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Intersectional discrimination and noncommunicable disease risk factors among sexual minority men of color
Madison Shea Smith1,2, Drexler James3, Joshua M Schrock2
1Department of Medical Social Sciences, Northwestern University, Chicago, IL 60611, USA.
Background:
Sexual minority men (SMM) of color face disproportionate risk for noncommunicable diseases (eg, hypertension) and associated risk factors (eg, substance use) due to intersecting ethnoracial and heterosexist stressors. Existing research often examines experiences of ethnoracial and heterosexist discrimination separately, thereby overlooking the distinct nature of intersectional discrimination.
Purpose:
We used 2 independent samples of SMM of color to examine (1) the impact of intersectional discrimination on noncommunicable disease outcomes and risk factors above and beyond experiences of ethnoracial and heterosexist discrimination, and (2) whether effects differ by type of intersectional discrimination (racism in LGBT communities; heterosexism in POC [people of color] communities).
Methods:
Study 1. Participants were 414 SMM of color from a large cohort study (Mage = 26.37). Study 2. Participants were 767 gay/bisexual men of color from a web-based survey (Mage = 30.67). Regressions examined the effect of intersectional discrimination on noncommunicable disease outcomes (eg, chronic illness) and risk factors (eg, substance use), controlling for socio-demographics and ethnoracial and heterosexist discrimination.
Results:
Intersectional discrimination (Study 1), racism in LGBT communities (Study 2), and heterosexism in POC communities (Study 2) were uniquely associated with perceived stress and alcohol use. Racism in LGBT communities and heterosexism in POC communities were uniquely associated with self-reported body mass index (Study 2). Racism in LGBT communities was associated with illicit drug use (Study 2). Few significant findings emerged for disease outcomes.
Conclusions:
Intersectional discrimination was associated with stress and health behaviors (eg, alcohol use), highlighting pathways that may increase chronic disease risk among SMM of color.
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