Objective—This report demonstrates use of three National Center for Health Statistics (NCHS) data systems to study differences in health by sexual orientation. Sexual orientation differences in a broad selection of health indicators were examined using the National Health and Nutrition Examination Survey (NHANES), National Survey of Family Growth (NSFG), and National Health Interview Survey (NHIS).

Background—NHANES, NSFG, and NHIS have included measures of sexual orientation since 1999, 2002, and 2013, respectively. These data systems support comprehensive examinations of sexual orientation differences in health status, access to care, sexual and reproductive health, anthropometric measures, health beliefs and behaviors, and other indicators.

Methods—Data from multiple years of NHANES (2005–2018), NSFG (2011–2019), and NHIS (2013–2018) were pooled into three separate files. Analyses were stratified by sex. After adjusting for age and survey year and cycle, measures of access to care and health status, behaviors, and beliefs among lesbian, gay, and bisexual (LGB) adults were compared with heterosexual adults.

Results—Across the three data systems, LGB adults differed from heterosexual adults on several health indicators. For example, bisexual men and women, gay men, and lesbian women reported smoking and heavy drinking (NHIS) and using marijuana and illicit stimulants (NSFG) more often than heterosexual people. Compared with heterosexual women, lesbian and bisexual women reported diagnoses of arthritis, asthma, cancer, diabetes, heart disease, and hypertension more often (NHIS), and bisexual women reported having ever been diagnosed with endometriosis, ovulation or menstrual problems, and pelvic inflammatory disease, more often (NSFG). Anthropometric measures from NHANES (weight and waist circumference) also differed by sexual orientation for men and women.

Conclusions—NHANES, NHIS, and NSFG enable research on topics relevant to the health of LGB people, which may inform efforts to advance health equity by targeting disparities by sexual orientation.

Suggested citation: Heslin KC, Alfier JM. Sexual orientation differences in access to care and health status, behaviors, and beliefs: Findings from the National Health and Nutrition Examination Survey, National Survey of Family Growth,

and National Health Interview Survey. National Health Statistics Reports; no 171. Hyattsville, MD: National Center for Health Statistics. 2022. DOI: https://dx.doi.org/10.15620/cdc:115982.

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