Sexual minority health: Using the 2016 National Health Interview Survey to evaluate physical activity, behavioral risk factors, and health outcomes

Due to the historical exclusion of LGB individuals in research, there is a gap in knowledge regarding physical activity (PA) adoption and adherence which prevents public health professionals from creating evidence-based interventions tailored to fit the specific needs and barriers for LGB populations. This is a major public health concern because, until recently, national surveys did not gather information on sexual orientation. LGB individuals face similar barriers as their heterosexual peers; however, specific health disparities affect LGB individuals as a result of discrimination and societal stigma.
Positive health benefits of PA spread across physical, psychological, and social dimensions of health. A comprehensive approach is needed to examine the unique experiences of LGB individuals, including the effect of PA on general health status, chronic disease, and psychosocial health (Gorczynski & Brittain, 2016) as well as risk factors associated with those health outcomes (ODPHP, 2014). Due to the scarcity of research on PA and health outcomes based on sexual orientation, this study sought to determine if sexual orientation is a predictive factor of certain health behaviors and outcomes. Utilizing data from the 2016 National Health Interview Survey, this research study focused on the following: (1) To evaluate the effect of physical activity on self-reported behavioral risk factors, and health status for LGB participants; and (2) To evaluate the effect of sexual orientation on physical activity, cigarette smoking, alcohol use, and health status.
When looking at the impact of PA on behavioral outcomes, the duration of vigorous PA had a direct, positive relationship with alcohol use. This indicates that as the minutes of vigorous PA increases, alcohol use also increases. PA also had an impact on smoking; as an individual increases their strengthening activities, he or she is less likely to smoke. Additionally, as participants increased the frequency of vigorous PA, their BMI decreased.
Results also revealed a direct link between race and PA, indicating Caucasians do not participate in an adequate amount of PA for optimal health benefits. In addition to race, results also showed as participants got older, they were less likely to be active, decreasing the health benefits from PA. These are alarming since results showed as individuals increase their duration of vigorous PA, they were more likely to be in excellent health versus good health. For comparative analysis, 331 heterosexual participants were included in the study. Heterosexual participants lived in all regions of the U.S., but they made more money when compared to LGB participants. Even though the mean averages revealed participants from both sexual orientations to be overweight, LGB individuals had higher BMI when compared to heterosexual counterparts. Additionally, LGB participants were more likely to be current smokers and heterosexuals were more likely to have never smoked. LGB participants were more likely to be heavy drinkers and less likely to report excellent health and participate in the recommended levels of PA. Binge drinking was also more prevalent for LGB participants. The following chapter further discusses the implications of these findings. Comparisons of LGB and heterosexual participants show some differences and similarities with sociodemographic factors. For instance, the average age for heterosexual participants was 41, and slightly younger for LGB participants at 39. Healthy BMI is 18.5-24.9, overweight is 25-29.9, and obese is 30 or greater. The average BMI for LGB (28.0) and heterosexual (27.1) participants were both classified as overweight, but mean LGB participant BMI was higher than their heterosexual counterparts. Additionally, results showed heterosexuals were more likely to have never smoked (62% versus 59%) or be former smokers (24.5% versus 24%), and LGB participants were more likely to be current smokers (17% versus 13%). Heterosexual participants had slightly higher rates of light (57% versus 54.5%) and moderate drinking (35% versus 30.5%), but LGB participants had a much higher prevalence of heavy drinking (15% versus 8.5%). LGB participants were also 6.1% less likely to report excellent health and 0.9% more likely to report fair/poor health. Lastly, heterosexuals were more likely to participate in the recommended amount of PA (11.2% versus 7.5% for LGB participants).