Are alcohol-related disparities between sexual minority and heterosexual youth decreasing?

Jessica N. Fish, Ryan J. Watson, Carolyn M. Porta, Stephen T. Russell, Elizabeth M. Saewyc

Research output: Contribution to journalArticlepeer-review

49 Scopus citations


Background and Aims: Although sexual orientation-related alcohol use disparities are well established, researchers have not identified whether disparities are diminishing as societal attitudes towards lesbian/gay and bisexual (LGB) people become more accepting. We examined changes in four alcohol-related disparities between heterosexual and LGB youth from 1998 to 2013 by (1) estimating the prevalence of these behaviors; (2) estimating disparities in alcohol-related outcomes between heterosexual and LGB youth within each wave year; and (3) testing whether the degree of difference in alcohol-related disparities between heterosexual and LGB youth has changed. Design: Logistic regression models and year × sexual orientation interactions with repeated, cross-sectional, provincially representative data. Setting: British Columbia, Canada. Participants: Students (ages 12–19) from the 1998 (n = 22 858), 2003 (n = 29 323), 2008 (n = 25 254) and 2013 (n = 21 938) British Columbia Adolescent Health Survey (total n = 99 373, 48.7% male, mean age = 14.84). Measurements: We modeled age-adjusted differences in life-time alcohol use, age of onset, past 30-day drinking and past 30-day heavy episodic drinking between heterosexual and three subgroups of sexual minority youth (i.e. mostly heterosexual, bisexual and lesbian/gay). Findings: Generally, alcohol use declined for all youth, although less so among LGB youth [average adjusted odds ratio (aOR) = 0.58 and aOR = 0.53 for heterosexual males and females and aOR = 0.71 and aOR = 0.57 for sexual minority males and females, respectively). Within-year comparisons demonstrated elevated rates of alcohol use among LGB compared with heterosexual youth for each of the four survey years, especially among females. Findings indicate few changes over time; however, results show an increase in risky alcohol use from 1998 to 2013 among mostly heterosexual (aOR = 1.58 for life-time alcohol use, aOR = 1.58 for 30-day alcohol use and aOR = 1.34 for 30-day heavy episodic drinking), and bisexual (aOR = 1.95 for life-time alcohol use) females. Conclusion: Despite the general decline in the prevalence of alcohol use among young people in Canada since 1998, lesbian/gay and bisexual youth in Canada continue to show elevated rates of alcohol use compared with heterosexual youth.

Original languageEnglish (US)
Pages (from-to)1931-1941
Number of pages11
Issue number11
StatePublished - Nov 2017

Bibliographical note

Funding Information:
This study was funded by grants #CPP 86374 and #MOP 119472 from the Canadian Institutes of Health Research. The authors acknowledge the McCreary Centre Society ( for access to the British Columbia Adolescent Health Survey. In addition, J.N.F. was funded by the National Institute on Alcohol Abuse and Alcoholism, F32AA023138. J.N.F. and S.T.R. also received support from grant R24HD042849, awarded to the Population Research Center at The University of Texas at Austin by the Eunice Kennedy Shriver National Institute of Child Health and Human Development. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Publisher Copyright:
© 2017 Society for the Study of Addiction


  • Adolescents
  • LGB
  • alcohol
  • disparities
  • school health surveys
  • sexual minority


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