Population-based study finds health behaviors associated with quality of life among U.S. gay and bisexual men

Gay and bisexual men in the United States reported more mental-distress days and slightly more activity-limitation days than heterosexual men in a population-based study, while their reported physical-distress days were similar. The analysis also found that both health-promoting and health-risk behaviors were more prevalent among the gay and bisexual men included in the study.

Researchers analyzed 2021 data from the Behavioral Risk Factor Surveillance System. The study included 88,319 men, of whom 3,702 self-identified as gay or bisexual. Health-related quality of life was assessed through three outcomes: physical-distress days, mental-distress days, and activity-limitation days during the previous 30 days. The researchers compared these outcomes between sexual-minority and heterosexual men and examined sociodemographic and behavioral correlates of quality of life among the gay and bisexual men.

Sexual-minority men reported an average of 6.82 mental-distress days in the previous 30 days, compared with 3.19 among heterosexual men. They also reported 5.42 activity-limitation days, compared with 4.92, while physical-distress days were 3.65 and 3.44, respectively. Within the sexual-minority group, age and employment status were strongly associated with the measured quality-of-life outcomes. Compared with retired men, men unable to work reported substantially more physical-distress, mental-distress, and activity-limitation days.

Leisure-time physical activity was associated with fewer unhealthy days across all three outcomes, while current smoking was associated with more mental-distress days among gay and bisexual men. The group also reported higher levels of both health-promoting behaviors and risk behaviors, including smoking and binge or heavy drinking. These findings are based on the study abstract, which does not report confidence intervals, model estimates, response rates, or other methodological details needed for fuller assessment of precision and generalizability. The observational associations do not establish that the measured behaviors caused differences in health-related quality of life.

Subject of Research: Associations between health behaviors and health-related quality of life among U.S. gay and bisexual men

Article Title: Association between health-related quality of life and health behaviors among men who have sex with men in the United States: a nationwide population-based study

Article References: Chan, A. S. W., Tam, H. L., Leung, I. S. H., Asiamah, N., Li, S., & Mo, P. K. H. (2026). Association between health-related quality of life and health behaviors among men who have sex with men in the United States: a nationwide population-based study. BMC Psychology. https://doi.org/10.1186/s40359-026-05634-8

Image Credits: AI Generated

DOI: 10.1186/s40359-026-05634-8

Keywords: health-related quality of life, gay and bisexual men, mental distress, physical activity, smoking, alcohol use, employment status, population-based study, United States, Association, between, health-related