HEALTH-RELATED CHARACTERISTICS AMONG LESBIAN AND HETEROSEXUAL WOMEN ENROLLED IN THE ESTHER (EPIDEMIOLOGIC STUDY OF HEALTH RISKS) PROJECT

This dissertation took steps towards filling major research gaps in lesbian health in the form of three manuscripts evaluating epidemiologic evidence for health disparities. Although the health disparities explored were not closely related, each was based upon analysis of data collected as part of the ESTHER (Epidemiologic STudy of HEalth Risk in Women) Project, a large cross-sectional study examining risk factors for coronary heart disease (CHD) among lesbian and heterosexual women living in the Pittsburgh, Pennsylvania area. Data were collected between 2003 and 2006, and these analyses were completed in 2009. The first manuscript examined differences in complementary and alternative medicine (CAM) use between lesbian and heterosexual women. Lesbians were more likely to have used CAM in their lifetime and within the past 12 months when compared to heterosexual women. Among women who had used CAM within the past 12 months, the types of CAM reported did not vary by sexual orientation. The second manuscript investigated the association between lesbian sexual orientation, sexual abuse history, and adulthood obesity. Lesbian sexual orientation and a history of childhood sexual abuse (CSA) perpetrated by a family member were each independently associated with current adulthood obesity. The third manuscript explored potential differences in the prevalence and associated factors of polycystic ovary syndrome (PCOS) by sexual orientation. A small sample size limited the power of the analysis to confirm statistical difference in PCOS prevalence or associated factors; however, meaningful trends were observed. If the observed trends are reflective of the larger population, lesbians may exhibit differences in PCOS determinate factors, have higher rates of PCOS, and may be more likely to be diagnosed with PCOS compared to heterosexual women. The public health significance of this dissertation was to explore potential health-related differences that may exist between heterosexual and lesbian women in the areas of CAM, obesity, and PCOS research. Findings contributed to the literature on health disparities and provided further support for a greater focus on lesbian health, including public health training, education, screenings, and interventions to better serve the lesbian population