Abstract

Mental Health and Suicide Risk Among Deaf* LGBTQ Youth

Jonah DeChants, PhD, MSSP The Trevor Project

APHA 2022 Annual Meeting and Expo

Purpose: Deaf* LGBTQ youth are impacted by both audism and anti-LGBTQ prejudice, creating increased minority stress and vulnerability to poor mental health. This study examined mental health and suicide risk among Deaf* LGBTQ youth to better understand how the intersection of Deaf* and LGBTQ identities impact youths’ mental health.

Methods: Data from 1,909 Deaf* LGBTQ youth who participated in a 2020 cross-sectional survey were analyzed using adjusted logistic regressions. Respondents were identified to be Deaf* if they reported “Deafness or serious difficulty hearing. Questions assessing recent depression were taken from the PHQ-2. Questions assessing suicide risk were taken from the CDC’s YRBS. Adjusted logistic regression models controlled for age, race/ethnicity, gender identity, sexual orientation, and socioeconomic status.

Results: Deaf* LGBTQ youth reported significantly higher odds of recent depression (aOR = 1.70), considering suicide in the last year (aOR = 1.61), and attempting suicide in the last year (aOR = 1.88). Deaf* youth who reported discrimination due to their LGBTQ identity in the last year reported both increased odds of considering suicide in the last year (aOR = 1.90) and increased odds of attempting suicide in the last year (aOR = 2.42). Deaf* LGBTQ youth who reported high levels of family support reported decreased odds of both considering suicide (aOR = 0.56) and attempting suicide (aOR = 0.49) in the last year.

Conclusion: These findings highlight the urgent need for mental health services which are both LGBTQ-affirming and accessible to Deaf* youth and their families.

Abstract

The differing relationship between discrimination and mental and behavioral health outcomes for Black sexual minority youth in Baltimore City

Annie Smith, MPH, Beth Marshall, MPH, DrPH, Olivia Kachingwe, MPH, PhD, Terrinieka Powell, MA, PhD, Kristin Mmari, MA, DrPH Johns Hopkins University Bloomberg School of Public Health

APHA 2022 Annual Meeting and Expo

In addition to being a social injustice, discrimination is associated with adverse mental health outcomes, particularly among marginalized groups such as racial and ethnic minorities, and lesbian, gay, bisexual, transgender, and queer or questioning (LGBTQ+) individuals. The role of discrimination in the mental health and wellbeing of individuals who identify with multiple marginalized groups is less understood, particularly among youth. The present study sought to identify whether experiencing discrimination differentially affects mental and behavioral health outcomes for youth who identify as lesbian, gay, bisexual, or questioning (LGBQ) compared to heterosexual youth, in a sample of Black adolescents. Our data source was cross-sectional survey data from the Wellbeing of Adolescents in Vulnerable Environments (WAVE) study, which used respondent-driven sampling to document the health of adolescents who were more likely to be overlooked by household- and school-based surveys. Our analytic sample was comprised of Black youth ages 15-19 from a historically redlined area of Baltimore City. Using logistic regression, we explored the relationship between discrimination and mental and behavioral health outcomes separately for sexual minority and heterosexual youth. Outcomes included alcohol use, cigarette smoking, marijuana use, depressive symptoms, and suicidality. We found that, while LGBQ youth had higher adjusted odds of most mental and behavioral health outcomes overall, LGBQ youth who reported discrimination had lower odds of substance use compared to heterosexual youth, and significantly higher odds of adverse mental health outcomes. Findings highlight the importance of acknowledging and accounting for young peoples’ multiple intersecting identities in assessing the role of discrimination in health and wellbeing.

Abstract

Sexual and gender diversity associated with elevated risk of frequent mental distress during the early COVID-19 period in Massachusetts

Koen Tieskens, PhD¹, Prasad Patil, PhD², Xiaojing Peng, MS², Ta-Wei Lin, DrPH³, Lauren Cardoso, PhD³, Caroline Stack, MPH³, Elizabeth Beatriz, PhD^3, Jessica Leibler, DrPH, ScM¹ (1)Department of Environmental Health, Boston University School of Public Health, (2)Department of Biostatistics, Boston University School of Public Health, (3)Bureau of Community Health and Prevention, Massachusetts Department of Public Health

APHA 2022 Annual Meeting and Expo

Background: An emerging literature details negative mental health consequences of the COVID-19 pandemic, although research on disproportionate impacts on socially vulnerable groups is limited.

Objective: We assessed whether socially vulnerable groups in Massachusetts experienced elevated risk of frequent mental distress during the first six months of the pandemic.

Methods: We evaluated odds of experiencing >14 days of self-reported poor mental health (“frequent mental distress ) in the last 30 days among respondents to the Massachusetts Department of Health’s COVID-19 Community Impact Survey (CCIS) (n=23,559) during September-November 2020. We evaluated predictors of gender, sexuality, race, ethnicity and disability. We compared three weighting approaches to draw state-level inferences.

Results: Lesbian or gay (OR:1.63; 95%CI(1.61, 1.64), bisexual (OR: 1.81; 95%CI(1.80, 1.82) , non-binary (OR:1.55; 95%CI(1.53, 1.57) and female (OR:1.49; 95%CI(1.47, 1.50) respondents reported significantly elevated odds of frequent mental distress. Hispanic/Latino (OR:0.77; 95%CI(0.75, 0.78), Black (OR:0.57; 95%CI(0.58, 0.59), and Asian (OR:0.55; 95%CI(0.53, 0.56) respondents reported lower odds of frequent mental distress. Individuals with mobility disabilities reported elevated odds (OR:1.54; 95%CI(1.52, 1.55). Findings were robust to the weighting scheme used.

Conclusions: During the pandemic, poor mental health may be experienced differentially by socially vulnerable groups, with sexual and gender diverse individuals at notably elevated risk.

Abstract

Understanding the impacts of the COVID-19 pandemic on sexual minority mental health: Results from a prospective cohort study of U.S. adults

Ariel Beccia, PhD ¹, Dougie Zubizarreta, MS², S. Bryn Austin, ScD¹, Julia R. Raifman, ScD³, Jorge E. Chavarro, ScD⁴, Brittany M. Charlton, ScD⁵ (1)Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, (2)Department of Epidemiology, Harvard T.H. Chan School of Public Health, (3)Department of Health Law, Policy and Management, Boston University School of Public Health, (4)Department of Nutrition, Harvard T.H. Chan School of Public Health, (5)Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute

APHA 2022 Annual Meeting and Expo

Background: Accumulating evidence indicates that the COVID-19 pandemic is exacerbating mental health inequities for sexual minorities (SMs); however, few studies have examined longitudinal and/or intersectional effects. To address these gaps, we quantified trends in mental health symptoms from April 2020-April 2021 by sexual orientation and tested for within-group differences by gender identity and race/ethnicity.

Methods: Data came from the COVID-19 Sub-Study, a prospective study of U.S. adults embedded within three national cohorts (Nurses’ Health Study 2 and 3 and the Growing Up Today Study; N=54,437). We fit modified Poisson GEE models with wave-by-sexual-orientation interaction terms to estimate risk ratios (RRs) and 95% confidence intervals (CIs) for trends in depressive and anxiety symptoms, perceived stress, coping-motivated eating, and diet-pill use across four groups (gay/lesbian, bisexual, mostly heterosexual, completely heterosexual). We then added interaction terms between sexual orientation and either gender identity (cisgender women, cisgender men, transgender/gender diverse) or race/ethnicity (Asian, Black, Hispanic/Latine, White, unlisted) to test for intersectional effects

Results: Relative to completely heterosexual participants (n=3,425), gay/lesbian (n=788), bisexual (n=606), and mostly heterosexual (n=49,618) participants had higher risks of all outcomes at each wave, with gay/lesbian (RR:1.20, 95%CI:1.03-1.39) and bisexual (RR1.19, 95%CI:1.02-1.38) participants experiencing widening inequities in depressive and anxiety symptoms by the end of follow-up. All other inequities among SM groups persisted; none attenuated. In general, inequities were largest for transgender/gender diverse SMs and SMs of color across the study period.

Conclusions: Mental health inequities affecting diverse SM populations may have widened during the pandemic, underscoring the need for intervention.