Health Disparities Among Women by Sexual Orientation Identity and Same-Sex or Different-Sex Cohabiting Partnership Status

Background: The objective of this study was to compare health outcomes by sexual orientation identity and cohabiting partnership status (defined as whether heterosexual, lesbian, and bisexual women were non-partnered, partnered in a cohabiting same-sex relationship, or partnered in a cohabiting different-sex relationship). Methods: We used data on heterosexual (n = 95,289) and sexual minority (n = 2,600) women aged 18 years and older from the 2013-2018 National Health Interview Survey. We estimated adjusted odds ratios (AORs) with 95% confidence intervals (CIs) from multivariable logistic regression models comparing health outcomes by sexual orientation identity and cohabiting partnership status while controlling for sociodemographic characteristics. Results: Compared with heterosexual women in a different-sex relationship, nonpartnered women generally reported worse health outcomes regardless of sexual orientation. Lesbian women with a same-sex partner were more likely to report poor/fair health (AOR, 1.61; 95% CI, 1.09-2.37), current cigarette smoking (AOR, 1.48; 95% CI, 1.14-1.94), and binge drinking (AOR, 1.63; 95% CI, 1.19-2.23) compared with heterosexual women with a different-sex partner. Bisexual women with a different-sex partner were more likely to report poor/fair health (AOR, 1.91; 95% CI, 1.23-2.97), severe psychological distress (AOR, 2.86; 95% CI, 1.78-4.59), current cigarette smoking (AOR, 1.38; 95% CI, 1.01-1.88), and binge drinking (AOR, 1.66; 95% CI, 1.18-2.32) compared with heterosexual women with a different-sex partner. Conclusion: More research is needed to identify the processes in which heterosexual and sexual minority women partner and cohabitate with members of the same or different sex-and whether or how this influences their health. Meanwhile, health care providers should be mindful that families are diverse, and acknowledging this diversity could be a first step toward achieving health equity for all women regardless of sexual orientation. (c) 2021 Jacobs Institute of Women's Health, George Washington University. Published by Elsevier Inc. All rights reserved.