Sexual and gender minority college student disparities in biobehavioral health outcomes: a call to action
Restricted (Penn State Only)
- Author:
- Yerger, Jordan
- Area of Honors:
- Biobehavioral Health
- Degree:
- Bachelor of Science
- Document Type:
- Thesis
- Thesis Supervisors:
- Laura Cousino Klein, Thesis Supervisor
Kari Christine Kugler, Thesis Honors Advisor - Keywords:
- Sexual and gender minorities (SGM)
health disparities
biobehavioral health outcomes
college students - Abstract:
- Sexual and gender minority (SGM) individuals are burdened by disparities for numerous mental and physical health outcomes. More college students than ever identify as sexual and/or gender minorities, yet health disparity research is greatly lacking for this young adult, college-specific population. The present study analyzed a current secondary data set that surveyed (N=3312; mean age = 20.45 + 0.03 years) students at a large northeastern university in the United States. Biobehavioral health outcomes—including self-reported measures of perceived stress, depressive symptoms, happiness, sleep quality, nicotine use, alcohol intake, physical activity, physical activity enjoyment, self-efficacy for exercise, grade point average (GPA), connectedness to nature, and body mass index (BMI)—were examined among SGM college students (N=445) and their cisgender heterosexual (non-SGM) peers (N=2867). I hypothesized that 1) depressive symptoms and perceived stress would be positively associated with negative health outcomes for all college students; 2) SGM college students would report higher levels of depressive symptoms and perceived stress and have poorer health outcomes than their non-SGM peers; and 3) stress would be a stronger predictor of negative health outcomes for SGM college students compared to their non-SGM peers. Only the first two hypotheses were partially supported. Analyses revealed that SGM students were younger, reported more perceived stress and depressive symptoms, less happiness, poorer sleep quality, and drank less alcohol than their peers (p's<0.05) compared to their non-SGM peers. SGM and non-SGM participants were similar in BMI, GPA, and nicotine use. For both SGM and non-SGM students, perceived stress and depressive symptoms were correlated with each other, sleep quality, physical activity, physical activity enjoyment, self-efficacy for exercise, and GPA. However, only depressive symptoms, rather than perceived stress, was associated with happiness ratings, for all participants; only depressive symptoms correlated with BMI and only for SGM students; only depressive symptoms correlated with alcohol use and only for non-SGM students; and only depressive symptoms were associated with nicotine use, and not for SGM students. Since perceived stress and depressive symptoms were highly correlated, both variables plus an interaction variable for perceived stress and depression were entered into forward stepwise linear regressions to determine which of those variables was a significant predictor of each health outcome. Contrary to the third hypothesis, perceived stress did not serve as a predictor of negative health outcomes for SGM college students except for reduced physical activity enjoyment and self-efficacy for exercise; rather, depressive symptoms predicted more health outcomes for SGM students, including reduced sleep quality, happiness, physical activity, and self-efficacy for exercise. The interaction between stress and depression predicted self-efficacy for exercise and lower GPA. For non-SGM students, both perceived stress and depressive symptoms predicted several health outcomes. Depressive symptoms predicted every poor health outcome except for BMI; perceived stress predicted physical activity enjoyment and self-efficacy for exercise; and the interaction between depression and stress predicted nicotine and alcohol use. Overall, results show the existence of significant SGM health disparities, both by supporting existing disparity research and contributing new findings for certain health outcomes. Furthermore, results add new research on SGM disparities specifically for college student populations. Implications for public health interventions and future directions for research are discussed.