Thesis (Ph. D.)--University of Toronto, 2005.

published_or_final_version / Public Health / Master / Master of Public Health

This thesis examines the relationship between activism, identity and well-being among a small group of lesbian activists in Vancouver, B.C. It explores the idea of the margin as a site of resistance, highlighting the connection between (stigmatized) identities and resilience. The relationship between activism and mental and physical wellbeing is explored, political consciousness and social justice work being named as key determinants of health. Individual interviews with 7 lesbians (the author included) who have been active in social justice work were conducted, as well as a focus group. A self-reflective exercise was also undertaken to capture the researcher's thoughts and feelings throughout the process. This project highlights the power of identity, however shifting and unstable it may be, in the lives of lesbian activists. Their narratives disrupt Utopian visions of lesbian communities as ideologically homogeneous, stable and nurturing; Depicted is a more complex image of activist networks where differential power relations exist and certain subjectivities are privileged. Activism, despite having a negative impact on physical health, was seen to be beneficial for mental well-being, increasing the participants' sense of purpose, connection, and power.

This thesis examines the relationship between activism, identity and well-being among a small group of lesbian activists in Vancouver, B.C. It explores the idea of the margin as a site of resistance, highlighting the connection between (stigmatized) identities and resilience. The relationship between activism and mental and physical wellbeing is explored, political consciousness and social justice work being named as key determinants of health. Individual interviews with 7 lesbians (the author included) who have been active in social justice work were conducted, as well as a focus group. A self-reflective exercise was also undertaken to capture the researcher's thoughts and feelings throughout the process. This project highlights the power of identity, however shifting and unstable it may be, in the lives of lesbian activists. Their narratives disrupt Utopian visions of lesbian communities as ideologically homogeneous, stable and nurturing; Depicted is a more complex image of activist networks where differential power relations exist and certain subjectivities are privileged. Activism, despite having a negative impact on physical health, was seen to be beneficial for mental well-being, increasing the participants' sense of purpose, connection, and power. / Education, Faculty of / Educational Studies (EDST), Department of / Graduate

Cardiovascular disease (e.g., myocardial infarction, stroke, coronary artery disease) is the leading cause of death and disability worldwide. There is a growing body of literature that indicates sexual minority (e.g., gay, lesbian, bisexual, queer) adults are at a higher risk of cardiovascular disease than their heterosexual counterparts. The aim of this dissertation was to identify factors that contribute to the cardiovascular health (CVH) disparities that have been observed among sexual minority individuals. Guided by an adaptation of the minority stress model of CVH among sexual minority individuals, this dissertation includes three studies. In the first study (i.e., Chapter 2), we conducted a scoping review of the literature that investigated social determinants of cardiovascular health among sexual minority adults. Although findings were mixed, several social determinants of health were found to influence the CVH of sexual minority adults. For instance, sexual minority adults who lived in environments that were more supportive of sexual and gender minority people had lower odds of being overweight or obese. In the second study (i.e., Chapter 3), we used data from a racially and ethnically diverse sample of sexual minority women to examine the associations of family-related factors (i.e., sexual identity disclosure and family social support) with self-reported incident hypertension. Additionally, we examined whether these associations were moderated by race/ethnicity and sexual identity, or mediated by depressive symptoms. We found that higher levels of family social support were associated with lower levels of depressive symptoms among sexual minority women. However, family-related factors were not associated with self-reported incident hypertension. Further, race/ethnicity and sexual identity did not moderate the associations between family-related factors and reported incident hypertension. In the third study (i.e., Chapter 4), we used data from a nationally representative sample of adults to investigate sexual identity differences in ideal CVH (as defined by the American Heart Association’s Life Simple 7) and whether these associations were mediated by depressive symptoms. Compared to exclusively heterosexual women, mostly heterosexual and lesbian women were less likely to meet ideal criteria for tobacco use. In contrast, lesbian women were more likely to meet ideal criteria for glycosylated hemoglobin than exclusively heterosexual women. Among men, relative to exclusively heterosexual men, mostly heterosexual men were less likely to meet ideal criteria for tobacco use. Gay and bisexual men were less likely to meet ideal criteria for physical activity, whereas gay men were more likely to meet ideal criteria for body mass index compared to exclusively heterosexual men. Bisexual men were less likely to meet ideal criteria for blood pressure relative to exclusively heterosexual men. Depressive symptoms were found to partially mediate the association between sexual identity and physical activity only among mostly heterosexual women. Overall, these dissertation findings highlight CVH disparities among sexual minority adults. Clinicians should be educated about the CVH disparities that have been documented among sexual minority adults to provide personalized and culturally competent care. Results also indicate there is a need to develop behavioral interventions tailored specifically to the needs of sexual minority adults to improve their CVH outcomes and reduce CVH-related disparities.