Tuesday, September 16, 2025 9/16/2025

Contextual Determinants of Sexual Minority Health in the United States

Award Number: R01MD016417
ORGANIZATION: NATIONAL CENTER ON MINORITY HEALTH AND HEALTH DISPARITIES
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 07/21/2022
PERIOD OF PERFORMANCE END DATE: 03/31/2026

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Contextual Determinants of Sexual Minority Health in the United States - Contextual Determinants of Sexual Minority Health in the United States R01 Application Summary/Abstract Kara Joyner (PI) and Wendy Manning (Co-I) Researchers have long documented health disparities for sexual minority populations (or sexual diverse populations) and they are beginning to document them for gender minority populations (or gender diverse populations). These health disparities remain largely intractable because researchers have not been able to rigorously capture the putative mechanism behind them: stigma. The minority stress perspective posits that sexual minority populations, like racial/ethnic minority populations, experience a higher prevalence of adverse health outcomes than heterosexual populations due to their stigmatized status in society. Researchers testing this perspective have increasingly measured stigma at the societal level or “structural stigma,” a concept that captures both social climate (public attitudes towards sexual/gender minorities) and legal climate (laws and policies relevant to sexual/gender minorities). Researchers have been hampered in their ability to adequately assess the effects of structural stigma due to the design of most population-based surveys that include questions on sexual minority status and health. Few of these surveys permit researchers to measure stigma at multiple levels. Another limitation of these surveys is that they are cross-sectional, precluding a consideration of how exposure to structural stigma changes over the life course. The National Longitudinal Study of Adolescent to Adult Health (Add Health) has the necessary criteria to rigorously investigate the effects of structural stigma on the health outcomes of sexual minority respondents, including a formal and regulated mechanism for producing and disseminating contextual data. Add Health users interested in testing minority stress and intersectionality perspectives will have unprecedented opportunities to examine how various outcomes are associated with structural stigma for sexual minority respondents and how the associations differ across subgroups. Aim 1 of this project is to create a contextual database that researchers can use to better study the effects of structural stigma. Specifically, this database will include measures of social and legal climate relevant to sexual minorities that correspond to the tract, county, and state levels before or around the time of Waves 3, 4, and 5. This database will also include measures of structural racism since many sexual minorities are also racial/ethnic minorities. We will convene an advisory team to ensure we have the best measures of structural stigma and racism. Aim 2 will examine with this contextual database how state-level measures of legal climate are associated with self-rated health and health biomarkers among Add Health respondents and consider how these associations differ by key factors (e.g., gender, socioeconomic status, and race/ethnicity). This database will promote research on health disparities for sexual and racial minority populations that is both rigorous and innovative. Research made possible by the creation of this contextual database has the potential to inform policies and interventions that improve the health of sexual and racial minority populations, including subgroups of these populations, ensuring all populations have equal opportunities for long, healthy, and productive lives.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2025 ( Subtotal = $0 )
2025	2024	THE UNIVERSITY OF TEXAS AT SAN ANTONIO	1 UTSA CIR	SAN ANTONIO	TX	78249	BEXAR	USA	Minority Health and Health Disparities Research	000	3	3/20/2025	NON-COMPETING CONTINUATION	$0
2025	2024	THE UNIVERSITY OF TEXAS AT SAN ANTONIO	1 UTSA CIR	SAN ANTONIO	TX	78249	BEXAR	USA	Minority Health and Health Disparities Research	002	3	7/16/2025	NON-COMPETING CONTINUATION	$0
2025	2024	THE UNIVERSITY OF TEXAS AT SAN ANTONIO	1 UTSA CIR	SAN ANTONIO	TX	78249	BEXAR	USA	Minority Health and Health Disparities Research	001	3	7/5/2025	NON-COMPETING CONTINUATION	$0
														Subtotal = $0

Issue Date FY: 2024 ( Subtotal = $291,186 )
2024	2024	UNIVERSITY OF TEXAS AT SAN ANTONIO, THE	1 UTSA CIRCLE	SAN ANTONIO	TX	78249	BEXAR	USA	Minority Health and Health Disparities Research	000	3	4/11/2024	NON-COMPETING CONTINUATION	$270,173
2024	2024	THE UNIVERSITY OF TEXAS AT SAN ANTONIO	1 UTSA CIR	SAN ANTONIO	TX	78249	BEXAR	USA	Minority Health and Health Disparities Research	001	3	5/28/2024	NON-COMPETING CONTINUATION	$21,013
														Subtotal = $291,186

Issue Date FY: 2023 ( Subtotal = $300,192 )
2023	2023	UNIVERSITY OF TEXAS AT SAN ANTONIO, THE	1 UTSA CIRCLE	SAN ANTONIO	TX	78249	BEXAR	USA	Minority Health and Health Disparities Research	000	2	3/10/2023	NON-COMPETING CONTINUATION	$300,192
														Subtotal = $300,192

Issue Date FY: 2022 ( Subtotal = $350,192 )
2022	2022	UNIVERSITY OF TEXAS AT SAN ANTONIO, THE	1 UTSA CIRCLE	SAN ANTONIO	TX	78249	BEXAR	USA	Minority Health and Health Disparities Research	000	1	7/21/2022	NEW	$350,192
														Subtotal = $350,192

Grand Total All Awards = $941,570

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Contextual Determinants of Sexual Minority Health in the United States

Award Number: R01MD016417

ORGANIZATION: NATIONAL CENTER ON MINORITY HEALTH AND HEALTH DISPARITIES

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 07/21/2022

PERIOD OF PERFORMANCE END DATE: 03/31/2026

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