Identifying Social Determinants of Health Among Lesbian, Gay, and Bisexual US Veterans Using Primary Care Services in the Veterans Health Administration, 2021-2022.

Abstract

<b>Objectives.</b> To assess differences in social determinants of health identified through <i>International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM)</i> and <i>Tenth Revision (ICD-10-CM)</i> codes between lesbian, gay, bisexual, and other nonheterosexual ("sexual minority") veterans and heterosexual veterans who utilize primary care services in the US Veterans Health Administration. <b>Methods.</b> We used the Veterans Health Administration Survey of Healthcare Experiences of Patients, weighted descriptive statistics, and multivariable logistic regression to examine differences in sociodemographic characteristics and social determinants of health-related <i>ICD-9-CM</i> and <i>ICD-10-CM</i> code domains by sexual orientation (sexual minority vs heterosexual). <b>Results.</b> Of the 455 165 veterans surveyed, roughly 3% (n = 14 065) identified as sexual minority. Compared with heterosexual veterans, sexual minority veterans were often younger and more likely to be racially/ethnically diverse, live in urban areas, and identify as female. All sexual minority groups had a greater risk of issues related to housing, economic circumstances, and other psychosocial circumstances than heterosexual veterans. <b>Conclusions.</b> Sexual minority veterans had increased vulnerabilities across various social determinants of health <i>ICD-9-CM</i> and <i>ICD-10-CM</i> code domains associated with health and well-being. Future research should continue to explore this relationship and develop evidence-based interventions to support sexual minority veterans effectively. (<i>Am J Public Health</i>. Published online ahead of print July 30, 2026:e1-e11. https://doi.org/10.2105/AJPH.2026.308563).