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Mental Health Disparities From Climate Change: The Role of Housing Insecurity and LGBTQ+ Identity, California, 2023
Elizabeth Choa1, David Vlahov1, Hermine Poghosyan1
1Elizabeth Choa was with the Graduate School of Arts and Sciences and School of Nursing, Yale University, New Haven, CT, at the time of this study. David Vlahov is with the School of Nursing and the School of Public Health, Yale University. Hermine Poghosyan is with the School of Nursing, Yale University.
Abstract:
Objectives. To examine the relationship between housing insecurity and lesbian, gay, bisexual, pansexual, transgender, gender-expansive, queer, and questioning (LGBTQ+) identity with mental health burdens from climate events among California adults. Methods. We used cross-sectional data from 2023 California Health Interview Survey (n = 14 307). The outcome was self-reported mental health burden from climate events. Primary predictors were LGBTQ+ identity and housing insecurity. We conducted survey-weighted descriptive statistics and multivariable logistic regression, adjusting for covariates, with an interaction term assessing synergistic effects of primary predictors. Results. Transgender or gender-expansive (adjusted odds ratio [AOR] = 4.05; 95% confidence interval [CI] = 2.66, 6.15) and bisexual or pansexual individuals (AOR = 1.67; 95% CI = 1.19, 2.33) had significantly higher odds of climate-related mental health burden. High housing insecurity was also associated with greater odds (AOR = 1.26; 95% CI = 1.07, 1.48). Among gay respondents, experiencing housing insecurity was associated with approximately threefold higher odds of climate-related mental health burden (adjusted ratio of odds ratios = 3.1; 95% CI = 1.40, 6.82). Conclusions. Bisexual or pansexual and transgender or gender-expansive individuals reported higher mental health burdens from climate events. Housing insecurity appears to be a key social driver shaping disparities in climate-related mental health among LGBTQ+ populations. (Am J Public Health. 2026;116(6):779-789. https://doi.org/10.2105/AJPH.2025.308379).
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