SURVEY TITLE: Women's Health Initiative
ACRONYM: WHI
SPONSOR: National Heart, Lung, and Blood Institute, National Institutes of Health, United
States Department of Health and Human Services.
SURVEY PURPOSE: The Women's Health Initiative (WHI) was a major 15-year research
program to address the most common causes of death, disability and poor quality of life in
postmenopausal women -- cardiovascular disease, cancer, and osteoporosis.
LOCATION SAMPLED: United States.
YEARS SEXUAL ORIENTATION DATA COLLECTED: 1991-2005
SAMPLE SIZE: The three major components of the WHI were: a randomized controlled clinical trial of promising but unproven approaches to prevention; an observational study to identify predictors of disease; and a study of community approaches to developing healthful behaviors. Sample size: 161,808 women aged 50-79 total. Of the 93,311 women who were asked sexual orientation in the analysis sample, most (97.1%) were heterosexuals. Self-identified lesbians represented only 573 (0.6%) of the sample, almost equally divided between lifetime lesbians and those who identified themselves as lesbians only after age 45 years. Bisexuals were 0.8% of the sample. Only 1.5% reported never having had sex as an adult.
METHOD OF SEXUAL ORIENTATION DATA COLLECTION: Self-completed Questionnaire.
SEXUAL ORIENTATION QUESTIONS:
"Regardless of whether you are currently sexually active, which response best describes who you have had sex with over your adult lifetime? 1) have never had sex; 2) sex with a woman or with women; 3) sex with a man or with men; 4) sex with both men and women; 5) prefer not to answer” (If respondents checked the “with both men and women”): “Which response best describes who you have had sex with after 45 years of age? 1) sex with a woman or with women; 2) sex with a man or with men; 3) sex with both men and women; 4) prefer not to answer”
RESULTS:
DATA ACCESS: www.nhlbi.nih.gov/whi/index.html
ACRONYM: WHI
SPONSOR: National Heart, Lung, and Blood Institute, National Institutes of Health, United
States Department of Health and Human Services.
SURVEY PURPOSE: The Women's Health Initiative (WHI) was a major 15-year research
program to address the most common causes of death, disability and poor quality of life in
postmenopausal women -- cardiovascular disease, cancer, and osteoporosis.
LOCATION SAMPLED: United States.
YEARS SEXUAL ORIENTATION DATA COLLECTED: 1991-2005
SAMPLE SIZE: The three major components of the WHI were: a randomized controlled clinical trial of promising but unproven approaches to prevention; an observational study to identify predictors of disease; and a study of community approaches to developing healthful behaviors. Sample size: 161,808 women aged 50-79 total. Of the 93,311 women who were asked sexual orientation in the analysis sample, most (97.1%) were heterosexuals. Self-identified lesbians represented only 573 (0.6%) of the sample, almost equally divided between lifetime lesbians and those who identified themselves as lesbians only after age 45 years. Bisexuals were 0.8% of the sample. Only 1.5% reported never having had sex as an adult.
METHOD OF SEXUAL ORIENTATION DATA COLLECTION: Self-completed Questionnaire.
SEXUAL ORIENTATION QUESTIONS:
"Regardless of whether you are currently sexually active, which response best describes who you have had sex with over your adult lifetime? 1) have never had sex; 2) sex with a woman or with women; 3) sex with a man or with men; 4) sex with both men and women; 5) prefer not to answer” (If respondents checked the “with both men and women”): “Which response best describes who you have had sex with after 45 years of age? 1) sex with a woman or with women; 2) sex with a man or with men; 3) sex with both men and women; 4) prefer not to answer”
RESULTS:
- Valanis BG, Bowen DJ, Bassford T, Whitlock E, Charney P, Carter RA. Sexual orientation and health: comparisons in the women's health initiative sample. Arch Fam Med. 2000 Sep-Oct;9(9):843-53. CONTEXT: Little is known about older lesbian and bisexual women. Existing research rarely compares characteristics of these women with comparable heterosexual women. OBJECTIVE: To compare heterosexual and nonheterosexual women 50 to 79 years on specific demographic characteristics, psychosocial risk factors, screening practices, and other health-related behaviors associated with increased risk for developing particular diseases or disease outcomes. DESIGN: Analysis of data from 93,311 participants in the Women's Health Initiative (WHI) study of health in postmenopausal women, comparing characteristics of 5 groups: heterosexuals, bisexuals, lifetime lesbians, adult lesbians, and those who never had sex as an adult. SETTING: Subjects were recruited at 40 WHI study centers nationwide representing a range of geographic and ethnic diversity. PARTICIPANTS: Postmenopausal women aged 50 to 79 years who met WHI eligibility criteria, signed an informed consent to participate in the WHI clinical trial(s) or observational study, and responded to the baseline questions on sexual orientation. MAIN OUTCOME MEASURES: Demographic characteristics, psychosocial risk factors, recency of screening tests, and other health-related behaviors as assessed on the WHI baseline questionnaire. RESULTS: Although of higher socioeconomic status than the heterosexuals, the lesbian and bisexual women more often used alcohol and cigarettes, exhibited other risk factors for reproductive cancers and cardiovascular disease, and scored lower on measures of mental health and social support. Notable is the 35% of lesbians and 81% of bisexual women who have been pregnant. Women reporting that they never had sex as an adult had lower rates of Papanicolaou screening and hormone replacement therapy use than other groups. CONCLUSIONS: This sample of older lesbian and bisexual women from WHI shows many of the same health behaviors, demographic, and psychosocial risk factors reported in the literature for their younger counterparts, despite their higher socioeconomic status and access to health care. The lower rates of recommended screening services and higher prevalence of obesity, smoking, alcohol use, and lower intake of fruit and vegetables among these women compared with heterosexual women indicate unmet needs that require effective interactions between care providers and nonheterosexual women.
DATA ACCESS: www.nhlbi.nih.gov/whi/index.html
