Health behaviors, health status, and access to and use of health care - A population-based study of lesbian, bisexual, and heterosexual women

Background: There is a dearth of validated information about lesbian and bi sexual women's health. To better understand some of these issues, we used p opulation-based data to assess variations in health behaviors, health statu s, and access to and use of health care based on sexual orientation. Methods: Our study population was drawn from a population-based sample of w omen, the 1997 Los Angeles County Health Survey. Participants reported thei r sexual orientation and these analyses included 4697 women: 4610 heterosex ual women, 51 lesbians, and 36 bisexual women. We calculated adjusted relat ive risks to assess the effect of sexual orientation on important health is sues. Results: Lesbians and bisexual women were more likely than heterosexual wom en to use tobacco products and to report any alcohol consumption, but only lesbians were significantly more likely than heterosexual women to drink he avily. Lesbians and bisexual women were less likely than heterosexual women to have health insurance, more likely to have been uninsured for health ca re during the preceding year, and more likely to have had difficulty obtain ing needed medical care. During the preceding 2 years, lesbians, but not bi sexual women, were less likely than heterosexual women to have had a Papani colaou test and a clinical breast examination. Conclusions: In this first population-based study of lesbian and bisexual w omen's health, we found that lesbians and bisexual women were more likely t han heterosexual women to have poor health behaviors and worse access to he alth care. These findings support our hypothesis that sexual orientation ha s an independent effect on health behaviors and receipt of care, arid indic ate the need for the increased systematic study of the relationship between sexual orientation and various aspects of health and health care.