Little is known about the risk of cardiovascular disease (CVD) among sexual minorities. The mechanisms linking sexual minority orientation and CVD risk is rarely studied as well. Based on minority stress theory, this dissertation developed a general hypothesis that sexual minorities are exposed to higher levels of stress than heterosexuals, which may leads to increased risks of mental health disorders and CVD. Four cross-sectional studies were conducted in this dissertation, analyzing the NESARC data of nationally-representative non-institutionalized U.S. adults. Specific analytic approaches include multiple logistic regression modelling, mediation analysis, latent class analysis, stratified analysis, and quantitative intersectionality analysis. In the first study, we assessed CVD risk among lesbians, gay men, and bisexuals (LGB) compared with self-identified heterosexuals and whether mental health disorders mediate this association. In the second study, we evaluated the impact of sexual minority stress on the CVD risk among sexual minorities and whether intersection of other social identities and psychosocial factors interactively affect this relationship. In the third study, we assessed the risk of CVD and mental health disorders for persons with uncertain sexual identity and those who self-identified as heterosexual but had same-gender sex and /or attraction. In the fourth study, we assessed the geographic disparities in CVD risk for LGB persons and modified effect by social support.Ph.D., Epidemiology -- Drexel University, 201
