Dissertation
Contextualizing Health Disparities: The Role of Social Support, Internalized Stigma, and State Policy Climate in Shaping Substance Abuse and Mental Distress Among Sexual Minority Adults
Washington State University
Doctor of Philosophy (PhD), Washington State University
05/2024
DOI:
https://doi.org/10.7273/000006482
Abstract
This three-article style dissertation examines disparities in substance abuse and mental health among sexual minorities, focusing on the roles of social support, internalized homophobia, and state policies. Utilizing data from the Generations Study, it highlights the nuanced and varied experiences of lesbian, gay, bisexual individuals, as well as those of other sexual orientations. Study One identifies the differential impact of social support on mental health and substance abuse, revealing that while social support generally attenuates negative mental health outcomes for gay and lesbian individuals, bisexuals still experience higher rates of substance abuse and mental distress regardless of support levels. Study Two investigates how internalized homophobia impacts rates of substance abuse and mental distress. Results indicate that bisexuals, and to a lesser extent other sexual minorities, consistently report higher substance abuse and mental health scores compared to lesbians and gays. This suggests that bisexual individuals may face higher levels of stress and greater stigmatization due to their sexual orientation. Study Three explores the role of state-level policies, demonstrating that protective policies do not uniformly translate into better health outcomes. Interestingly, lesbian and gay individuals in protectivestates report higher substance abuse rates than those in discriminatory states, suggesting that the policy context within states can vary significantly by city or municipality. In contrast, bisexuals show elevated mental distress across all policy climates, implying that structural protections may be insufficient to address their specific stressors. The dissertation reveals that while social support and progressive policies provide some resiliency, they do not fully protect against the higher propensity for substance abuse and mental distress among bisexuals and other sexual minorities. These findings underscore the need for data collection that reflects the diverse contexts and experiences within the LGBTQ+ community, to better understand the social factors which contribute to the health disparities experienced among sexual minorities.
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Details
- Title
- Contextualizing Health Disparities
- Creators
- Caleb Cameron Cooley
- Contributors
- Justin T Denney (Chair)Monica K Johnson (Committee Member)Thomas Rotolo (Committee Member)
- Awarding Institution
- Washington State University
- Academic Unit
- Department of Sociology
- Theses and Dissertations
- Doctor of Philosophy (PhD), Washington State University
- Publisher
- Washington State University
- Number of pages
- 181
- Identifiers
- 99901121437601842
- Language
- English
- Resource Type
- Dissertation