Hispanic sexual minority individuals, linguistic acculturation, and behavioral health: Evidence of a healthy migrant effect.

Purpose: Stress-based theories suggest that sexual minority Hispanic migrants are at increased risk of adverse behavioral health outcomes. However, a body of descriptive evidence shows migrants exhibit improved health outcomes. Responding to calls for intersectional investigations of the 'healthy migrant effect,' we quantitatively examine whether sexual minority status moderates the relationship between English proficiency (a proxy for acculturation) and behavioral health.

Methods: We used pooled cross-sectional data from the Hispanic respondents to the 2015-2019 National Survey on Drug Use and Health. We used logistic regression models to examine the association of the level of English proficiency with past-year major depressive episode (MDE) and past-year substance use disorder (SUD) and used interactions to examine the moderating effect of sexual minority status.

Results: For both MDE and SUD, sexual minority Hispanic individuals with lower levels of English proficiency had lower odds of reporting adverse outcomes than sexual minority individuals with higher levels of English proficiency and did not have significantly different outcomes than their heterosexual counterparts. The direction of these relationships did not change when stratified by gender.

Conclusions: There appears to be a healthy migrant effect with regard to sexual minority Hispanic individuals and behavioral health outcomes. This also suggests that acculturation may be a uniquely important risk factor for this population. Preventative efforts should be targeted at this group to avoid the development of behavioral health concerns.