Category: Health Psychology / Behavioral Medicine - Adult
Hypertension is a major health concern, with prevalence rates rising globally. In the general population, religiosity has been linked to lower levels of blood pressure (BP), hypertension prevalence, and cardiovascular disease. Few studies have examined the relationship between religiosity and physical health in sexual minorities (SM); however, this relationship would theoretically be inversed given that most major world religions hold negative attitudes toward SM. For SM individuals who are religious, attempts at reconciling identities that may be viewed as incompatible may lead to elevated stress, a common risk factor associated with hypertension.
The current study analyzed data collected from Wave IV of the National Longitudinal Study of Adolescent to Adult Health (Add Health), a publically available, nationally representative dataset (N = 4,860, 50.2% Male, Mean age = 29, SD = 1.78 years). Participants were identified as a sexual minority if they identified themselves as 100% gay, mostly gay, or bisexual, or reported same sex attraction (N = 347, 7.1%). A religiosity variable was created by standardizing and averaging responses of two items assessing attendance of religious services and religious activities. BP was measured as systolic (SBP) and diastolic blood pressure (DBP). BP scores were used to determine clinical cutoffs relating to hypertension. Relevant covariates were controlled for in the models. Two separate general linear models were conducted, with SBP and DBP entered as outcome variables. Three logistic regression models were conducted to examine levels of increasing clinical severity in hypertension.
In all models, there was a significant interaction between sexual orientation and religiosity at p < .05. Subsequent simple slope analyses were conducted probing the interaction term at each level of sexual orientation. Across the 5 clinical markers of BP and hypertension, a pattern emerged with crossover interactions, such that religiosity was associated with greater risk of elevated BP and hypertension for SM participants, and conversely, religiosity was found to be a buffer from elevated BP and hypertension among heterosexual participants.
Results from the current study are the first to test and find an effect of religiosity on BP and hypertension, moderated by sexual orientation. Mental health professionals may wish to recognize that individuals who are religious and SM may experience a wide variety of problems heightened by the dissonance these two conflicting identities place into their lives. An intersectionist approach may be appropriate when working clinically with this population, recognizing they may experience discrimination in unique and interdependent ways.