Place-based disorder, social cohesion, and physical and mental health outcomes of LGBTQIA+ adults in the United States

Abstract Place-based disorder and social cohesion may influence lesbian, gay, bisexual, transgender, queer, intersex, asexual, and other sexual and gender minority (LGBTQIA+) adults’ physical and mental health in meaningful ways given their heightened exposure to minority stress and discrimination. However, few studies have examined these associations. Using a sample of 3790 LGBTQIA+ adults in 786 counties from The Population Research in Identity and Disparities for Equality Study, we assessed associations of place-based disorder and social cohesion with depressive symptoms, perceived stress, and physical health using linear mixed models. We tested effect modification by gender modality and ethnoracial group. Residing in counties with higher social cohesion by 1 unit was associated with 1.06 points lower (95% CI, −1.56, −0.56) for depressive symptoms, 1.60 points lower (95% CI, −2.26, −0.94) for perceived stress, and 1.17 points higher (95% CI, 0.43, 1.90) for physical health. Residing in counties with higher place-based disorder by 1 unit was associated with 1.17 points higher (95% CI, 0.32, 2.01) for perceived stress; no association was observed for depressive symptoms or physical health. We did not detect evidence of effect modification by ethnoracial groups, though the association between place-based disorder and depressive symptoms appeared to differ by gender modality. Findings indicate that physical and social environments are important to the health of LGBTQIA+ individuals.