Participants carry a rainbow flag during an annual Gay Pride Parade along the streets of Ciudad Juarez, Mexico June 19, 2016. REUTERS/Jose Luis Gonzalez

By Andrew M. Seaman

Gay, lesbian and bisexual individuals reported more health problems than straight men and women, in a large U.S. survey.

For the first time since its launch in 1957, the National Health Interview Survey in 2013 and 2014 included a question about sexual orientation.

With nearly 69,000 participants, the survey revealed that lesbian, gay and bisexual adults "were more likely to report impaired physical and mental health, heavy alcohol consumption, and heavy cigarette use, potentially due to the stressors that (they) experience as a result of interpersonal and structural discrimination," researchers wrote online June 28 in JAMA Internal Medicine.

Overall, 67,150 survey respondents were heterosexual, 525 lesbian, 624 gay and 515 bisexual. The average age was about 47.

Gilbert Gonzales of the Vanderbilt University School of Medicine in Nashville and colleagues found that compared to heterosexual women, lesbians were 91 percent more likely to report poor or fair health. Lesbians were 51 percent more likely, and bisexual women were more than twice as likely, to report multiple chronic conditions, compared to straight women.

Gay, lesbian and bisexual people were also more likely than heterosexuals to report heavy drinking and smoking.

While gays and lesbians reported worse psychological distress than heterosexuals, bisexual people suffered the most, the survey showed.

For example, about 17 percent of heterosexual men had at least moderate psychological distress, compared to about 26 percent of gay men and about 40 percent of bisexual men.

Similarly, about 22 percent of heterosexual women had at least moderate psychological distress, compared to about 28 percent of lesbian women and about 46 percent of bisexual women.

Gonzales told Reuters Health that the health disparities are likely due to the stress of being a minority, which is likely exacerbated among bisexual people, who may not be accepted by lesbian, gay, bisexual and transgender communities.

"While there aren’t that many studies focusing on bisexual adults, previous studies have indicated they’re probably at greater risk," he said.

Other factors too, along with so-called minority stress, may account for health differences between heterosexuals and lesbian, gay and bisexual people, Gonzales said.

For example, he said, survey respondents may not have had access to marriage, which wasn't legalized at the federal level in the U.S. until 2015.

"It will be interesting to see how legal same-sex marriage will affect these health disparities," Gonzales said.

In a note published with the study, Dr. Mitchell Katz says the disparities may decrease with the growing acceptance of sexual minority populations.

"Health care professionals can help by creating environments that are inclusive and supportive of sexual minority patients," writes Katz, who is an editor of the journal.

"In caring for people who have experienced bias and discrimination, support is a very potent medicine," he writes.

"It’s important that all our federal surveys begin to collect sexual orientation status and gender identity," said Gonzales. "This kind of work would not be (possible) if the question wasn’t asked."

SOURCE: http://bit.ly/292xGb2 and http://bit.ly/292x85a

JAMA Intern Med 2016.