Abstract
Objective
To assess the association between sexual orientation and functional limitations in
a large representative sample of the English population.
Design
Cross-sectional.
Setting
Data were from the 2007 Adult Psychiatric Morbidity Survey.
Participants
A total of 7403 adults aged 16-95 years (51.4% female; mean age, 46.3±18.6y) were
included in the present study.
Interventions
Not applicable.
Main Outcome Measures
Sexual orientation was assessed using 2 items adapted from the Kinsey scale and was
dichotomized into heterosexual and sexual minority orientation. Functional limitations
were assessed using 7 activities of daily living (ADL) and instrumental activities
of daily living (IADL). Functional limitations were defined as at least 1 difficulty
in 1 of 7 ADL and IADL. Adjusted logistic regression analyses were conducted to investigate
the association between sexual orientation (independent variable) and functional limitations
(dependent variable).
Results
The level of sexual minority orientation and prevalence of functional limitations
in the sample was 7.1% and 32.9%, respectively. After adjusting for several potential
confounders, sexual minority orientation was positively and significantly associated
with functional limitations (odds ratio, 1.51; 95% confidence interval, 1.18-1.95;
reference group: heterosexual orientation).
Conclusions
Based on the findings of this study, interventions aiming to prevent against and/or
manage/reduce functional limitations in sexual minorities are needed. More research
is also warranted to better understand mediators (eg, obesity, cognitive complaints,
psychiatric disorders) involved in the sexual orientation–functional limitation relationship.
Keywords
List of abbreviations:
ADL (activities of daily living), APMS (Adult Psychiatric Morbidity Survey), CI (confidence interval), IADL (instrumental activities of daily living), OR (odds ratio), UK (United Kingdom), US (United States)To read this article in full you will need to make a payment
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References
Office for National Statistics. Sexual orientation, UK: 2017. Available at: https://www.ons.gov.uk/peoplepopulationandcommunity/culturalidentity/sexuality/bulletins/sexualidentityuk/2017. Accessed March 5, 2021.
- A systematic review of cardiovascular disease in sexual minorities.Am J Public Health. 2017; 107: e13-e21
The University of New South Wales. National Centre in HIV Epidemiology & Clinical Research. Available at: https://kirby.unsw.edu.au/sites/default/files/kirby/report/KI_2010-Annual-report.pdf. Accessed March 5, 2021.
Mental Health Foundation. Mental health statistics: LGBT people. Available at: https://www.mentalhealth.org.uk/statistics/mental-health-statistics-lgbt-people. Accessed March 5, 2021.
- Factors associated with high-risk alcohol consumption among LGB older adults: the roles of gender, social support, perceived stress, discrimination, and stigma.Gerontologist. 2017; 57: S95-104
Abdulrahim D, Whiteley C, Moncrieff M, Bowden-Jones O. Club drug use among lesbian, gay, bisexual and trans (LGBT) people. Available at:http://neptune-clinical-guidance.co.uk/wp-content/uploads/2016/02/neptune-club-drug-use-among-lgbt-people.pdf. Accessed March 5, 2021.
- Sexual behaviours, HIV testing, and the proportion of men at risk of transmitting and acquiring HIV in London, UK, 2000-13: a serial cross-sectional study.Lancet HIV. 2016; 3: e431-e440
- Experiences of ex-ex-gay individuals in sexual reorientation therapy: reasons for seeking treatment, perceived helpfulness and harmfulness of treatment, and post-treatment identification.J Homosex. 2014; 61: 1242-1268
- The growing regulation of conversion therapy.J Med Regul. 2016; 102: 7-12
- Conversion therapy in the southern United States: prevalence and experiences of the survivors.J Homosex. 2020; (Nov 18. [Epub ahead of print])
- Association between recalled exposure to gender identity conversion efforts and psychological distress and suicide attempts among transgender adults.JAMA Psychiatry. 2020; 77: 68-76
- The definition of disability: what is in a name?.Lancet. 2006; 368: 1219-1221
- Disability among lesbian, gay, and bisexual adults: disparities in prevalence and risk.Am J Public Health. 2012; 102: e16-e21
Stonewall. Stonewall report reveals impact of discrimination on health of LGBT people. Available at:https://www.stonewall.org.uk/about-us/media-releases/stonewall-report-reveals-impact-discrimination-health-lgbt-people. Accessed March 5, 2021.
- Disparities in health and disability among older adults in same-sex cohabiting relationships.J Aging Health. 2015; 27: 432-453
- Sexual orientation differences in functional limitations, disability, and mental health services use: results from the 2013-2014 National Health Interview Survey.J Consult Clin Psychol. 2017; 85: 1111-1121
- Disability, sexual orientation, and the mental health outcomes of intimate partner violence: a comparative study of women in the U.S.Disabil Health J. 2019; 12: 164-170
- Application of an intersectional framework to understanding the association of disability and sexual orientation with suicidal ideation among Oregon Teens.Disabil Health J. 2019; 12: 557-563
- Outness, stigma, and primary health care utilization among rural LGBT populations.PLoS One. 2016; 11e0146139
- Disability, mental health, sexual orientation and gender identity: understanding health inequity through experience and difference.Health Res Policy Syst. 2018; 16: 97
- A deviation too many? Healthcare professionals’ knowledge and attitudes concerning patients with intellectual disability disrupting norms regarding sexual orientation and/or gender identity.J Appl Res Intellect Disabil. 2020; 33: 1199-1209
- The British Mental Health Survey Programme: achievements and latest findings.Soc Psychiatry Psychiatr Epidemiol. 2009; 44: 899-904
McManus S, Meltzer H, Brugha T, Bebbington P, Jenkins R. Adult psychiatric morbidity in England, 2007: results of a household survey. Available at:https://digital.nhs.uk/data-and-information/publications/statistical/adult-psychiatric-morbidity-survey/adult-psychiatric-morbidity-in-england-2007-results-of-a-household-survey. Accessed March 5, 2021.
- Adult psychiatric morbidity survey, 2007.UK Data Service, London2017
Kinsey Institute, Indiana University. The Kinsey scale. Available at:https://kinseyinstitute.org/research/publications/kinsey-scale.php. Accessed March 5, 2021.
- Relationship between sexual orientation and psychotic experiences in the general population in England.Psychol Med. 2021; 51: 138-146
- The physical and mental health of lesbian, gay male, and bisexual (LGB) older adults: the role of key health indicators and risk and protective factors.Gerontologist. 2013; 53: 664-675
- Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO Collaborative Project on Early Detection of Persons with Harmful Alcohol Consumption–II.Addiction. 1993; 88: 791-804
- The measurement of alcohol dependence and impaired control in community samples.Addiction. 1994; 89: 167-174
R Core Team. R: a language and environment for statistical computing. Available at: https://www.R-project.org/. Accessed March 5, 2021.
- Elevated risk of cognitive impairment among older sexual minorities: do health conditions, health behaviors, and social connections matter?.Gerontologist. 2021; 61: 352-362
- Cognitive impairment and disability in older Japanese adults.PLoS One. 2016; 11e0158720
- Risk of type 2 diabetes among lesbian, bisexual, and heterosexual women: findings from the Nurses’ Health Study II.Diabetes Care. 2018; 41: 1448-1454
- Diabetes and risk of physical disability in adults: a systematic review and meta-analysis.Lancet Diabetes Endocrinol. 2013; 1: 106-114
- Problem drinking predicts functional health and mortality risk 10 years later in the MIDUS Study.Innov Aging. 2020; 4: 404
- Scrambling for access: availability, accessibility, acceptability and quality of healthcare for lesbian, gay, bisexual and transgender people in South Africa.BMC Int Health Hum Rights. 2017; 17: 16
- Discrimination in the United States: experiences of lesbian, gay, bisexual, transgender, and queer Americans.Health Serv Res. 2019; 54: 1454-1466
- Influence of sexual orientation on diabetes management in US adults with diabetes.Diabetes Metab. 2021; 47101177
- Asthma status and risks among lesbian, gay, and bisexual adults in the United States: a scoping review.Ann Allergy Asthma Immunol. 2019; 122: 535-536
- Forecasted trends in disability and life expectancy in England and Wales up to 2025: a modelling study.Lancet Public Health. 2017; 2: e307-e313
- Personality and sexual orientation: new data and meta-analysis.J Sex Res. 2020; 57: 953-965
- Sexual function and satisfaction among heterosexual and sexual minority U.S. adults: a cross-sectional survey.PLoS One. 2017; 12e0174981
- Smoking cessation programs for lesbian, gay, bisexual, transgender, and intersex people: a content-based systematic review.Nicotine Tob Res. 2017; 19: 1408-1417
- Systematic review of interventions to reduce problematic alcohol use in men who have sex with men.Drug Alcohol Rev. 2016; 35: 148-157
- Substance use among men who have sex with men: patterns, motivations, impacts and intervention development need.Sex Transm Infect. 2017; 93: 342-346
- Addressing health care disparities among sexual minorities.Obstet Gynecol Clin. 2017; 44: 71-80
Article info
Publication history
Published online: May 04, 2021
Accepted:
April 2,
2021
Received in revised form:
March 8,
2021
Received:
February 9,
2021
Footnotes
Disclosures: none
Identification
Copyright
© 2021 The American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
