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Am J Public Health. 2014 Feb;104(2):311-8. doi: 10.2105/AJPH.2013.301745. Epub 2013 Dec 12.

Disparities in safety belt use by sexual orientation identity among US high school students.

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  • 1Sari L. Reisner and Allegra Gordon are with the Department of Society, Human Development, and Health, Harvard School of Public Health, and Jerel P. Calzo is with the Department of Pediatrics, Harvard Medical School, Boston, MA. Sari L. Reisner is also with and Aimee Van Wagenen is with the Fenway Institute, Fenway Health, Boston. Jerel P. Calzo is also with the Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston.



We examined associations between adolescents' safety belt use and sexual orientation identity.


We pooled data from the 2005 and 2007 Youth Risk Behavior Surveys (n = 26,468 weighted; mean age = 15.9 years; 35.4% White, 24.7% Black, 23.5% Latino, 16.4% other). We compared lesbian and gay (1.2%), bisexual (3.5%), and unsure (2.6%) youths with heterosexuals (92.7%) on a binary indicator of passenger safety belt use. We stratified weighted multivariable logistic regression models by sex and adjusted for survey wave and sampling design.


Overall, 12.6% of high school students reported "rarely" or "never" wearing safety belts. Sexual minority youths had increased odds of reporting nonuse relative to heterosexuals (48% higher for male bisexuals, 85% for lesbians, 46% for female bisexuals, and 51% for female unsure youths; P < .05), after adjustment for demographic (age, race/ethnicity), individual (body mass index, depression, bullying, binge drinking, riding with a drunk driver, academic achievement), and contextual (living in jurisdictions with secondary or primary safety belt laws, percentage below poverty, percentage same-sex households) risk factors.


Public health interventions should address sexual orientation identity disparities in safety belt use.

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