Mental Health Disparities From Climate Change: The Role of Housing Insecurity and LGBTQ+ Identity, California, 2023.

Abstract

<b>Objectives.</b> To examine the relationship between housing insecurity and lesbian, gay, bisexual, pansexual, transgender, gender-expansive, queer, and questioning (LGBTQ+) identity with mental health burdens from climate events among California adults. <b>Methods.</b> We used cross-sectional data from 2023 California Health Interview Survey (n = 14 307). The outcome was self-reported mental health burden from climate events. Primary predictors were LGBTQ+ identity and housing insecurity. We conducted survey-weighted descriptive statistics and multivariable logistic regression, adjusting for covariates, with an interaction term assessing synergistic effects of primary predictors. <b>Results.</b> Transgender or gender-expansive (adjusted odds ratio [AOR] = 4.05; 95% confidence interval [CI] = 2.66, 6.15) and bisexual or pansexual individuals (AOR = 1.67; 95% CI = 1.19, 2.33) had significantly higher odds of climate-related mental health burden. High housing insecurity was also associated with greater odds (AOR = 1.26; 95% CI = 1.07, 1.48). Among gay respondents, experiencing housing insecurity was associated with approximately threefold higher odds of climate-related mental health burden (adjusted ratio of odds ratios = 3.1; 95% CI = 1.40, 6.82). <b>Conclusions.</b> Bisexual or pansexual and transgender or gender-expansive individuals reported higher mental health burdens from climate events. Housing insecurity appears to be a key social driver shaping disparities in climate-related mental health among LGBTQ+ populations. (<i>Am J Public Health</i>. 2026;116(6):779-789. https://doi.org/10.2105/AJPH.2025.308379).