Structural stigma and sexual orientation disparities in health: Evidence from the Australian Census
Melbourne Institute Working Paper No. 14/23
Date: November 2023
Author(s):
Abstract
Objectives: To explore the extent to which structural stigma (sociocultural and institutional
constraining factors) is associated with sexual orientation disparities in long-term health
conditions.
Methods: Structural stigma was measured using the regional percentage of votes against
same-sex marriage from Australia’s Marriage Equality Survey and mapped to the 2021
Census survey of 10,093,399 and 136,988 individuals in different-sex and same-sex
relationships, respectively. Controlling for individual and area-level confounders, logistic
regression analyses were used to examine the association between quartiles of structural
stigma and sexual orientation disparities in long-term health conditions (e.g., any, mental
health, asthma, cardiovascular).
Results: In the lowest stigma quartile, individuals in same-sex relationships had 68% higher
odds of reporting a long-term health condition (OR 1.68, 95%CI 1.65-1.71) and this
increased to 82% in the highest stigma quartile (OR 1.82, 95%CI 1.77-1.88). Trends were
more pronounced for mental health conditions and asthma as well as for males and younger
populations.
Conclusions: Living in stigmatising environments may have deleterious health effects for
LGBTIQ+ Australians. Policy action and enhanced protections for LGBTIQ+ Australians are
urgently required.
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