ArticleBMC public health2026
Evaluating primary health care utilization among lesbian, gay, and bisexual individuals in Canada with a view to inform more equitable health measures.
Article in BMC public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundCanada is advancing several reforms to strengthen primary health care. Although lesbian, gay, and bisexual (LGB) individuals experience a higher burden of some health conditions, they remain largely absent from these reforms, partly because of limited data. We assessed differences in primary care utilization between LGB and heterosexual individuals to address this gap.
methodsWe used data from 91,172 heterosexual and 2,550 LGB participants in the 2015–2016 Canadian Community Health Survey. Guided by Andersen’s Behavioural Model of Health Services Use, we examined the association between primary care physician (PCP) consultation rates and our primary variables of interest: sex and sexuality. Estimates for heterosexual men, heterosexual women, gay and bisexual men (GBM), and lesbian and bisexual women (LBW) were obtained separately. Models were adjusted for additional covariates (predisposing, enabling, and need-based) identified in Andersen’s framework. Poisson regression was used for the main analysis, and results were compared with estimates from double-selection lasso models.
resultsGBM and LBW had higher PCP consultation rates over a 12-month period compared with heterosexual men. For every 100 PCP consultations among heterosexual men, there were an estimated 129 consultations (95% CI 112 to 148) among GBM and 123 consultations (95% CI 110 to 139) among LBW. In contrast, consultation rates for GBM and LBW were comparable with heterosexual women.
conclusionEven after adjusting for several covariates, GBM and LBW had higher PCP consultation rates than heterosexual men. These findings suggest that PCP engagement among LGB adults differs from that of heterosexual men. The comparability with heterosexual women requires further investigation. More comprehensive data are needed to verify and clarify these findings to support equitable primary care planning.
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