Physical Health Characteristics of Student Service Members and Veterans By Sexual Orientation

Background and Purpose

The number of military connected students on college campuses has increased significantly as a result of the Post 9/11 GI Bill. When compared to nonveterans, veterans experience disparities in some health-related outcomes and have health-related behaviors that differ from nonveterans.  LGB military members and veterans also experience some disparities in health and have health-related behaviors that differ from their heterosexual peers. Few national data sets measure both military/veteran status and sexual orientation resulting in large gaps in the literature related to understanding the health needs of the growing and diverse population of student service members and veterans (SSM/V).  The purpose of this study is to begin to fill the gap in the literature and help to inform health and prevention efforts on campuses of higher education by addressing the question: What are the differences in physical health characteristics by sexual orientation among a national sample of SSM/V?

Methods

Cross-sectional data from the American College Health Association’s (ACHA) 2011-2014 National College Health Assessment II (NCHA) was analyzed. 114,816 students responded to the survey between 2011-2014. Of those, 2,658 reported current or previous service in the U.S. Armed Forces. Questions from the NCHA II were utilized as measures of constructs for this study. Physical health characteristics of interest for this study were measured dichotomously and grouped into five categories: (1) illnesses affecting the respiratory system, (2) pain issues/injuries, (3) infections possibly transmissed via sexual contact, (4) HIV was included as an isolated category; (5) chronic health conditions. Control variables such as cigarette use, sexual behaviors, use of alcohol, and use of prescription drugs were also included. Maximum likelihood logistic regression models were estimated to assess the relationship between sexual orientation and physical health conditions.

Results

The average age of all participates was 30. Ninety percent of the sample identified as heterosexual, 3.3% identified as lesbian or gay (LG), 3.1% identified as bisexual, and 2% identified as unsure. LG and unsure SSM/V were more likely than heterosexual SSM/V to have been diagnosed or treated for illnesses affecting the respiratory system (p < 0.001). This relationship remained after controlling for demographic and behavior variables.  LG and unsure SSM/V were more likely than heterosexual SSM/V to have been diagnosed or treated for a chronic physical health condition (p = 0.001). LG and bisexual SSM/V were more likely to be diagnosed with HIV (p < 0.001).

Conclusions and Implications

Because SSM/V utilize health services on campuses at high rates, and health impacts educational outcomes, results of this study serve to inform policies and practices of campus health centers. Health centers may implement high impact HIV prevention practices that target SSM/V.  Health centers may also consider smoking cessation promotions that target SSM/V in an effort to increase respiratory health outcomes. Smoking cessation programs targeting SSM/V should include cigarettes and also include water pipes, cigars, and smokeless tobacco.  This study begins to fill a gap.  Further research is needed to explore the chronic physical health conditions experienced by this relatively young population of SSM/V.