Identifying Social Determinants of Health Among Lesbian, Gay, and Bisexual US Veterans Using Primary Care Services in...

Objectives. To assess differences in social determinants of health identified through International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) and Tenth Revision (ICD-10-CM) codes between lesbian, gay, bisexual, and other nonheterosexual ("sexual minority") veterans and heterosexual veterans who utilize primary care services in the US Veterans Health Administration. Methods. We used the Veterans Health Administration Survey of Healthcare Experiences of Patients, weighted descriptive statistics, and multivariable logistic regression to examine differences in sociodemographic characteristics and social determinants of health-related ICD-9-CM and ICD-10-CM code domains by sexual orientation (sexual minority vs heterosexual). Results. Of the 455 165 veterans surveyed, roughly 3% (n = 14 065) identified as sexual minority. Compared with heterosexual veterans, sexual minority veterans were often younger and more likely to be racially/ethnically diverse, live in urban areas, and identify as female. All sexual minority groups had a greater risk of issues related to housing, economic circumstances, and other psychosocial circumstances than heterosexual veterans. Conclusions. Sexual minority veterans had increased vulnerabilities across various social determinants of health ICD-9-CM and ICD-10-CM code domains associated with health and well-being. Future research should continue to explore this relationship and develop evidence-based interventions to support sexual minority veterans effectively. (Am J Public Health. Published online ahead of print July 30, 2026:e1-e11. https://doi.org/10.2105/AJPH.2026.308563).