Chronic Disease Among LGBT+ Minnesotans
Minnesota data on chronic disease show that lesbian, gay, bisexual, and transgender (LGBT+) adults experience higher rates of asthma, cognitive decline, and long COVID.
However, after accounting for differences in age, the disparities are even more pronounced. According to the 2023 Behavioral Risk Factor Surveillance System (BRFSS), LGBT+ adults report higher-than-expected rates for nine different chronic diseases: arthritis, asthma, high blood pressure, high cholesterol, chronic obstructive pulmonary disease, diabetes, long COVID, and stroke.
Note: These data use the term LGBT+ to reference lesbian, gay, bisexual, and transgender, and may include other queer identities not explicitly listed.
Age-adjusted percentage of LGBT+ and non-LGBT Minnesotans with various chronic conditions, BRFSS 2023
Adjusted using the direct method to the 2000 US standard population over the age groups 18-24, 25-44, 45-64, and ≥65.
Potential risk factors
Several factors could contribute to higher chronic disease rates among LGBT+ communities when adjusted for age.
Age
First, risk for chronic conditions increases as people age, which can make it challenging to detect health inequities between groups with very different age distributions. Younger adults tend to report fewer poor health conditions than older adults, and younger adults are also more likely to identify themselves as LGBT+.
Calculating age-adjusted rates is a common way that researchers account for age differences so they can more clearly understand whether certain groups have worse-than-expected health outcomes. This is often the first step toward exploring questions about what social, environmental, cultural, or systemic forces might be impacting health for these individuals.
Social and environmental factors
MDH estimates that about 40% of health is determined by social and economic factors. These factors could also be impacting LGBT+ health:
- Housing instability or homelessness
- Limited access to culturally responsive health care and education
- Stigma, discrimination, bias, harassment, marginalization
- Trauma and violence
- Lack of tailored resources or support
- Mental health conditions or other co-occurring conditions
- Food insecurity
The LGBT+ community experiences social stigma and discriminatory treatment at disparately high rates. One example is the tobacco industry historically targeting communities that experience higher stress, contributing to disproportionately high rates of smoking and vaping in the LGBT+ community—13.6% of LGBT+ adults in Minnesota vape, compared to 7% of Minnesota adults overall, according to BRFSS. Commercial tobacco use, like smoking, vaping, or using chew, as well as exposure to secondhand smoke or aerosol can cause or worsen many chronic conditions and diseases.
Demographics
In addition, Minnesotans can have several different intersecting identities. American Indian/Alaskan Native people experience some chronic diseases at higher rates than white people, such as diabetes and arthritis. People of color who identify as LGBT+ may face even greater health disparities. This can be true for other demographics, such as income or education level. These demographics can add other stressors or impacts to health.
Reducing LGBT+ health disparities in Minnesota
Ensuring LGBT+ adults receive high-quality, responsive, and affirming care is important to improve health disparities. MDH and partners can protect, maintain, and improve the health of LGBT+ Minnesotans in many ways:
- Create open and inclusive spaces for medical care, health education, and health behavior programming; avoid gendered language.
- Incorporate LGBT+ data into data collection and analysis to help identify and monitor disparities.
- Work alongside LGBT+ people and foster authentic community engagement to understand what social, systematic, or environmental factors could be impacting health.
- Reflect on how barriers LGBT+ adults face could also impact health and consider adaptations or additional resources that take those challenges into account.
- Create equitable policies that support human dignity, belonging, and safety.
Resources for LGBT+ inclusive health
Minnesota
- Using a Person’s Correct Pronouns Saves Lives (PDF)
- Gender Affirming Care Report (PDF)
- Summary of Findings: A Review of Scientific Evidence of Conversion Therapy (PDF)
- Commercial Tobacco Use and Your Health
- Get Help Quitting | Commercial Tobacco Use
- Support for Lesbian, Gay, Bisexual, Transgender and Queer (LGBTQ+) Parents
- LGBTQ+ mental health support – Department of Human Services
National
- National Coalition for LGBTQ Health
- Healthy People 2030 LGBT Health Objectives - Lesbian, Gay, Bisexual, and Transgender Health Workgroup
- National LGBTQIA+ Health Education Center
- 3 Ways to Provide Culturally Affirming Care to LGBTQ Patients
- Stress & Trauma Toolkit – American Psychiatric Association
References
Behavioral Risk Factor Surveillance System (BRFSS), 2023. Minnesota Center for Health Statistics, Minnesota Department of Health.