195495 State-level discrimination policies: Environmental risk factors for psychiatric morbidity in LGB populations

Wednesday, November 11, 2009: 9:00 AM

Mark Hatzenbuehler, MS, MPhil , Department of Psychology, Yale University, New Haven, CT
Katherine Keyes, MPH , Columbia University/New York State Psychiatric Institute, New York, NY
Deborah S. Hasin, PhD , Columbia University/New York State Psychiatric Institute, New York, NY

Objectives: Despite the high prevalence of discriminatory policies against lesbian, gay, and bisexual (LGB) individuals, few studies have examined the impact of such policies on the mental health of LGB populations. The current study investigated whether state-level discrimination policies moderate the relationship between LGB status and 12-month prevalence of psychopathology in the general population.

Methods: Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (N=34,653; 577 LGB individuals), a nationally representative study of noninstitutionalized U.S. adults. State-level anti-discrimination variables included: (1) recognition of same-sex unions, including marriage, civil unions, or domestic partnerships; (2) hate crime laws that specify sexual orientation as a protected category; and (3) state policies banning sexual orientation employment discrimination.

Results: Compared to living in states with policies extending protection and rights to LGB individuals, living in states without these policies predicted a significantly stronger association between LGB status and psychopathology, including: generalized anxiety disorder (F=3.87, DF=2, P=0.02); post-traumatic stress disorder (F=3.42, DF=2, P=0.04); and dysthymia (F=5.20, DF=2, P=0.02). Living in states with policies that did not extend protections and rights to LGB individuals also predicted a stronger relation between LGB status and psychiatric comorbidity (F=2.47, DF=2, P=0.04).

Conclusions: State-level discriminatory legislation modifies the effect of LGB status on psychopathology. Policies and laws that reduce discrimination against gays and lesbians (e.g., Employment Non-Discrimination Act, Matthew Shepard Act) are urgently needed to protect the health and well-being of this vulnerable population.

Learning Objectives:
1. Identify novel measures of exposure to sexual minority discrimination (i.e., state-level legislation and policies) that do not rely on self-report. 2. Evaluate associations between current discrimination policies (i.e., employment discrimination, hate crimes, anti-marriage laws) and psychiatric disorders in lesbian, gay, and bisexual (LGB) populations. 3. Discuss policy initiatives that may reduce social inequalities and mental health disparities in LGB populations.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have published five peer-reviewed articles and book chapters on the topic of LGBT mental health. My research on mental health disparities in LGBT populations, including the work for this abstract, has been supported by grants and awards from the National Institutes of Mental Health (National Research Service Award), the American Psychological Association (Division 44 Maylon-Smith Dissertation Award), and the Williams Institute at the UCLA School of Law (Small Grant Research Program Award).
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.