Lesbian, gay and bisexual adults in California have rates of health insurance coverage on par with or better than that of straight men and women in the state, but they are more likely to wait to see a doctor when they need medical care, the UCLA Center for Health Policy Research reported Wednesday.
“Our study shows bisexuals have among the greatest need for regular health care, but are the least likely to get it,” said Joelle Wolstein, a research scientist at the center and the study’s lead author. “Even if they have a high-quality insurance plan through an employer, health equity is far from a reality for many LGBTQ patients.”
Susan H. Babey, a co-author of the study, said one reason for the delayed care cited in other research is that sexual minorities sometimes experience discrimination when they seek health care.
“Sexual minorities who have had a bad experience with a medical provider because of their sexual orientation may try to avoid repeating it,” said Babey, who is co-director of the Chronic Disease Program at the center.
The UCLA study examined differences in access to care, behaviors that negatively affect health such as smoking or not exercising, and health problems that can result from those behaviors such as developing hypertension or being overweight, based on people’s sexual orientation.
The study used data from the combined 2011 to 2014 California Health Interview Survey; data on transgender people is not included because the survey did not begin collecting transgender data until 2015-16. More than 1 million California adults, or 4.5 percent of the state’s adult population, identify as lesbian, gay, homosexual or bisexual, according to the survey.
The findings show that 24 percent of bisexual men and 22 percent of straight men do not have a doctor they regularly see, compared with 13 percent of gay men, while 20 percent of gay men and 21 percent of bisexual men delayed seeking health care in the past year, compared with 13 percent of straight men.
The study also found that 13 percent of straight women and 15 percent of lesbians reported that they do not have a doctor they regularly see, while 22 percent of bisexual women said they do not have one. However, 29 percent of lesbians and bisexual women said they delayed seeking medical care in the past year, compared to 18 percent of straight women.
Other key findings from the research include:
— Bisexuals have the worst overall access to a doctor they see on a regular basis and high rates of unhealthy behaviors. Bisexual men have higher rates of unhealthy behaviors in four of the five categories analyzed in the study, while bisexual women have higher rates of smoking and binge drinking, and are more likely to eat fast food two or more times a week.
— Gay men report better overall health and fewer behaviors that lead to obesity and hypertension than straight men. Sixty-one percent of gay men said they considered themselves to be in excellent or very good health, compared to 52 percent of straight men and 44 percent of bisexual men. Gay men are also less likely to drink sugary beverages daily and less likely to binge drink than straight and bisexual men. Twenty-seven percent of straight men in the study were obese, compared with 21 percent of gay men and 20 percent of bisexual men.
— Straight women have the best access to a doctor they see on a regular basis, the best overall health and the lowest rates of unhealthy behaviors. Half of straight women said they were in excellent or very good health, compared to 44 percent of lesbians and 45 percent of bisexual women. Twenty-seven percent said they had engaged in binge drinking within the previous year, compared to 50 percent of bisexual women. Ten percent of straight women were smokers, compared with 23 percent of bisexual and lesbian women. Lesbians had the highest rate of obesity at 35 percent, compared with 26 percent of bisexual women and 24 percent of straight women.
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