Between and Within Sexual Identity-Group Differences in Asthma Prevalence in the United States

Abstract

BACKGROUND: Although prior studies have established the association of asthma with smoking and obesity, literature on difference-in-differences analyses involving sexual identity is sparse. Therefore, this study aimed to examine the between and within sexual identity-group differences in asthma prevalence among individuals who smoke and are obese. METHODS: We aggregated the 2017-2019 National Survey on Drug Use and Health data on adults (N 5 128,319) to perform weighted multivariable logistic regression analysis and marginal estimates and marginsplot to determine asthma prevalence by sexual identity and the status of smoking and obesity. RESULTS: About 66% of the study population reported having asthma. Among the individuals with asthma, 42% were obese, 10% were daily cigarette smokers, and 6% identified as bisexual persons. Lesbian/gay daily smokers (86%) or former smokers (75%) had a higher probability of having asthma than bisexual (daily smokers 5 78% vs former smokers 5 72%) and heterosexual (daily smokers 5 68% vs former smokers 5 65%) persons. Within each sexual identity subgroup, daily smokers (68-86%) had the highest probability of asthma. Obese bisexual (73%) or lesbian/gay (72%) persons had higher probabilities of having asthma than heterosexual persons (69%). Obese (73%) or overweight (72%) bisexual (compared to normal weight 5 70% or underweight 5 51%) and obese (69%) or overweight (65%) heterosexual (compared to normal weight 5 62% or underweight 5 57%) persons had the highest probabilities of having asthma within their groups, whereas overweight persons (overweight 5 81% vs underweight 5 79%, normal weight 5 78%, and obese 5 72%) had the highest probabilities within lesbian/ gay persons. CONCLUSIONS: Smoking and obesity show heightened odds for asthma, with significant odds for sexual minorities in asthma diagnosis relative to heterosexuals. These findings provide formative information for future longitudinal and experimental studies to explore these mechanisms of asthma risks among sexual and gender minorities.

Differences in the Perceived Likelihood of Receiving COVID-19 Vaccine

“…We also found that gay respondents were more likely to report vaccination intent than heterosexual individuals. However, it should be noted that their high perceived likelihood of receiving the vaccine may not be synonymous with vaccine access or eventual vaccination given that sexual minority communities experience greater health barriers than heterosexual individuals [ 30 , 31 , 32 ]. Specifically, sexual minority individuals experience higher rates of stigmatization, medical abuse, harassment, and medical mistrust due to historical medical mistreatment, health services or information often not being tailored to their needs, and the lack of safe, affirming clinical and public spaces—all of which have been linked with vaccine hesitancy among sexual minority groups [ 22 , 31 , 32 ].…”

The Influence of COVID-19 Pandemic on the Frequent Use of E-Cigarettes and Its Association with Substance Use and Mental Health Symptoms

“…The higher use of e-cigarettes among sexual minority persons such as lesbian individuals may be due to using e-cigarettes to cope with stressors such as discrimination, stigmatization, abuse, harassment, and health and social inequities [ 39 , 40 , 41 , 42 ]. This may be compounded by implicit cisnormative and heteronormative biases in health services and a lack of LGBTQ-specific interventions [ 40 , 41 , 43 ].…”

Sociodemographic factors, health behavior, parental or workplace smoking, and adult asthma risk in the United States

“…Numerous studies have explored the risk factors for asthma among children [13,14], especially those living in the US [15,16]. These studies identified older age, obesity, low socioeconomic status, smoking, and physical inactivity as asthma risk factors.…”