{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T11:53:34Z","timestamp":1791978814323,"version":"4.4.0"},"reference-count":36,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2019,7,28]],"date-time":"2019-07-28T00:00:00Z","timestamp":1564272000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100005506","name":"Blue Cross and Blue Shield of Florida Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100005506","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006545","name":"National Institute on Minority Health and Health Disparities","doi-asserted-by":"publisher","award":["U54MD002266"],"award-info":[{"award-number":["U54MD002266"]}],"id":[{"id":"10.13039\/100006545","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of School Health"],"published-print":{"date-parts":[[2019,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>Little research exists examining the impact of multiple minority identities, particularly sexual orientation, race\/ethnicity, and sex on health\u2010risk behaviors like mental health, substance use, violence, and sexual risk among high school students in the United States. In this study, we use a nationally representative dataset to examine differences between non\u2010Hispanic white heterosexuals (HSs) and non\u2010Hispanic white sexual minority, black HS, black sexual minority, Hispanic HS, and Hispanic sexual minority students.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>Data from the 2015 wave of the Youth Risk Behavioral Surveillance System were used in this study. Chi\u2010square and hierarchical logistic regression models examined differences between the groups on outcomes including: (1) mental health and suicide, (2) alcohol, tobacco, and illicit substances, (3) sexual risk and protective factors, and (4) school and physical and\/or sexual violence.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>Whereas sexual minority youth (SMY) generally demonstrate poorer health outcomes compared to HSs, SMY who are also racial\/ethnic minorities often have even poorer health outcomes, particularly relating to substance use, sexual risk behaviors, physical\/sexual violence, and suicide.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>The need for culturally tailored education and school\u2010based interventions that consider intersections between race\/ethnicity, sexual identity, and biological sex are warranted to address health disparities related to mental health and suicide, substance use, sexual risk, and violence.<\/jats:p><\/jats:sec>","DOI":"10.1111\/josh.12817","type":"journal-article","created":{"date-parts":[[2019,7,29]],"date-time":"2019-07-29T01:43:53Z","timestamp":1564364633000},"page":"800-808","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":58,"title":["Intersectionality and Health Behaviors Among US High School Students: Examining Race\/Ethnicity, Sexual Identity, and Sex"],"prefix":"10.1111","volume":"89","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5827-1389","authenticated-orcid":false,"given":"Karina A.","family":"Gattamorta","sequence":"first","affiliation":[{"name":"University of Miami School of Nursing and Health Studies, 5030 Brunson Drive, Coral Gables, FL 33146"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John P.","family":"Salerno","sequence":"additional","affiliation":[{"name":"University of Maryland School of Public Health, College Park, MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda J.","family":"Castro","sequence":"additional","affiliation":[{"name":"University of Miami School of Nursing and Health Studies, Coral Gables, FL"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,7,28]]},"reference":[{"key":"e_1_2_6_2_1","first-page":"1","volume-title":"Intersectionality: Moving women's Health Research and Policy Forward","author":"Hankivsky O","year":"2009"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/ANS.0b013e3181a3b3fc"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.ss6509a1"},{"key":"e_1_2_6_5_1","first-page":"1","volume-title":"Behavioral Health Trends in the United States: Results from the 2014 National Survey on Drug Use and Health","author":"Center for Behavioral Health Statistics and Quality","year":"2015"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/josh.12650"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/josh.12353"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360-0443.2009.02531.x"},{"key":"e_1_2_6_9_1","volume-title":"Critical Perspectives on Racial and Ethnic Differences in Health in Late Life","author":"Anderson N","year":"2004"},{"key":"e_1_2_6_10_1","unstructured":"HenryJ.Kaiser Family Foundation. 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