ways that reflected anti-gay sentiment.
In every wave of surveys analyzed by the group, these four prejudice questions were asked, though not all questions were asked among all respondents in every year.
The National Death Index found that of the 914 sexual minorities surveyed, 134 had died by 2008. Analysis of causes of death in this group showed that suicide and homicide-related deaths were higher in the high-prejudice, high-stigma areas. Around 6 percent of high-stigma deaths were from suicide, compared to almost 3 percent in low stigma communities. Another 6 percent of deaths in high-stigma areas were due to violence, compared to 2 percent in low-stigma communities.
Hatzenbuehler says his study will likely confirm what LGBT individuals already know about the impact of prejudice on their lives.
“Anecdotally, when you talk to gays and lesbians about what it’s like to live in environments where they are targeted for social exclusion, they report how stressful these environments can be," he says. "Thus our study provides empirical evidence to substantiate the lived experience of LGBT individuals.”
Hatzenbuehler said that his previous research on the health consequences of same-sex marriage policies has been cited in documents related to court cases on sexual orientation discrimination. He believes the social science data from this study could also be useful to legal scholars and policymakers.
This study was published in the February issue of Social Science & Medicine.