Changes in General Health and Mental Health Outcomes in an Urban Population Over a Decade: A Population-Representative Analysis Stratified by Sexual Orientation.

Purpose: We explored population-level changes in general and mental health outcomes among sexual minority and heterosexual New York City (NYC) adults. Methods: Using the NYC Health and Nutrition Examination Surveys, we analyzed data from 2931 adults surveyed between 2004 and 2014. Sexual minority (LGB+) participants included those who identified as lesbian , gay , bisexual , something else , or not sure . Prevalence estimates of general health, mental health services use, prescription use for a mental/emotional condition, and mental/emotional disability were calculated. Changes in these estimates were compared across survey iterations with two-sided t -tests. Multivariate log binomial regression modeling was also employed. Results: Across the study period, LGB+ adults reported a decrease in fair/poor general health (24%-18%). Compared to 2004, LGB+ adults in 2014 were more likely to use mental health services (15%-27%), take prescription medication for a mental/emotional condition (11%-20%), and have a mental/emotional disability limiting work (5%-10%). Point estimates showed similar changes over time among both LGB+ and heterosexual adults, but some changes were not statistically significant. We also found that bisexual adults utilized mental health services (prevalence ratio [PR] = 2.15; 95% confidence interval [CI]: 1.34-3.44) and medications (PR = 2.92; 95% CI: 1.72-4.96) more than heterosexual adults. Conclusion: Although reporting fair/poor general health decreased, the prevalence of using mental health services, using prescription medication, and having a mental/emotional disability increased for both LGB+ and heterosexual adults in NYC. These findings may be related to greater mental health literacy and awareness or to other population-wide trends.