If you're an LGBT person, where you live could have an impact on your longevity, mood disorders, and other health issues.
While most people are now aware of how homophobia affects the wellbeing of someone psychologically or socially thanks to research on those topics, there have been less studies on how homophobic legislation, policies, and more impacts the health of queer men and men who have sex with men (MSM).
Columbia University's Dr. Mark Hatzenbuehler talked about what researchers have found about the latter at the 2015 Gay Men's Health Summit on November 5 at SFU Harbour Centre. Hatzenbuehler's keynote address was the launchpad for the theme of this year's conference: undoing stigma.
Hatzenbuehler said that the vast majority of research on stigma has focused on how health is affected on individual and interpersonal levels, such as being closeted, internalized homophobia, hate crimes, or aggressive interactions. However, he noted that research has "tended to overlook and ignore broader structural forms of stigma", such as societal conditions, cultural norms, and policies, and that many researches have noted this as a "dramatic shortcoming".
The reason for the lack of studies, Hatzenbuehler explained, is that there have been numerous challenges that researchers have faced.
First of all, most measures used in studies have been developed for the individual or interpersonal levels, not structural levels, he pointed out. Accordingly, new measures had to be developed.
Secondly, there's often a lack of variation in data for things like federal laws, which are applied equally across all states. Thus, there haven't been any differences to use as comparisons from region to region.
Third, a lack of information, such as very few details about where respondents live, has resulted in limited data structures.
However, Hatzenbuehler talked about a number of studies that have emerged which have begun to examine the relationship between structural stigma and health problems.
He said that one U.S. study found that the greater the structural stigma, the more likely men would engage in risky sexual activity.
"Men who lived in the lowest structural stigma states were significantly less likely to say that they had engaged in any condomless anal intercourse in the last three months compared to men living in high-structural stigma states."
Men in low structural stigma U.S. states, he added, were also more likely to discuss their sexual orientation with their healthcare providers.
Another study took a look at mortality data and found that there was an increased risk for a shortened life span among queer men who lived in high structural stigma places.
It found that there was an average life-expectancy difference of 12 years between those living in low and high structural stigma locations.
Even more pronounced was the age difference for suicide: those living in high stigma locations died at the average age of 38 versus 56 years old for those in low stigma areas.
An increase in mental health problems were also found in relation to structural stigma.
A mood-disorder study that Hatzenbuehler cited examined levels of various mental-health issues before and after a U.S. constitutional ban on same-sex marriage.
He said the study found that there was a 37 percent increase of mood disorders in U.S. states that banned same-sex marriage in comparison to a 24 percent increase in states in states that didn't have the ban.
In comparing medical and healthcare use and costs year before and after legalization of same-sex marriage, a substantial reduction in healthcare costs was found after same-sex marriage was legalized. There was a 14 percent reduction in depression, a 16 percent decrease in adjustment disorders, and an 18 percent drop in hypertension.
The 2015 Gay Men's Health Summit (presented by the Community-Based Research Centre for Gay Men's Health), which continued until November 6, explored a variety of other health topics related to stigma, including First Nations expertise and arts-based approaches to examining queer men's health issues.