Thursday, March 12, 2009

What Explains the General Health Advantage of Gay Men in New York City?

In 2007, the New York City Community Health Survey asked men (and women) how they identified their sexual orientation, and also the standard question "Would you say that your health in general is: Excellent, Very Good, Good, Fair, or Poor?"
44 of 153 self-identified gay men (29%) said they were in excellent health, while 563 of 3,049 self-identified heterosexual men (18%) said they were in excellent health. So, gay men were almost twice as likely to report excellent health (odds ratio = 1.95, 95% confidence interval 1.36-2.79).

What gives? Well, aside from gay men being in better health, there might be a lot of other potential explanations. Like, what if men who identify as gay are just on average younger? Or less likely to live in poverty? Or less likely to be unemployed? All those things are strongly associated with one's subjective assessment of health.

So, I tried controlling for age, race/ethnicity, employment status, educational attainment, being foreign-born, and the ratio of the household's income to the poverty level set for a household of that composition (the poverty threshold for a household with two adults and three kids is a lot higher than the poverty threshold for someone living alone).

Of these, controlling for the ratio of income to poverty made the biggest difference. After controlling for the income:poverty ratio, self-identified gay men were 60% more likely to report excellent health (odds ratio 1.60, with a confidence range of 1.11-2.31).

Controlling for all of them simultaneously explained more of the gap, with gay men being almost half-again as likely as straight men to report excellent health (odds ratio 1.46, confidence range 0.99-2.16).

Still, all things equal, wouldn't you rather be gay in New York City?

Then, I decided to break it down by borough. Gay men in Manhattan were 67% more likely to report excellent health (odd ratio 1.67, confidence range 0.99-2.80), gay men in Brooklyn were 37% more likely to report excellent health (odds ratio 1.37, confidence range 0.58-3.23), and gay men in Queens were only 15% more likely to report excellent health (odds ratio 1.15, confidence range 0.40-3.28). There weren't enough men in this particular sample to say anything worthwhile about the Bronx or Staten Island.

Hmmm... looks like where you live as a gay man has a big influence on how you feel.

1 comment:

  1. I would agree. Living in Kentucky, I feel mostly tired. So if asked about my health, I would NOT say I have excellent health simply because I work so much and live in an environment that is consistently antagonistic to me as a gay man.