Women's College Research Institute

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Sexual orientation as a social determinant of health

The World Health Organization Commission (WHO) final report: Closing the Gap in a Generation discusses many health inequalities related to a wide range of social determinants of health –including early childhood development, globalization, health systems, employment conditions, priority public health conditions, measurement and evidence, women and gender equality, urbanization, and social exclusion. However nowhere in the 200-page manual is there any mention of sexual orientation.

Dr. Carmen Logie, Women’s College adjunct scientist, takes issue with that.

“Sexual minorities are between five and 11 per cent more likely to experience a mental health issue compared with heterosexuals,” says Logie. “Chronic stress resulting from stigma and discrimination contributes to these mental health disparities among sexual minorities.”

In her recent commentary in the American Journal of Public Health, Logie asserts that a wide range of social and systemic factor contribute to health inequities in lesbian, gay and bi-sexual populations. She says that if the World Health Organization (WHO) is to succeed in closing gaps in health disparities, it needs to recognize that social injustices are endangering the health of sexual minorities.

Evidence clearly demonstrates that sexual minorities are disproportionately affected by health problems associated with stigma and discrimination – and it’s not related solely to stress and resulting mental health issues. Homosexuality is criminalized in 76 countries and punishable by death in five. In addition, sexual minorities account for a significant proportion of the global disease burden – which is strongly impacted by socio-political factors.

“The World Health Organization needs to recognize that sexual minorities have worse health outcomes, and that these poor outcomes are related to inequity – in other words, that they are unnecessary and changeable,” says Logie.

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