Asking Sexual Orientation Questions On State Risk Factor Surveys Allows 27 States To Document Health Disparities Affecting Sexual Minorities

Published: March 27, 2014

New Fenway brief analyzes state efforts to gather sexual orientation data on Behavioral Risk Factor Surveillance System Surveys

The Fenway Institute today issued “a call to action” to state health departments, urging them to ask questions about sexual orientation on their Behavioral Risk Factor Surveillance System surveys (BRFSS). In a policy brief focused on why states should ask about sexual orientation and how they should do this, The Fenway Institute noted that BRFSS surveys 500,000 Americans in all 50 states annually. Asking about sexual orientation—ideally both identity and behavior—dramatically increases knowledge about health disparities affecting lesbian, gay, and bisexual people (LGB).
The brief, written by Fenway researchers Leigh Evans, Kelsey Lawler, and Sammy Sass, examines efforts by 27 states to gather sexual orientation data in at least one year of BRFSS data collection from 1995 through 2012. These included southern states like North Carolina, Georgia, and Florida, as well as Texas and several Great Plains and Rocky Mountain states. However, in any given year only a small number of states ask the sexual orientation questions. For example, in 2009, only 13 states and the District of Columbia included a sexual orientation question on their BRFSS. The Fenway Institute encourages all 50 states to ask sexual orientation and gender identity questions on their BRFSS surveys every year.
States that have asked about sexual orientation have documented disparities and used the data to inform public health programming to address them. For example:
•Arizona’s public health department found through its BRFSS that 31% of Arizona lesbians smoked, about twice the rate of the state’s general female population. As a result, Tobacco Free Arizona targets lesbians and other members of the lesbian, gay, bisexual and transgender (LGBT) community with prevention and cessation interventions.
•New Mexico, Washington state, and Massachusetts also documented tobacco use disparities affecting lesbian, gay and bisexual people through, and also target the LGBT community with tobacco prevention and cessation efforts.
•BRFSS data from several states have shown that lesbians are less likely to get mammograms than other women, and have found higher rates of suicidality among LGB veterans, findings that have important public health implications.
“States in all regions of the country have tested sexual orientation questions on their Behavioral Risk surveys and gathered invaluable public health data,” said Sean Cahill, PhD, Director of Health Policy Research at The Fenway Institute. “But right now most states are not asking these questions. We strongly urge state health departments to add sexual orientation and gender identity questions to their BRFSS surveys to help identify health disparities affecting LGBT people.”
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