Sexual Identity and Self-Rated Health in Midlife: Evidence from the Health and Retirement Study

Purpose: This study examined health disparities among U.S. sexual minority people in midlife—a critical life course stage that is largely overlooked in the sexual minority health literature. Methods: Data were drawn from the 2016 Health and Retirement Study. We restricted the analysis to respondents aged 50–65. The final sample consisted of 3623 respondents, including 3418 self-identified heterosexual individuals, 99 self-identified gay/lesbian individuals, 38 self-identified bisexual individuals, and 68 respondents who identified as “something else.” Ordinal logistic regression models were estimated to predict the odds of reporting better health. Results: Bisexual midlifers reported significantly worse health than their heterosexual counterparts after age, gender, and race-ethnicity are controlled for (OR=0.43, 95% CI=0.25–0.76); this health disparity is mostly explained by marital status, socioeconomic status, and health behaviors (in particular smoking and exercising). We did not find evidence of a self-rated health disadvantage among gay and lesbian midlifers relative to their heterosexual counterparts. Conclusion: These findings highlight the diversity of the sexual minority population in midlife. Public policies and programs should be designed and implemented at the interpersonal and institutional levels to eliminate health and other social disadvantages among sexual minority people, in particular bisexual people, in midlife.