Allostatic Load Among Black Sexual Minority Women

Walubita, Tubanji; Forrester, Sarah N.; Jesdale, Bill M.

doi:10.1089/jwh.2020.8912

Cited by 7 publications

(3 citation statements)

References 30 publications

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“…Over the last decade, AL studies among sexual minorities have revealed the highest AL among bisexual men, the lowest AL among gay men, and no AL differences by sexual orientation among women (27,50,51). However, none of these AL studies among sexual minorities have directly measured individual-, interpersonal-, or structural-level stigma (52).…”

Section: Introductionmentioning

confidence: 99%

Associations Between Structural Stigma and Allostatic Load Among Sexual Minorities: Results From a Population-Based Study

Juster,

Rutherford,

Keyes

et al. 2024

Psychosom Med

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Objective Structural forms of stigma and discrimination are associated with adverse health outcomes across numerous stigmatized groups, including lesbian, gay, and bisexual (LGB) individuals. Yet, the biological consequences of structural stigma among LGB populations are understudied. To begin to address this gap, we assessed associations between indicators of structural stigma (i.e., state-level policies) targeting LGB individuals and allostatic load (AL) indices representing physiological dysregulations. Methods Pooled data from the continuous 2001-2014 National Health and Nutritional Examination Survey were analyzed (LGB: n = 864; heterosexual: n = 20,310). Ten state-level LGB-related policies (e.g., employment non-discrimination protections, same-sex marriage) were used to operationalize structural stigma. A sex-specific AL index representing 11 immune, metabolic, and cardiovascular biomarkers was estimated. Multi-level models were used to examine associations between structural stigma and AL, net of 9 individual-level characteristics (e.g., education, race/ethnicity, age, and health behaviors). Results Sexual minority men living in states with low levels of structural stigma experienced significantly lower AL (β = -.45, p = .02) compared to sexual minority men living in states with high structural stigma (i.e., fewer protective policies). There was no significant association between structural stigma and AL among sexual minority women. Conclusions By demonstrating direct associations between structural stigma and indices of physiological dysregulation, our findings provide a mechanistic understanding of how the social environment can “get under the skin and skull” for sexual minority men in the United States. Future research should explore whether these mechanisms generalize to other marginalized groups exposed to structural stigma.

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Section: Introductionmentioning

confidence: 99%

Associations Between Structural Stigma and Allostatic Load Among Sexual Minorities: Results From a Population-Based Study

Juster,

Rutherford,

Keyes

et al. 2024

Psychosom Med

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“…According to these theories, sexual-minority status affects cognitive outcomes via the same behavioral and physiological risk factors for AD and dementia that are in the general population, albeit at elevated levels: depression, stress, smoking, drug use, and drinking and higher chronic-inflammation biomarkers and decreased hippocampal volume [7]. In response to discrimination, stigma, and marginalization, LGB people experience higher rates of these risk factors than do straight people [6][7][8][9]. Gay and bisexual men's higher risk of human immunodeficiency virus (HIV) also increases their risk for dementia directly, through HIV-associated dementia, and indirectly, through associated illnesses, stigma, and social isolation [10].…”

Section: Introductionmentioning

confidence: 99%

“…These are all persistent problems that also intersect with other forms of marginalization, including race/ethnicity, sex/gender, and class [6,9]. Yet some LGB people are able to cultivate coping mechanisms and may experience greater resilience that mitigates their risk of cognitive decline [8].…”

Section: Introductionmentioning

confidence: 99%

Cognitive Aging in Same- and Different-Sex Relationships: Comparing Age of Diagnosis and Rate of Cognitive Decline in the Health and Retirement Study

Hanes

Clouston

2022

Gerontology

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Introduction: The ongoing marginalization of lesbian, gay, and bisexual people has been hypothesized to produce poorer late-in-life cognitive outcomes, according to mechanisms posited by minority stress and allostatic load theories. Yet the existence of those outcomes remains understudied, and results of existing studies have been contradictory. Using a population-based longitudinal aging study, this paper will compare age at diagnosis of Alzheimer’s disease (AD) or a related dementia and rates of cognitive decline between participants in same-sex relationships (SSRs) and different-sex relationships (DSRs). Methods: The study used longitudinal cognitive-health data from the Health and Retirement Study (HRS; 1998–2018; N = 26,344) to analyze the onset of cognitive impairment and AD/dementia and the rates of cognitive change between participants in SSRs and those in DSRs. We hypothesized that SSR participants would have worse overall cognitive functioning in old age and would experience earlier onset of cognitive impairment. Using multiple regression, we compared the ages at which participants in SSRs and DSRs first reported AD or dementia diagnoses and the ages at which they first scored below cutoffs for cognitive impairment, not dementia (CIND) and possible dementia as determined using the cognitive assessment. The study then compared rates of cognitive decline over time across the SSR and DSR groups, including stratified analyses by education, race/ethnicity, wealth, and sex/gender. Results: Participants in SSRs reported dementia diagnoses (β = −12.346; p = 0.001), crossed the threshold into CIND (β = −8.815; p < 0.001) and possible dementia (β = −13.388; p < 0.001) at a younger age than participants in DSRs. When adjusted for covariates, participants in SSRs also had lower cognition at baseline (β = 0.745; p = 0.003), though having slower rates of cognitive decline when SSR was interacted with time (β = 0.066; p = 0.003). In separate analyses, cognitive differences for SSR participants were only found in participants without undergraduate degrees, with below-median household incomes, and women. Conclusion: Our findings support theories suggesting that marginalization and stigma cause premature cognitive impairment. Findings also suggest that higher education might mitigate the adverse effects of sexuality-minority status on cognitive aging. Results do not support these theories’ claims of more rapid cognitive decline; the lower slopes of cognitive decline with time are compatible with the possibility of slower rates of decline for aging individuals in SSRs.

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Refining Research and Representation of Sexual and Gender Diversity in Neuroscience

Edmiston

Juster²

2022

Biological Psychiatry: Cognitive Neuroscience and Neuroimaging

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Allostatic Load Among Black Sexual Minority Women

Cited by 7 publications

References 30 publications

Associations Between Structural Stigma and Allostatic Load Among Sexual Minorities: Results From a Population-Based Study

Associations Between Structural Stigma and Allostatic Load Among Sexual Minorities: Results From a Population-Based Study

Cognitive Aging in Same- and Different-Sex Relationships: Comparing Age of Diagnosis and Rate of Cognitive Decline in the Health and Retirement Study

Refining Research and Representation of Sexual and Gender Diversity in Neuroscience

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