Place-based disorder, social cohesion, and physical and mental health outcomes of LGBTQIA+ adults in the US

ABSTRACT Place-based disorder and social cohesion may influence LGBTQIA+ adults’ physical and mental health in meaningful ways given their heightened exposure to minority stress and discrimination. However, few studies have examined these associations. Using a sample of 3790 LGBTQIA+ adults in 786 counties from The Population Research in Identity and Disparities for Equality Study, we assessed associations of place-based disorder and social cohesion with depressive symptoms, perceived stress, and physical health using linear mixed models. We tested effect modification by gender modality and ethnoracial group. Residing in counties with higher social cohesion by 1-unit was associated with 1.06 lower points (95% CI -1.56, -0.56) for depressive symptoms, 1.60 lower points (95% CI -2.26, -0.94) for perceived stress, and 1.17 higher points (95% CI 0.43, 1.90) for physical health. Residence in counties with higher place-based disorder by 1-unit was only associated with 1.17 higher points (95% CI 0.32, 2.01) for perceived stress; no association was observed for depressive symptoms or physical health. Findings indicate that physical and social environments are important to the health of LGBTQIA+ individuals. Competing Interest Statement Dr. Obedin-Maliver has received consultation fees from Ibis Reproductive Health, Hims and Hers Health Inc., Folx Health Inc., Sage Therapeutics and Upstream Inc. on topics unrelated to this work. Dr. Lunn received consultation fees from Hims and Hers Health Inc., Folx Health Inc., Otsuka Pharmaceutical Development and Commercialization Inc., and the American Dental Association on topics unrelated to this work. No other disclosures were reported. Funding Statement This study was partially funded by the Patient-Centered Outcomes Research Institute (PPRN-1501-26848 to MRL). The statements in this manuscript are solely the responsibility of the authors and do not necessarily represent the views of PCORI, its Board of Governors, or its Methodology Committee. Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: IRB of the WIRB-Copernicus Group and Stanford University gave ethical approval of this work. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes Data Availability The datasets generated during and/or analyzed during the current study are not publicly available due to ethical restrictions related to sensitive participant information but are available from the corresponding author on reasonable request. Researchers interested in The PRIDE Study data may submit a brief application which is reviewed by both a Research Advisory Committee (composed of scientists) and Participant Advisory Committee (composed of participants) to affirm appropriate data use. Details about the Ancillary Study process are available at www.pridestudy.org/collaborate or by contacting support{at}pridestudy.org or 855-421-9991 (toll-free).