INS NYC 2024 Program

Poster	Poster Session 05 Program Schedule 02/15/2024 02:30 pm - 03:45 pm Room: Shubert Complex (Posters 1-60) Poster Session 05: Neuropsychiatry \| Addiction/Dependence \| Stress/Coping \| Emotional/Social Processes Final Abstract #24 Prevalence of Traumatic Brain Injury in Sexual and Gender Minority Individuals: Leveraging the All of Us Database Jill Del Pozzo, Icahn School of Medicine at Mount Sinai, New York, United States Nicola de Souza, Icahn School of Medicine at Mount Sinai, New York, United States Amelia Hicks, Icahn School of Medicine at Mount Sinai, New York, United States Holly Carrington, Icahn School of Medicine at Mount Sinai, New York, United States Sarah Bannon, Icahn School of Medicine at Mount Sinai, New York, United States Kristen Dams-O'Connor, Icahn School of Medicine at Mount Sinai, New York, United States Category: Acquired Brain Injury (TBI/Cerebrovascular Injury and Disease - Adult) Keyword 1: traumatic brain injury Keyword 2: diversity Keyword 3: minority issues Objective: Millions of Americans sustain traumatic brain injuries (TBI) annually, leading to chronic health challenges and disability. Little is known about rates and correlates of TBI among sexual and gender minority (SGM; LGBTQ+) groups. Some research suggests that SGM-identifying individuals might experience higher TBI rates and more severe consequences than cisgender, heterosexual-identifying individuals. Marginalization, victimization, limited healthcare access, stigma, and unmet healthcare needs among SGM individuals can impact chronic TBI outcomes. The present study evaluated the prevalence of TBI among adults with and without SGM identities, utilizing the National Institutes of Health (NIH) All of Us (AoU) database. Participants and Methods: The NIH AoU database contains >486,000 participants and prioritizes recruitment of historically marginalized groups. Our analysis involved 413,360 participants providing sexual orientation and gender identity data. TBI exposure was determined through electronic medical record (EMR) data using ICD-10 diagnosis codes covering a broad range of brain injuries. We analyzed TBI exposure using a binary variable (TBI vs. no-TBI) and categorized SGM individuals into two groups: sexual orientation minoritized vs. sexual orientation non-minoritized, and gender identity minoritized vs. gender identity non-minoritized. Chi-square tests of independence were conducted to determine significant differences between TBI exposure and identification as a sexual orientation-minoritized identity, as well as between TBI and identification as a gender-minoritized identity. Results: Our findings revealed that within the AoU dataset, 6,899 individuals (1.7%) experienced TBI during the study period. When focusing on the subset of individuals with TBI exposure, a closer examination of gender identity indicated that 2.1% identified with a gender-minoritized group, compared to 1.7% of individuals who identified as a non-gender minoritized identity. A chi-square test of independence showed that there was a significant association between gender and TBI exposure, X² (1, N = 405,402) = 4.53, p = .03. Additionally, among the TBI-exposed group, 1.8% identified with a sexual orientation minoritized identity, compared to 1.6% who identified as a non-sexual orientation minoritized group. Similarly, a chi-square test of independence was performed to examine the relationship between TBI exposure and sexual orientation. The relationship between these variables was significant, X² (1, N = 398,765) = 7.08, p < .01. Conclusions: We observed a higher prevalence of TBI among SGM individuals, particularly those with gender-minoritized identities. Our findings underscore the need for comprehensive investigation into TBI prevalence, risks, and impacts within these marginalized groups. By leveraging the NIH AoU database, our study demonstrates the potential of large-scale research in identifying characteristics of understudied and potentially overlooked groups. However, it is important to acknowledge that this database only uses diagnoses coded in EMRs and only reflects a period for which records are available, and underestimates of TBI incidence may be disproportionately high among SGM-identifying individuals due to barriers in access to care and a lack of lifetime assessment of TBI. Additional research is needed to explore and address the unique challenges faced by SGM individuals with respect to TBI risk, care needs, and outcomes.

Poster

02/15/2024
02:30 pm - 03:45 pm
Room: Shubert Complex (Posters 1-60)

Poster Session 05: Neuropsychiatry | Addiction/Dependence | Stress/Coping | Emotional/Social Processes

Final Abstract #24

Prevalence of Traumatic Brain Injury in Sexual and Gender Minority Individuals: Leveraging the All of Us Database

Jill Del Pozzo, Icahn School of Medicine at Mount Sinai, New York, United States
Nicola de Souza, Icahn School of Medicine at Mount Sinai, New York, United States
Amelia Hicks, Icahn School of Medicine at Mount Sinai, New York, United States
Holly Carrington, Icahn School of Medicine at Mount Sinai, New York, United States
Sarah Bannon, Icahn School of Medicine at Mount Sinai, New York, United States
Kristen Dams-O'Connor, Icahn School of Medicine at Mount Sinai, New York, United States

Category: Acquired Brain Injury (TBI/Cerebrovascular Injury and Disease - Adult)

Keyword 1: traumatic brain injury
Keyword 2: diversity
Keyword 3: minority issues

Objective:

Millions of Americans sustain traumatic brain injuries (TBI) annually, leading to chronic health challenges and disability. Little is known about rates and correlates of TBI among sexual and gender minority (SGM; LGBTQ+) groups. Some research suggests that SGM-identifying individuals might experience higher TBI rates and more severe consequences than cisgender, heterosexual-identifying individuals. Marginalization, victimization, limited healthcare access, stigma, and unmet healthcare needs among SGM individuals can impact chronic TBI outcomes. The present study evaluated the prevalence of TBI among adults with and without SGM identities, utilizing the National Institutes of Health (NIH) All of Us (AoU) database.

Participants and Methods:

The NIH AoU database contains >486,000 participants and prioritizes recruitment of historically marginalized groups. Our analysis involved 413,360 participants providing sexual orientation and gender identity data. TBI exposure was determined through electronic medical record (EMR) data using ICD-10 diagnosis codes covering a broad range of brain injuries. We analyzed TBI exposure using a binary variable (TBI vs. no-TBI) and categorized SGM individuals into two groups: sexual orientation minoritized vs. sexual orientation non-minoritized, and gender identity minoritized vs. gender identity non-minoritized. Chi-square tests of independence were conducted to determine significant differences between TBI exposure and identification as a sexual orientation-minoritized identity, as well as between TBI and identification as a gender-minoritized identity.

Results:

Our findings revealed that within the AoU dataset, 6,899 individuals (1.7%) experienced TBI during the study period. When focusing on the subset of individuals with TBI exposure, a closer examination of gender identity indicated that 2.1% identified with a gender-minoritized group, compared to 1.7% of individuals who identified as a non-gender minoritized identity. A chi-square test of independence showed that there was a significant association between gender and TBI exposure, X² (1, N = 405,402) = 4.53, p = .03. Additionally, among the TBI-exposed group, 1.8% identified with a sexual orientation minoritized identity, compared to 1.6% who identified as a non-sexual orientation minoritized group. Similarly, a chi-square test of independence was performed to examine the relationship between TBI exposure and sexual orientation. The relationship between these variables was significant, X² (1, N = 398,765) = 7.08, p < .01.

Conclusions:

We observed a higher prevalence of TBI among SGM individuals, particularly those with gender-minoritized identities. Our findings underscore the need for comprehensive investigation into TBI prevalence, risks, and impacts within these marginalized groups. By leveraging the NIH AoU database, our study demonstrates the potential of large-scale research in identifying characteristics of understudied and potentially overlooked groups. However, it is important to acknowledge that this database only uses diagnoses coded in EMRs and only reflects a period for which records are available, and underestimates of TBI incidence may be disproportionately high among SGM-identifying individuals due to barriers in access to care and a lack of lifetime assessment of TBI. Additional research is needed to explore and address the unique challenges faced by SGM individuals with respect to TBI risk, care needs, and outcomes.