Health Promotion Opportunities for Lesbian, Gay and Bisexual People: Using Data From the New Zealand Health Survey

Health inequity for sexual minority (lesbian, gay and bisexual) people compared with heterosexual people is well documented globally. However, limited local data have been used to inform health policy and practice. This project analysed data from the New Zealand Health Survey to determine areas of inequity in health behaviours and identify opportunities for health promotion action.

We used pooled data from six waves of the New Zealand Health Survey (from 2015/2016 to 2020/2021). The sample for analysis comprised 67 426 people aged 15 years and older, including 1224 sexual minority females and 703 sexual minority males. We applied multiple logistic regression to investigate the association between health behaviours and sexual identity.

Sexual minority people were found to have poorer health behaviours in comparison to heterosexual people in relation to alcohol consumption, smoking, drug use, physical activity and nutrition (eating fruit and vegetables). For example, compared to heterosexual females, female minorities were more likely to be binge drinkers (OR:1.61; 95% CI:1.60, 1.62), current smokers (OR:1.88; 95% CI:1.86, 1.90), drug users (OR:3.23; 95% CI:3.20, 3.25) as well as being less likely to meet fruit (OR:0.84; 95% CI:0.84, 0.85) and vegetable consumption guidelines (OR:0.94; 95% CI:0.93, 0.94). It shows similar patterns of the associations when compared to heterosexual males with male minorities. In relation to physical activity, female minority people were more likely to meet the guidelines compared to heterosexual females.

Our results from the New Zealand Survey data are broadly consistent with the current international literature demonstrating health inequity for sexual minorities compared with heterosexual people in relation to alcohol consumption, smoking, drug use, physical activity and eating fruit and vegetables. SO WHAT?: Opportunities exist in New Zealand to improve the health behaviours of sexual minorities, and health promotion agencies should ensure their interventions address the needs of these groups. Health promotion agencies have an ethical and moral responsibility to address these areas of inequity.