Cancer Survivors Mental, Physical Health Varied by Race, Sexual Orientation

Cancer survivors who identify as sexual minorities had two to three times greater risk for depression and/or poor mental health compared with heterosexual counterparts. These findings were consistent for White, Black, and Hispanic male and female survivors, according to a new study.

The study used data from 40,482 respondents of the 2014-2019 Behavior Risk Factor Surveillance Survey to assess cancer survivors’ health outcomes in relation to gender, sexual orientation, and race/ethnicity.

Consistently, White male heterosexual survivors had the lowest rates of fair or poor health (32%), depression (16%), poor mental health (9%), poor physical health (22%), and poor activity (14%). Hispanic heterosexual men had the highest rate of fair or poor health (47%).

In contrast, Hispanic men who were sexual minorities had the highest rates of depression (45%), poor mental health (43%), poor physical health (34%), and poor activity (46%). Similarly, Hispanic women who were sexual minorities had the highest percentages of fair or poor health (60%), depression (59%), poor mental health (40%), poor physical health (41%), and poor activity (31%).

For Black women, those who identify as a sexual minority had the lowest rates of fair or poor health (30%) and poor activity (16%). White heterosexual women had the lowest rates of poor mental health (16%) and poor mental health (25%). Black heterosexual women had the lowest rate of depression (25%).

The researchers noted that within each racial group, men’s likelihood of fair or poor health was similar regardless of sexual orientation.

“However, within each race or ethnicity group, sexual minority men had significantly greater odds of depression in comparison with their heterosexual counterparts, and after adjustments for confounders, these differences remained for White and Black sexual minority men but not for Hispanic sexual minority men,” the researchers wrote.

In women, non-heterosexual orientation was associated with greater odds of poor or fair health, poor physical health, depression, poor mental health, and physical and mental health interfering with daily activities compared with heterosexual peers.

“Concerning mental health, our findings consistently showed that sexual minority cancer survivors had two to three times greater odds of depression and/or poor mental health in comparison with their heterosexual counterparts among White, Black, and Hispanic male and female survivors,” the researchers wrote, noting that some of these findings were not statistically significantly, likely due to smaller sample sizes for Black and Hispanic individuals.

“Highlighting cancer survivorship disparities allows for the development of interventions that take into account the unique experiences of individuals across multiple intersecting social positions,” the researchers wrote. “Ultimately, creating a more equitable cancer care continuum that accounts for the unique experiences of multiply marginalized communities requires advances in training, data collection, and political will to prioritize health equity across multiple intersecting axes of social inequality.”