Compared to heterosexual individuals, gay/lesbian individuals experience health and sociopolitical disparities. Health disparities include... Show moreCompared to heterosexual individuals, gay/lesbian individuals experience health and sociopolitical disparities. Health disparities include higher prevalence of binge drinking, tobacco use, and cardiovascular disease (CVD) among gay/lesbian individuals. Sociopolitical disparities are rooted in structural stigma and include policies and norms that fail to protect, or actively discriminate against, gay/lesbian individuals. These health and sociopolitical disparities can be understood by converging two theories previously tested among gay/lesbian individuals – minority stress and cognitive escape. Minority stress theory asserts factors such as structural stigma may relate to proximal stress and negative health sequelae in targeted minority groups, while cognitive escape theory suggests escape-related behaviors like substance use may mediate links between systemic factors and individual health. This study used binary logistic regressions to test mediation models in which substance use mediated links between structural stigma and health within a large sample of gay/lesbian individuals. Structural stigma was operationalized as number of sexual orientation anti-discrimination laws, health was operationalized as presence versus absence of any CVD conditions, and substance use was operationalized as binge drinking and tobacco use. Models were tested in an aggregated sample, and also in sex/gender subsamples. In bivariate and component-path analyses, structural stigma predicted smoking frequency across samples. Stigma-binge drinking linkages were more salient among lesbian women compared to gay men. According to Sobel tests, smoking status mediated the stigma-CVD status relation for males-only and combined-sex samples. Study strengths, limitations, and implications are discussed. Show less
