National representative data on the health of lesbian, gay and bisexual adults in England published for the first time
A first of its kind report has been published today by NHS Digital on the health outcomes and health behaviours of lesbian, gay and bisexual (LGB) adults.
The data is based on a representative sample of adults aged 16 and over who participated in the Health Survey for England (HSE)  between 2011–2018. Breakdowns by age, ethnicity and sex are also covered in the report.
The National Centre for Social Research’s  (NatCen) analysis found that 2% (1,132) of adults surveyed over the eight years identified as lesbian, gay or bisexual , .
Data from this period has now been brought together on conditions such as diabetes and hypertension, weight, smoking and drinking. A summary of the findings is below:
A higher proportion of LGB adults (7%) reported ‘bad’ or ‘very bad’ health compared with heterosexual adults (6%).
A lower proportion of LGB adults were overweight or obese  (51%) than heterosexual adults (63%).
The prevalence of limiting longstanding illness  was higher among LGB adults (26%) compared with heterosexual adults (22%).
The prevalence of musculoskeletal conditions (including arthritis/rheumatism/fibrositis and back problems/slipped disc/spine/neck) was lower in LGB adults (13%) compared with heterosexual adults (16%).
LGB adults were more likely to drink at levels which put them at increased or higher risk of alcohol-related harm, (that is more than 14 units in the last week): 32% of LGB adults compared with 24% of heterosexual adults.
Among the white population, heterosexual and LGB adults were equally likely to report that they drank no alcohol in the last week (35% and 33% respectively). Among those from an ethnic minority, heterosexual adults were more likely to report no alcohol consumption in the last week (71%) compared to LGB adults (55%).
More LGB adults (27%) than heterosexual adults (18%) were current smokers. The proportion of adults who currently smoked cigarettes was highest among LGB women at 31% and lowest among heterosexual women at 16%.
Mental health and wellbeing:
LGB adults had lower average mental well-being scores on the Warwick-Edinburgh Mental Well-being Scale (WEMWBS) (48.9) compared with heterosexual adults (51.4), with LGB women reporting the lowest well-being scores (47.3).
16% of LGB adults said they had a mental, behavioural or neurodevelopmental disorder  as a longstanding condition. The proportion of heterosexual adults reporting the same was lower at 6%.
NHS Digital’s Chief Statistician Chris Roebuck said: “One of the biggest benefits to collecting and publishing health data is the ability to highlight health inequalities.
“We’re pleased to be able to publish these LGB statistics for the first time, which show important differences in health status and behaviours.”
The HSE series was designed to monitor trends in the nation's health; estimating the proportion of people in England who have specified health conditions, and the prevalence of risk factors and behaviours associated with these conditions.
It is commissioned by NHS Digital and carried out by NatCen in conjunction with University College London (UCL). NatCen authored this report.
This publication is classed as experimental statistics and feedback is welcome here: firstname.lastname@example.org Please reference “Health Survey for England Additional Analyses - Health and health-related behaviours of lesbian, gay and bisexual adults” in the title of the email.
Notes for editors
- A total of 58,226 adults (aged 16 and over) were interviewed in the Health Survey for England (HSE) surveys from 2011 to 2018. The HSE provides information about people living in private households in England. The survey consists of an interview in person, followed by a visit from a nurse who takes a number of measurements and samples. The HSE, in common with other surveys, collects information from a sample of the population. The sample is designed to represent the whole population as accurately as possible within practical constraints, such as time and cost. Consequently, statistics based on the survey are estimates, rather than precise figures, and are subject to a margin of error. However, only findings with statistically significant differences are presented in this press notice. The samples who take part in the survey are weighted to provide statistics that are representative of the population.
- The National Centre for Social Research is an independent social research organisation: www.natcen.ac.uk
- A survey question about sexual orientation was first included in HSE in 2011. In the HSE surveys, sexual identity has been asked as a question within the self-completion section: “Which of the following options best describes how you think of yourself?”. Participants had the option to select from the five following answer options: Heterosexual or Straight, Gay or Lesbian, Bisexual, Other and Prefer not to say. This is a standard question recommended for surveys by the Office for National Statistics: Sexual orientation data harmonised standard – GSS (civilservice.gov.uk).
- Of all adults, 96% identified as heterosexual or straight (55,673 adults) and 2% (1,132 adults) identified as lesbian, gay or bisexual. Another 2% (1,421 adults) identified as ‘Other’ or answered ‘Prefer not to say’ to the question on sexual orientation, and these adults were not included in the analyses due to potential difficulties with interpretation. HSE does not include a question about gender identity or trans status. It is not therefore possible to present findings on trans and non-binary people’s health outcomes and health-related behaviours in this publication. This question is currently being considered for future surveys.
- This has been measured using Body Mass Index (BMI) defined as weight in kilograms divided by the height in metres squared (kg/m2). This is used as a measure of obesity in the HSE series. BMI does not distinguish between mass due to body fat and mass due to muscular physique. It also does not take account of the distribution of fat.
- The question on longstanding illness asks about physical and mental health and refers to illnesses or conditions ‘lasting or expected to last 12 months or more’. A longstanding illness is defined as limiting if the participant reports that it reduces their ability to carry out day-to-day activities.
- Those who reported that they had a long-standing condition were also asked “What is the matter with you?”, and their answers for up to six conditions were recorded verbatim. These were coded into 42 conditions which were further grouped into the 14 chapter categories of the medical classification ICD-10, the 10th iteration of the International Classification of Diseases. Mental, Behavioural and Neurodevelopmental conditions include mental illness (e.g. anxiety, depression, ‘nerves’ and others), learning disabilities, behavioural and neurodevelopmental conditions.
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