The Predictive Syndemic Effect of Multiple Psychosocial Problems on Health Care Costs and Utilization among Sexual Minority Women

Sarah E. Valentine, Steven Elsesser, Chris Grasso, Steven A. Safren, Judith B. Bradford, Ethan Mereish, Conall O’Cleirigh

Research output: Contribution to journalArticle

11 Scopus citations

Abstract

Previous studies documenting sexual minority women’s disproportionate risk for a range of medical, mental health, and substance use disorders have not provided a predictive framework for understanding their interrelations and outcomes. The present study aimed to address this gap by testing the syndemic effect of co-occurring psychosocial problems on 7-year health care costs and utilization among sexual minority women. The sample was comprised of sexual minority women (N = 341) who were seen at an urban LGBT-affirmative community health center. Medical and mental health care utilization and cost data were extracted from electronic medical records. Demographically adjusted regression models revealed that co-occurring psychosocial problems (i.e., childhood sexual abuse, partner violence, substance use, and mental health distress [history of suicide attempt]) were all strongly interrelated. The presence of these indicators had a syndemic (additive) effect on medical costs and utilization and mental health utilization over 7-year follow-up, but no effect on 7-year mental health costs. These results suggest that the presence and additive effect of these syndemic conditions may, in part, explain increased medical costs and utilization (and higher medical morbidity) among sexual minority women.

Original languageEnglish (US)
Pages (from-to)1092-1104
Number of pages13
JournalJournal of Urban Health
Volume92
Issue number6
DOIs
StatePublished - Dec 1 2015

Keywords

  • Bisexual
  • Health care costs
  • Health care utilization
  • Lesbian
  • Mental health
  • Sexual minority

ASJC Scopus subject areas

  • Health(social science)
  • Urban Studies
  • Public Health, Environmental and Occupational Health

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