Disparities in Health Outcomes and Access to Care Between Sexual Minority and Heterosexual Hispanic Adults: A Non-Monolithic Approach.

A large body of research has documented disparities in health and access to care experienced by sexual minorities and Hispanic populations in the United States. Very few population-based studies have examined health outcomes at the intersections of sexual orientation and Hispanic ethnicity- and large research gaps remain on the health of lesbian, gay, bisexual, and queer/questioning (LGBQ+) Hispanic communities by specific Hispanic ethnicities and/or ancestries. The objectives of this study are to compare health outcomes and access to care between LGBQ + adults and heterosexual adults by specific Hispanic ethnicities. We use representative data from Hispanic adults identifying as sexual minority (n = 768) or heterosexual (n = 26,036) in the 2013-2018 National Health Interview Surveys. Descriptive statistics and chi-squared tests were used to compare demographic characteristics (e.g., age, sex, relationship status, survey language, and educational attainment) across ethnicities by sexual minority status. Logistic regression models evaluated differences in self-reported health outcomes and barriers to care. After adjusting for sociodemographic characteristics, compared to their heterosexual peers, sexual minority Mexicans, Mexican Americans, and Central/South Americans were significantly more likely to report moderate to severe psychological distress and unmet mental health care needs due to cost. Sexual minority Cubans were more likely to report having a chronic health condition compared to their heterosexual peers. This study demonstrates the importance of approaching LGBQ + and Hispanic health with non-monolithic perspectives. Future research should continue to leverage community-based research, large-scale quantitative surveys, and qualitative research to help inform targeted interventions that advance LGBQ + Hispanic health equity.