Ethnic and sexual identities: inequalities in adolescent health and wellbeing in a national population-based study

Abstract

AbstractAimsTo examine inequalities related to dual sexual- and ethnic-identities in risk for health, wellbeing, and health-related behaviours in a nationally representative sample of adolescents.Methods9,789 adolescents (51% female) aged 17 years from the UK-wide Millennium Cohort Study, with data on self-identified sexual- and ethnic-identities. Adolescents were grouped into White-Heterosexual, White sexual minority (White-SM), ethnic minority (EM)-heterosexual, and ethnic- and sexual minority (EM-SM).Mental health (e.g., self-reported psychological distress, doctor-diagnosed depression, attempted suicide, victimisation), general health (self-rated health, chronic illness, BMI) and a range of health-related behaviours (e.g., smoking, substance use) were assessed by questionnaires. Associations between dual identities and outcomes were analysed using logistic and linear regression (adjusted for sex and parental income).ResultsSexual minorities (White:18% and ethnic minority:3%) had increased odds for mental ill-health and attempted suicide, with higher odds in White-SM than EM-SM. Compared to White-heterosexuals, White-SM and EM-SM had higher odds for psychological distress (OR 3.47/2.24 for White-SM/EM-SM respectively), and emotional problems (OR 3.17/1.65). White-SM and EM-SM had higher odds for attempted suicide (OR 2.78/2.02), self-harm (OR 3.06/1.52), and poor sleep quality (OR 1.88/1.67). In contrast, White-Heterosexual and White-SM groups had similarly high proportions reporting risky behaviours except for drug use (OR 1.34) and risky sex (OR 1.40) more common in White-SM individuals. EM-Heterosexuals and EM-SM individuals had decreased odds for health-related behaviours.ConclusionsSexual minorities (White and EM) had substantially worse mental health compared to their heterosexual peers. Adverse health-related behaviours were more common in White sexual minority individuals. Further investigation into potentially different mechanisms leading to adverse health in White-SM and EM-SM individuals is needed.