Sexual minorities still face more mental health, substance use conditions – SFU study

A new Simon Fraser Univerity study finds sexual minorities still experience a greater burden of mental health and substance use conditions than heterosexual people despite legislative and policy advances and improvements in social attitudes in recent decades.

Led by SFU health sciences assistant professor Travis Salway, the study, published in SSM – Population Health, found that inequalities in mental health and substance use conditions between sexual minority and heterosexual populations have not improved since 2003. 

The disparities in mental health and substance use suggest a failure of public policy that calls for more in-depth investigations into how and why developments in structural stigma are not improving sexual minority health disparities, according to Salway.

“Sexual minority-affirming legislative and policy developments, among improvements in social attitudes toward sexual minorities in recent decades, should presumably reduce experiences of minority stress,” says Salway. “However, sexual minority populations have continued to experience a greater burden of mental health and substance use conditions—a health inequality that has mainly been attributed to forms of stress.” 

The study encompasses the longest period of trend analysis among sexual minority adults, spanning 18 years in total.

Researchers analyzed the annual prevalence of anxiety, depression, poor self-rated mental health, and cigarette smoking by sexual orientation using data from the Canadian Community Health Survey between 2003 and 2020.

They found that the commonness of self-rated mental health and mood and anxiety disorders increased, while the prevalence of smoking decreased among both sexual minority and heterosexual people in Canada.

“We found no evidence that sexual orientation disparities in mental health and substance use have improved during a period of amendments in legislative and policy efforts to protect the well-being of sexual minority populations, as well as improvements in societal attitudes toward sexual minority people.”

“Our findings highlight the need to better understand the mechanisms bolstering sexual orientation health disparities,” says Salway. 

Salway recommends that future analyses expand upon their research, especially as sexual and gender minority-inclusive data platforms continue to grow. 

“Future studies could adopt intersectional approaches to monitor for other differences, such as on the basis of race, socioeconomic position, and geography,” says Salway.