Depression and substance use among LGB public health clinic patients in los angeles county, CA, 2012

Background: Rates of depression and substance use have been reported as higher in lesbian, gay, and bisexual (LGB) populations than heterosexual populations. Few reports, however, are based on population surveys and findings vary across subpopulations. We assessed mental health and substance use among LGB individuals seeking care at urban public health clinics. Methods: We used data from the 2012 Los Angeles County Health and Nutrition Examination Survey (n=1422, 69% response rate), a targeted health assessment of adults seeking care at public health clinics in Los Angeles County, CA. We examined respondents' reports of mental health and substance use, stratified by gender. Results: Lesbian and bisexual women were more likely to be depressed than heterosexual women (47.2% vs 32.5%, p < 0.05). Gay and bisexual men were more likely to be depressed than heterosexual men (46.7% vs 25.0%, p < 0.01). Lesbian and bisexual women were more likely to report smoking (43.1% vs 25.1%, p <0.01) and binge drinking than heterosexual women (54.4% vs 38.0%, p < 0.05). Conclusions: Among low-income LGB seeking care at public health clinics in Los Angeles County, differences in the prevalence of depression, smoking, and alcohol use are pronounced when compared to the heterosexual population. This is particularly the case for lesbian and bisexual women. Although the factors contributing to these disparities are complex, public health clinics may represent an important opportunity to reach these low-income LGB populations whose access to and engagement in medical care may otherwise be limited.