Friday, January 9, 2009

Gay Men in Excellent Health - More from CHIS

So, I decided to look at this phenomenon of gay men being more likely to report being in excellent health than straight men from a slightly different angle - namely does it make a difference where one lives.
In particular, does the social environment of heteronormativity play a role in gay men being more likely to report being in excellent health?

The recent vote in California on whether to restrict the legal definition of marriage to "one man and one woman" (OMOW) seems like a pretty good way to define an area's heteronormativity, the more people who endorsed proposition 8, the higher the level of heteronormativity. Got this data from the California Secretary of State's Statement of the Vote.

So, using AskCHIS, I got estimates for the proportion of gay men and straight men reporting themselves to be in excellent health for 11 regions of the state: the counties of Los Angeles, San Francisco, and Riverside, and then 8 groups of counties (East Bay, South Bay, North Bay, Sacramento area, North & Sierras, Central Coast, Orange & San Bernardino, San Diego & Imperial, and the San Joaquin (Central) Valley). I had to use groups of counties in order to get enough sample size to estimate the proportion of men reporting excellent health within each region.

The proportion of gay men reporting excellent health was highest in San Francisco county, 34%, but this needs to be taken with a pretty big grain of salt, because the CHIS survey data would be compatible with a range from 25% to 42%. The lowest proportion of gay men in excellent health was in Riverside county, 13%, with a range compatible with the survey from 5% to 21%.
These two seem to line up with my hypothesis pretty well, in that only 25% of San Francisco voters endorsed a OMOW definition of marriage, while 65% of Riverside county voters did.
But, voters in the San Joaquin Valley (San Joaquin county down to Kern) endorsed OMOW by 70%, and yet had the 2nd highest proportion of gay men reporting excellent health: 32%, range 12% to 51%. So, it's not like there's a one-to-one correspondence.

Among straight men, the highest proportion reporting excellent health was also in San Francisco, 26% (23%-30%), and the lowest was in the San Joaquin Valley, 19% (17%-21%). In general, there was a much tighter correlation between the proporotion of str8 men reporting excellent health and how voters endorsed the OMOW restriction of Prop8. The tight correlation has mostly to do with the fact that there are more str8 men, and therefore better estimates of how healthy they are.

Of course there are many other potential explanations for why gay men (and str8 men) seem to be healthier in areas that are less homophobic (as measured by endorsing Prop8) in the CHIS data. For instance, it could be that older people are more likely to live in the more homophobic areas, and since old people are less likely to report being in excellent health, that's why you see fewer gay and str8 men reporting excellent health in the more homophobic areas.
Also, the mode of analysis I used is very preliminary - not only no control for potential confounders, but also the estimates of how likely men are to report being in excellent health is based on some pretty small numbers. But, it's enough to get the brain juices flowing, and perhaps to help me convince CHIS to give me access to individual-level data files...

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