Perceived Community Belonging as a Moderator of the Association Between Sexual Orientation and Health and Well-Being

Abstract

Purpose: This study examines the moderating role of perceived community belonging in the association between sexual orientation and various health and well-being outcomes. Design: A national cross-sectional survey. Setting: Confidential microdata from the 2021 Canadian Community Health Survey. Subjects: Individuals aged 15 and older, with a sample size ranging from 43,000 to 44,100. Measures: Sexual orientation, health and well-being outcomes, and sense of community belonging were all self-reported. Outcomes included self-rated general and mental health, depressive symptoms, and life satisfaction. Analysis: A series of multiple linear regression models. Results: Compared to heterosexual individuals, bisexual individuals reported poorer self-rated general health (b =.402, P <.001 for men; b =.454, P <.001 for women) and mental health (b =.520, P <.001 for men; b =.643, P <.001 for women), higher depressive symptoms (b = 2.140, P <.001 for men; b = 2.685, P <.001 for women), and lower life satisfaction (b =.383, P <.05 for men; b =.842, P <.001 for women). Few disparities were observed among gay men and lesbians. Contrary to some recent findings, no disparities were observed among individuals uncertain about their sexual orientation or those who chose not to disclose it, even without controlling for covariates. A stronger sense of community belonging mitigated the disadvantages associated with self-rated general health (b = -.276, P <.01) and depressive symptoms (b = -.983, P <.01) for gay men, and life satisfaction (b = -.621, P <.01) for lesbians. Conclusion: This study is among the first to highlight the stress-buffering role of community belonging in the association between sexual orientation and health and well-being outcomes.