Semester

Spring

Date of Graduation

2023

Document Type

Dissertation

Degree Type

PhD

College

Eberly College of Arts and Sciences

Department

Psychology

Committee Chair

Julie Hicks Patrick

Committee Member

Ryan Best

Committee Member

Shari Steinman

Committee Member

J. Kasi Jackson

Abstract

Sexual orientation, age, and race are all identity-based variables that can contribute to health disparities (Dannefer, 2020; Meyer, 2003; Forde et al., 2019). The minority diminished returns (MDR) theory states that marginalized identities (i.e. race and sexual orientation) dampen the positive impact education has on physical and mental health (Assari, 2018). Some evidence suggests that health disparities narrow in older sexual minority adults (Nelson & Andel, 2020a) but this question has not been asked with nationally representative data, and research with older sexual minorities is limited. The present study explored whether 1) age dampens or exacerbates disparities in self-rated health due to sexual orientation and 2) multiple marginalized identities (sexual orientation, age, and race) interact with education in their influence on health. The study utilized data from the 2021 Behavioral Risk Factor Surveillance System (BRFSS) data from the CDC with an overall sample size of 167, 508. Structural equation modeling (SEM) found that lesbian/gay, bisexual, and “other” sexual minority identities were associated with worse overall health and these associations were significantly smaller in participants over the age of 50 than those younger than 50. A multivariate analysis of variance (MANOVA) found a significant education by sexual orientation by race interaction for number of poor physical and mental health days. Investigation into the means found that White bisexual and “other” sexual minorities with low education had the worse mental and physical health, respectively. However, Black and Hispanic individuals of the same sexual orientation and education had elevated, though slightly lower number of poor health days. These findings suggest that 1) sexual minority individuals might be developing resilience in the face of their minority stress as they age and 2) examining race, sexual orientation, and education together can highlight health disparities not seen when looking at these variables independently.

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