Differences in Health and Access to Care Between Heterosexual and Sexual Minority Health Care Professionals

Importance Little is known about the health and access to care of sexual minority health care professionals (HCPs). Objective To compare health outcomes, health insurance coverage, and access to care between sexual minority and heterosexual HCPs. Design, Setting, and Participants For this survey study, cross-sectional data analysis of the 2020, 2021, 2023, and 2024 National Health Interview Surveys was performed. The study population included nationally representative household probability samples of noninstitutionalized US civilian adults aged 18 years or older, restricted to HCPs working in health care settings. Data analysis was conducted between February 2024 and August 2026. Exposure Self-reported sexual orientation, categorized as sexual minority (gay, lesbian, bisexual, or another nonheterosexual identity) or heterosexual. Main Outcomes and Measures The main outcomes included cigarette smoking, lifetime diagnosis of depression, moderate to severe psychological distress, selected physical health conditions, primary source of health insurance coverage, and delayed or forgone medical care, mental health care, and prescription medications due to cost. Multivariable logistic regression models compared outcomes while adjusting for sociodemographic characteristics. Results The sample included 2890 HCPs (2731 heterosexual and 159 sexual minority; mean [SE] age, 44.9 [0.7] years; 74.7% [0.9%] female [survey weighted]). Sexual minority individuals represented 5.7% (95% CI, 4.8%-6.7%) of HCPs and were more likely to be younger (aged 26-34 years: 38.8% [95% CI, 30.1%-48.3%] vs 24.0% [95% CI, 22.2%-25.9%]), never married (32.7% [95% CI, 24.7%-41.8%] vs 14.6% [95% CI, 13.0%-16.4%]), and living in households below the federal poverty level (7.4% [95% CI, 3.4%-15.4%] vs 1.1% [95% CI, 0.7%-1.7%]) compared with heterosexual HCPs. Sexual minority HCPs were significantly more likely to report a lifetime diagnosis of depression (adjusted odds ratio [AOR], 3.05 [95% CI, 2.02-4.59]), moderate to severe psychological distress (AOR, 2.06 [95% CI, 1.23-3.46]), arthritis (AOR, 2.45 [95% CI, 1.42-4.22]), and delayed medical care due to cost (AOR, 2.06 [95% CI, 1.14-3.72]). Sexual minority HCPs faced greater disparities in access to care: they were more likely to forgo mental health care (AOR, 3.74 [95% CI, 2.11-6.63]) and to forgo prescription medications (AOR, 4.81 [95% CI, 2.52-9.15]) due to cost than their heterosexual peers. Conclusions and Relevance In this cross-sectional survey study of HCPs, sexual minority HCPs were more likely than heterosexual HCPs to report depression, psychological distress, and financial barriers to health care. These findings highlight disparities in health and access to care among sexual minority HCPs and the need for workplace supports to address factors contributing to these disparities.