Temporal trends in mental health disparities among sexual minorities

In an article for SSM Population Health, Faculty Associate Jessica Fish and her colleagues conducted the first temporal trend analyses of yearly prevalence of depression, anxiety, poor self-reported mental health, and cigarette smoking. The temporal trend analyses were stratified by six sexual orientation and gender / sex subgroups using the Canadian Community Health Survey from 2003-2020. The mental health outcomes are among the most studied psychological and behavioral disparities that affect sexual minorities, with cigarette smoking constituting "both a parallel effect of minority stress as well as a potential coping strategy for sexual minorities experiencing anxiety or depression." 

Dr. Fish and her colleagues used descriptive analyses to display temporal trends, joinpoint regression to identify significant changes in prevalence data during 2003-2020, and prevalence ratio estimations by year to detect any reduction in disparities. It was found that while the prevalence of smoking decreased, there was increased prevalence of self-rated mental health and anxiety disorders among both sexual minority and heterosexual people between 2003 and 2020. In addition, no evidence was found to indicate that sexual orientation disparities in mental health and substance abuse have improved during a period where legislative and policy efforts have been made to protect the well-being of sexual minority populations. 

Dr. Fish and her colleagues find that the continuity of sexual orientation disparities in mental health and substance use suggest that public policy is failing. They emphasize that there is a need for ongoing secondary and tertiary prevention efforts, such as mental health supports for sexual minority service users.