Evidence map›Paper›PMID 36337988›Full record

ArticleSSM - population health2022

Preventable mortality among sexual minority Canadians.

Travis Salway, Ashleigh J Rich, Olivier Ferlatte, Dionne Gesink, Lori E Ross, Richard Bränström, Aida Sadr, Syma Khan, Troy Grennan, Mostafa Shokoohi and 2 more

Abstract read
In one paragraph

Article in SSM - population health, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Travis SalwayFaculty of Health Sciences, Simon Fraser University, Burnaby, Canada.
Ashleigh J RichDepartment of Social Medicine, University of North Carolina at Chapel Hill, Chapel Hill, USA.
Olivier FerlatteÉcole de santé publique, Université de Montréal, Montréal, Canada.
Dionne GesinkDalla Lana School of Public Health, University of Toronto, Toronto, Canada.
Lori E RossDalla Lana School of Public Health, University of Toronto, Toronto, Canada.
Richard BränströmDivision of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
Aida SadrDepartment of Family Practice, Faculty of Medicine, University of British Columbia, Vancouver, Canada.
Syma KhanDepartment of Emergency Medicine, Faculty of Medicine, University of British Columbia, Vancouver, Canada.
Troy GrennanBritish Columbia Centre for Disease Control, Vancouver, Canada.
Mostafa ShokoohiDalla Lana School of Public Health, University of Toronto, Toronto, Canada.
David J BrennanFactor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada.
Mark GilbertBritish Columbia Centre for Disease Control, Vancouver, Canada.

Funding

Research Services CoreP2CHD050924 · NICHD · UNIV OF NORTH CAROLINA CHAPEL HILL · PI KAREN B GUZZO · 2015 to 2026
$9.6M
NICHD NIH HHS P2C HD050924
6 · The paper itself

Abstract

Background: Epidemiologic studies point to multiple health inequities among sexual minority people, but few studies have examined mortality. Some causes of death are more preventable than others, and access to prevention is theorized to follow patterns of access to social and material resources. The objective of this study is to compare estimates of preventable mortality between sexual minority (SM)-i.e., bisexual, lesbian, gay-and heterosexual adults in Canada. Methods: A population-based retrospective cohort with 442,260 (unweighted N) Canadian adults, ages 18-59 years, was drawn from the Canadian Community Health Survey/Canadian Mortality Database linked database (2003-2017). The Rutstein preventability rating index was used to classify cause-specific mortality (low/high). Longitudinal analyses were conducted using Cox proportional hazards models. Results: SM respondents had higher hazard of all-cause mortality (unadjusted hazard ratio [uHR] 1.28, 95% CI 1.06, 1.55). The uHR increased when the outcome was limited to highly-preventable causes of mortality (uHR 1.43, 95% CI 1.14, 1.80). The uHR further increased in sensitivity analyses using higher thresholds of the Rutstein index. SM respondents had higher hazard of cause-specific mortality for heart disease (uHR 1.53, 95% CI 1.03, 2.29), accidents (uHR 1.97, 95% CI 1.01, 3.86), HIV (uHR 75.69, 95% CI 18.77, 305.20), and suicide (uHR 2.22, 95% CI 0.93, 5.30) but not for cancer (uHR 0.86, 95% CI 0.60, 1.25). The adjusted HR (aHR) for highly-preventable mortality was not attenuated by adjustment for confounders (aHR 1.57, 95% CI 1.20, 2.05) but was reduced by adjustment for hypothesized mediators relating to access to social and material resources (marital status, children, income, education; aHR 1.11, 95% CI 0.78, 1.58). Conclusions: Preventable mortality was elevated for SM Canadians compared to heterosexuals. Early and broad access to sexual minority-affirming primary and preventive healthcare should be expanded.

Indexed as

MortalitySexual and gender minoritiesSocial determinants of health

Identifiers

PMID36337988
PMCPMC9634359

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.