Philadelphia LGBT Assessment

The Philadelphia LGBT Community Assessment
Final Report
Prepared by Philadelphia Health Management Corporation
A Project Funded by
The City of Philadelphia
and the Philadelphia Foundation
October 27, 2006

Table of Contents
Introduction...................................................................................................................................................3
Data Sources .................................................................................................................................................9
Prevalence of Homosexual/Bisexual Populations in Philadelphia .............................................................12
Geographic Patterns of Same-sex Partner Couples in Philadelphia ...........................................................13
Comparing Homosexual and Bisexual Residents of Philadelphia with Heterosexual Residents................21
Defining Gaps in the Data...........................................................................................................................59
Community Input and Feedback.................................................................................................................61
Recommendations.......................................................................................................................................61
Conclusion ..................................................................................................................................................64
Appendices..................................................................................................................................................65
Acknowledgements.....................................................................................................................................68
2
Introduction
Genesis and Structure of the LGBT Assessment
In 2004, Lynette Campbell of the Philadelphia Foundation led an initial discussion with Michael Hinson
of the Mayor’s Office, City of Philadelphia, and Robert Morrison, former President of the Board of
Directors, Delaware Valley Legacy Fund about the need for a comprehensive understanding of the LGBT
Communities of Philadelphia, including their size, geographic scope, and needs. The project was early on
conceived as a census, but discussions with Lanette Swopes of the United States Census Bureau led to an
understanding that a community assessment based upon existing data (and not built upon a costly and
logistically complicated census) would be the best way to proceed.
Next, these early stakeholders convened The Philadelphia LGBT Assessment Coalition, a group of
representatives from local government, foundations, businesses and community based organizations to
discuss in what ways such an assessment might be valuable for strategic planning, fundraising, and
community organizing. After identifying ways that such data would be valuable, the group
enthusiastically endorsed the creation of an LGBT Community Assessment for the City of Philadelphia.
Finally, key leaders from the City (Michael Hinson), the Philadelphia Foundation (Andrew Swinney and
Melissa DeShields), the Delaware Valley Legacy Fund (Robert Morrison and Perry Monastero), and
Philadelphia Health Management Corporation (John Loeb and Lynn Kotranski) met to discuss next steps.
This group decided that they would pursue a two-phase strategy. Phase I, to be conducted in one year,
would involve the collection and analysis of all existing data (which would be culled from the 2000
United States Census and the 2004 PHMC Southeastern Pennsylvania Household Health Survey), as well
as the identification of gaps in the data. The Philadelphia Foundation and the City of Philadelphia
funded the Phase I work, and hired Philadelphia Health Management Corporation (PHMC) to conduct
the project. PHMC hired consultant Chris Bartlett to coordinate the project, and PHMC Research
Associate Heather Batson led efforts to collect and analyze the available data. Following completion of a
preliminary report, project staff met with numerous groups of stakeholders from the government,
business, foundation and community sectors, and presented initial data in order to receive feedback.
Using feedback from these group meetings, project staff have made recommendations (contained herein)
about the future of the LGBT Community Assessment. This final report represents the culmination
of Phase I.
Phase II involves the pursuit of further information to fill gaps that were identified in Phase I, as well as
the enrollment of additional funders and stakeholders from government, business, foundation, and
community sectors to ensure that additional information collected meets the needs of these sectors. The
recommendations at the end of this report represent the possible next steps that will be pursued in
continuing the work of Philadelphia's LGBT Community Assessment.
Background
This report presents the results of data collection and analysis about LGBT populations in the City of
Philadelphia. The report expands upon a growing body of work being done nationally that examines the
demographics and trends of LGBT communities and their cultures. In their groundbreaking work, The
Gay and Lesbian Atlas1, Gary Gates and Jason Ost analyzed data about same-sex unmarried couples
1
Gates, Gary J. and Jason Ost, The Gay and Lesbian Atlas, Urban Institute Press, Washington, D.C., 2004.
3
from the 2000 census to begin to paint a picture, through maps, of the diverse gay and lesbian
communities of the United States on the national and state levels. Their work laid out an important
challenge to localities around the United States: to expand this work by examining in detail their own
LGBT communities at home.
The project fits into a growing body of demographic study that has grappled with the complex axes of
LGBT communities and the identities of their members. In particular, our work recognizes that much
data have been collected on the sexual and relational behaviors of LGBT individuals, but no data have
been collected on identity, desire, attraction, and many other key axes of understanding these individuals.
This project takes on these challenges and has framed the work as a multi-step process: first, identifying
and analyzing existing data about LGBT people; second, considering the existing data and
recommending steps forward for pursuing additional information; and third, seeking out appropriate
partners to assist in a more complete study of LGBT communities in Philadelphia and vicinity. In this
report, we present the first two steps, and make recommendations about how to accomplish the third.
This report includes analysis of data from the 2000 United States Census and the Philadelphia Health
Management Corporation 2004 Southeastern Pennsylvania Household Health Survey (referred to as the
PHMC Household Health Survey). Included are findings from meetings that were held with community,
business, government and foundation stakeholders. Finally, recommendations for next steps for the next
phase of the Community Assessment are presented.
A quantitative and qualitative understanding of LGBT communities in Philadelphia will help to improve
the health and well-being of these diverse communities, which have been shown to play a key role in the
strengthening of cities like Philadelphia. Richard Florida, in The Rise of the Creative Class, makes the
case that vibrant LGBT communities within urban settings are strong predictors of the success of that
city.2 He argues that cities that contain tolerance, technology, and talent are likely to thrive as a result of
these characteristics. 3 He further argues that cities that have strong and vibrant LGBT communities are
likely to attract those who bring with them tolerance, technology, and talent, and that cities that attract
gay people are likely to attract those who will create “creative economies”.4 Thus an understanding of
what makes LGBT communities thrive also will help to illuminate what makes cities more generally
thrive. Furthermore, it is important to understand the nature of the LGBT communities in Philadelphia
because this will help us understand 1) how lesbians, gay men and bisexuals fit into the fabric of the
overall city; 2) how they can be described in terms of demographics and related social trends, and 3) how
we might best aim strategies (political, social, business, etc.) towards this diverse and wide-ranging set of
communities.
Uses for LGBT Community-Level Data5
After discussions with stakeholders in the business, government, philanthropic and non-profit sectors, we
have identified many uses for a repository of LGBT community data.
2
Florida, Richard, The Rise of the Creative Class: and How It’s Transforming Work, Leisure, Community and Everyday
Life., Basic, 2002.
3
Florida, Richard, "Cities and the Creative Class" City and Community 2:1, 2003.
4
Ibid, p. 12
5
Gates and Ost, pp. 2-6 showed these uses for the data on a national level. We use the Gates/Ost framework to consider local
uses of data.
4
1. Political Awareness: The data presented here, identifies the large extent to which homosexual
and bisexual individuals permeate the fabric of every neighborhood of the city. Though much
public awareness of gay communities in Philadelphia focuses on the “gayborhood” in Center
City, and the well-known lesbian and gay enclaves of East and West Mount Airy, our report
shows the extent to which same-sex unmarried couples live in a many city communities that
would not be traditionally thought of as containing LGBT residents. Our research will also shed
light on the estimated size of these communities. We will further explore demographic
similarities and differences between homosexual/bisexual individuals and their heterosexual
counterparts.
It is also important to explore the relative urbanization and suburbanization of these populations
to better understand why LGBT individuals might choose to live either within the city proper or
in its suburbs. These data also point to diverse family structures; many LGBT individuals live in
households that include children (both related and unrelated), and an understanding of these
families helps to improve understanding of the nature of LGBT family participation. Finally,
these data have implications for political organizing: as we better understand the size and nature
of these communities, it will be easier to understand their potential political impact.
2. Community and Economic Development: Recent sociological research has shown that cities
that welcome a range of diversity, including LGBT individuals and communities, are more likely
to thrive in the high tech and creative spheres. Richard Florida’s6 work suggests that thriving
LGBT communities in Philadelphia would support the development of powerful high-tech and
artistic communities that would aid in the improvement of the city’s economy. The data and
analysis that we provide can be a crucial tool in understanding these potential economic
dynamics. Further, this report will be valuable in long-term community and economic strategic
planning for the city and the region. The collection and analysis of data that describe the
economic impact of Philadelphia’s LGBT residents is critical for city and regional planning.
3. Social Science Research: As noted above, there is rapidly growing interest in social science
research into LGBT communities. This report provides the framework and foundation for
additional detailed study of these diverse communities, including additional research around
identity, desire, community affiliation, and social networks. Our work paints a first-time picture
of these communities, showing clearly how diverse these communities are. This report suggests
ways that research organizations, government agencies, and others who study these communities
can ask the sorts of questions that will lead to an improved understanding of these communities.
4. Marketing: The data we present provide useful insights into the geographic locations of gay and
lesbian individuals, as well as demographic variations. These data can be of great use to
organizations, both for- and non-profit, who are interested in marketing their services to the
LGBT community. The geography-specific nature of these data also allow such organizations to
target their efforts to the needs of a specific neighborhood or neighborhoods.
5. Public Health: Our data can help us draw conclusions about the need for improved public health
initiatives targeted at lesbian and gay individuals. In the future, data describing transgender
populations will point to strong needs in these communities. The City of Philadelphia
Department of Public Health has expressed a commitment to addressing health disparities
existing in particular populations of the City. This report identifies key health disparities between
homosexual/bisexual populations and heterosexual populations, and within homosexual/bisexual
6
Op. Cit.
5
populations. Furthermore, the data and analysis will help those working in the public health
sphere to provided targeted services to particular subpopulations.
6. Organizational Development: This report will be useful for community based organizations who
are seeking to create strategic plans, fundraising documents, intervention plans, and other
organizational plans and strategies that might rely on detailed knowledge of LGBT organizational
stakeholders.
Existing Research with LGBT Populations Outside of Philadelphia:
The 2002 National Survey of Family Growth7 made major headway in assessing the sexual and
behavioral identities of males and females, age 15-44 in the United States. This study enables us to see
how our local data compare to national data regarding sexual behaviors, and help us to see how future
data about sexual identities would be useful in better understanding our LGBT populations.
In 2003, Ron Stall and colleagues completed research that looked at large targeted population-based
samples of MSM in San Francisco, Los Angeles, Chicago and New York8. This study represented one of
the first efforts to understand the interrelated impact of multiple factors (including violence, drug use,
and sexual abuse) on the transmission of HIV among gay men. This study shed light on possibilities for
community-wide research that examines multifactorial synergies operating in community health. Stall
used statistical analyses to show how “syndemics” (interrelating health epidemics) operate in gay
communities. Though he used a population sample, his focus was on HIV and related syndemics.
Significant community assessment projects have been launched by other geographic areas, including
Pittsburgh9; the state of Rhode Island10; Santa Clara County, California11; Boulder, Colorado; and the
state of Illinois. In each case, these studies made use of small community surveys (300-600 participants)
and focus groups to assess the needs of these communities.
Existing Research of LGBT Populations in Philadelphia:
Research into LGBT communities of Philadelphia has largely focused upon HIV/AIDS /STD
transmission, sexual health, and other health-related issues of men who have sex with men. Limited
needs assessments have been completed of the transgender populations of the city. No research has been
conducted into the lesbian or bisexual communities of the city.
Various organizations in the City of Philadelphia have participated in research projects that have assessed
the HIV/AIDS-related needs of men who have sex with men in Philadelphia. These studies include the
7
William D. Mosher, Ph.D.; Anjani Chandra, Ph.D.; and Jo Jones, Ph.D., Division of Vital Statistics
8
Stall R, Mills TC, Williamson J, et al. Co-occurring psychosocial health problems among urban men who have sex with men
are increasing vulnerability to the HIV/AIDS epidemic. Am J Public Health. 2003;93:939–942.
9
Quinn, S.C. and Aaron, D., Voices for a New Tomorrow: An Assessment of the Lesbian, Gay , Bisexual and Transgendered
Community of Allegheny County. Persad, 2003.
10
Meet the Neighbors, A full-length portrait of Rhode Island’s lesbian, gay, bisexual, transgender, transsexual, two-spirited,
queer and questioning individuals, Rhode Island Foundation and John Snow, Inc., 2004.
11
County of Santa Clara Lesbian, Gay, Bisexual, and Transgender Needs Assessment, Billy De Frank Lesbian and Gay
Community Center and John Snow, Inc.
6
SafeGuards Men’s Survey12, The PHMC NIMH Funded Factors Associated with Counseling and
Testing (FACT) Survey13, and the PHMC CDC-funded local arm of the Brothers Y Hermanos study,
known here as the Black Men’s Health Study14. The studies share a common interest in HIV/AIDS
related health of men who have sex with men, and chart trends related to sexual health.
In addition, needs assessments of the City’s transgender populations have been completed by
ActionAIDS and the University of Pennsylvania. These studies provide limited information about the
transgender populations of Philadelphia, primarily focusing upon HIV-related issues.
The New Territory Explored by the LGBT Community Assessment
By comparison, Philadelphia’s Community Assessment is the first assessment, to our knowledge, to

make use of a large-scale region-wide phone survey to examine differences between
homosexual/bisexual and heterosexual populations for a specific locality with the intention of
understanding not only health-related trends, but also broader trends and demographics of these
communities. Our analysis allows us to understand LGBT communities from a perspective that includes
but is larger than health alone, so that we can begin to understand these vibrant communities
The population sample provided by the PHMC Household Health Survey is a unique resource because it
expands our view beyond that provided in other research by convenience samples or samples focused
only on zip codes with high gay concentrations. This sample also allows us to compare homosexual and
bisexual men and women to their heterosexual counterparts, so that we can begin to see unique trends at
work within these communities. Furthermore, the PHMC Household Health Survey of over 10,000 adults
in the region (and nearly 4000 in Philadelphia alone) serves as an impartial data source that is population-
based.
Given the limited scope of research into Philadelphia’s LGBT communities, The LGBT Community
Assessment aims to fill a large gap in the literature. The assessment seeks to portray a broad picture of
LGBT lives, including housing, income, social networks and community involvement, religion and
spirituality, and other factors related to the day-to-day lives of Philadelphia’s LGBT citizens.
Over the past two decades, the urgency of the AIDS epidemic has meant that research efforts focused on
LGBT individuals were focused primarily on their HIV-related needs and sexual health. The Community
Assessment seeks to greatly broaden the picture of these communities so that they can be understood
within the framework of their broader lives.
A Note on Terminology
The data sources used in this project shed light on certain behavioral aspects of homosexuality,
bisexuality, and heterosexuality. By this we mean that no data are collected that show the self-declared
identities of individuals. So though we know that our sample have participated in same-sex behaviors, or
live in same-sex couples, we do not know whether they culturally identify as gay, lesbian, bisexual, or
some other identity. This distinction is an important one, and is related to some of our recommendations.
Through this report, we will refer behaviorally to homosexual/bisexual individuals and compare them to
heterosexual individuals. We use this language to highlight one large gap in our current knowledge: the
self-proclaimed identities of homosexual and bisexual men and women in Philadelphia. Where we do
12
SafeGuards Men’s Survey, Journal Of the Gay and Lesbian Medical Association, 2:3, September, 1998, pp.113-129.
13
PHMC Fact Survey
14
PHMC Black Men’s Survey
7
refer to cultural communities of these homosexual and bisexual men and women, we will refer to LGBT
communities and their associated cultures. We hope that much of the picture we paint in these pages will
challenge your traditional assumptions of who LGBT Philadelphians are. We also must make clear that
our initial data present no information about transgender populations. We are disappointed that the
currently existing data do not allow us to make visible Philadelphia’s thriving transgender communities,
which include a broad array of individuals diverse in both their sexual and gender orientations.
Behavior and Identity
We have collected available data from the 2000 US Census and the PHMC Household Health Survey.
These data sources provide valuable information about a broad range of areas of interest to our work,
including specific demographics, as well as living arrangements, education, experience of violence, and
community involvement. However, these data provide absolutely no information about either sexual or
gender identity of the respondents.15 Thus, though data are available about the sexual and/or relational
behaviors of the respondents, it is impossible to show whether the respondents in fact identify as lesbian,
gay, bisexual or transgender. At this point in time, it is possible to talk about populations with same-sex
partners or same-sex sexual experiences. However, LGBT communities are not built upon sexual
behavior or relationships alone, but are instead formed because community members have shared
worldviews, values, and identities. Therefore, when information about identity is not available, it is
difficult to know whether individuals with a certain behavior should be considered part of an LGBT
community, or not.
Data about sexual and relational behaviors can be extremely valuable. It is important to keep in mind,
however, that these behaviors are not the same as identifying as part of an LGBT community.
15
The 2000 census includes two data sets: one which can tell you the total number of same-sex couple in an area but can't
provide crosstabulations any other way, and one which is a 5% sample of households that provides more specific information
about same-sex couples. The Community Health Database asks whether sexual partners are male, female or both. The
Youth Risk Behavior Survey asks whether respondents have had sex with men, women, both, or neither.
8
Data Sources
US Census 2000
Census data sets
The U.S. Census is not one data set, but two: the regular census, which includes data on everyone who
filled out a census form, presented by geographic catchment areas (known as tracts); and the Public Use
Microdata sample (PUMS) which is a 5% sample of individual and household data, cleaned of
identifying characteristics such as names and exact locations. This report includes data from the regular
census files. The regular census data have a wealth of information about geographic areas, but it is not
possible to do individual level cross-tabs on any variable. In this report, we are able to describe the
geographic areas where same-sex couples are likely to live as compared to areas where same-sex couples
are less likely to live, but we are not able to report on the specifics of the same-sex couples compared to
other households.
Methodological issues with the census

There are some methodological issues with the census. Although the US census is intended to be a count
of every person in the United States, some populations may be less likely to respond to the census and
therefore not be counted—these include many racial and ethnic minorities, especially those who do not
have English language proficiency16. In addition, there are methodological issues with the way that the
census counts homosexual and bisexual people: it does so by using the unmarried partner designation for
same-sex couples.
Comparing same-sex unmarried partner data in Census 2000 to earlier Census data
The results from census 2000 are not readily comparable to earlier census numbers: in the previous
census, 1990, same-sex couples who chose the "spouse" option to describe their relationship were
assumed to have made an error with gender, since the Federal Government does not recognize same-sex
marriages. Therefore, the census recoded any same-sex couples that choose the spousal relationship so
that one of the partners was of the opposite sex. In census 2000, cases like this were recoded as
unmarried partners and the gender was not changed. In addition, in 2000,there was a large push by
LGBT advocacy groups that encouraged same-sex couples to use this "unmarried partner" relationship
designation when filling out the census so that as many people partnered with same-sex partners would
be counted as possible.
Limitations of the "unmarried partner" designation

Second, there are limitations about what the census data can tell us about homosexual and bisexual
people: data about couples who are in a committed unmarried partner arrangement are likely to be
somewhat biased. Certain subgroups may be more likely to be settled down into couples than others. If
we tried to learn about the population of heterosexuals by only looking at the individuals who were
married, we would get a skewed picture of the population, and some data sources indicate that
homosexual and bisexual people are less likely than heterosexual people to be living with a partner. For
example, in the PHMC Household Health Survey, 41% of the homosexual and bisexual people were
16
Details about the Census 2000 undercount are not available, but the Census bureau suggests these populations are likely to
be undercounted in their report on the 1990 census undercount: "What is the 1990 Undercount", found at
"http://www.census.gov/dmd/www/techdoc1.html". The undercount of Census 2000 for Philadelphia was estimated by the
US Census to be 1.3% overall by Eugene Ericksen, "Estimates of State and County Undercount Rates," Press Release by the
U.S. Census Monitoring Board Presidential Members May 1, 2001. Found at:
http://govinfo.library.unt.edu/cmb/cmbp/news/050101.undercountrelease.asp.htm However, census staff indicated that there
could be up to 30% of the population missing from Census 2000 (personal communication).
9
single. These individuals may be very different from those who are partnered in both predictable and
unpredictable ways.
Potential bias in use of the "unmarried partner" designation

Furthermore, some of those individuals who are in committed unmarried partner relationships may not
have checked that relationship option. There is some indication that there was indeed undercounting of
same-sex couples, and that there was some bias to the undercount. A small study completed at the
Millennium March in 200017 suggests that a substantial minority of even highly politically active couples
attending this LGBT advocacy event were not counted as "same-sex unmarried partners" in the census.
Researchers expect that this population may be even more likely than the general population of same-sex
partners to have used the same-sex partner designation in the census. However, not only is there an
apparent undercount in this population, but it appears to also be a biased undercount. Couples with
higher levels of education and higher incomes were more likely to be counted than other couples, while
older couples and couples where at least one member was of color were less likely to use the same-sex
partner designation. This means that the population of same-sex couples in the census may appear to be
wealthier, more highly educated, disproportionately white, and younger, than is accurate. Confidentiality
concerns, non-standard household arrangements (for example, larger households where the
"householder" was not a member of the couple), and the selection of alternative relationships such as
"housemate" or "roommate" may have led couples to neglect the "same-sex partner" designation.
The PHMC Household Health Survey

The PHMC Household Health Survey data set
Philadelphia Health Management Corporation's (PHMC) 2004 Southeastern Pennsylvania (SEPA)
Household Health Survey is a unique data source for health and other data in the Southeastern PA region.
This survey has been conducted periodically for over 20 years, and takes a broad view of health that
includes both traditional health survey questions on topics such as health care access, physical health
conditions, and personal health behaviors; and also cover topics taking a more encompassing view of the
idea of health, such as experiences of violence, food availability, poverty, social capital, and mental
health.
PHMC Household Health Survey Methodology

The PHMC Household Health Survey is conducted via telephone in the five county area of SEPA that
includes Bucks, Chester, Delaware, Montgomery, and Philadelphia Counties. This report focuses on
information available from Philadelphia County. Households were contacted using a computerized
random digit dialing methodology so that households with unpublished numbers and people who had
recently moved to the area would be included in the sample. The adult with the most recent birthday was
selected as the adult respondent. A total of 4,415 interviews were conducted in Philadelphia, of which
3,184 were adult interviews.
Unlike the census, which attempts to include every person, the PHMC Household Health Survey used a
sample of households in SEPA. Although the survey sampling method attempted to be as representative
of the population as possible, some sampling bias did exist; some people were more or less likely to
respond to the survey than other people. To correct for this bias, the data are weighted to give more
weight to underrepresented segments of the population and reduce the weight of over-represented
segments. In addition, weights were used to produce projections of the population totals in the region.
It is these projections that are presented in this report. However, statistical significance was determined
using the smaller balance weights reflecting the actual size of the sample.
17
Badgett, M.V. Lee, and Rogers, Marc A. Left Out of the Count: Missing Same-Sex Couples in Census 2000. Amherst MA:
Institute for Gay and Lesbian Strategic Studies; 2003
10
Measures of Sexual Orientation in the PHMC Household Health Survey
In the PHMC Household Health Survey, like the census (where only data about the behavior of those
living in a committed same-sex couple relationship were available), data on sexual orientation are limited
to the behavioral. In this case, respondents were asked about the sex of their sexual partners. Those who
had sexual partners in the past year were categorized as "heterosexual" if they reported only opposite-sex
partners, "bisexual" if they had partners of both sexes, and "homosexual" if they reported only same-sex
partners. This question was intended to capture current partners, but as it is not anchored in time, it is
not clear how respondents answered. This behavior- based definition may create challenges when we try
to extrapolate behavior to identity-based communities such as LGBT communities. In this case, it is not
clear whether all of the people who had the behavior of sex with a same-sex partner are, in fact, people
who consider themselves members of one of the LGBT communities.
The Youth Risk Behavior Survey (YRBS)
The Centers for Disease Control and Prevention (CDC) conducts a biennial survey of health and sexual
behaviors within the School District of Philadelphia. The survey is conducted nationally, with local cities
having some control over certain questions, including sexual behavior. For the Philadelphia YRBS,
sexually active students were asked, “With whom have you had sexual intercourse?” with answer options
as “Females”, “Males”, “Females and Males”. Non-sexually active students were coded as having no
prior sex. No questions are asked to identify sexual or gender identities. The survey gives us a very
limited picture of sexual behaviors in a high-school aged, school-based sample of youth.
11
Prevalence of Homosexual/Bisexual Populations in Philadelphia
According to the PHMC Household Health Survey projections, there are about 51,600 adults who had
same-sex partners in Philadelphia County (about 5% of the population of Philadelphia). This represents
about 40,900 sexually active homosexual people (about 4% of all adult Philadelphians) and 10,700
bisexually sexually active people (about 1% of all adult Philadelphians). An additional projected
164,000 (about 15%) adults have no current sexual partners and 875,000 (80% of the total) adults have
heterosexual partners. (See Figure 1:Sexual Partners of Philadelphia residents) The 2004 PHMC
Household Health Survey used only two sex/gender categories, making it impossible to say anything
about gender identity or transgender populations.
Figure 1:
Sexual partners of Philadelphia residents
90% 80%
80% Same-sex partners
70% only
60% Both sex partners
50%
40% Heterosexual
30% partners only
20% 15%
No sex partners
10% 4% 1%
0%
Sex partner type
Source: PHMC SEPA Household Health Survey, 2004..
In contrast, the U.S. census recorded 4,308 households in Philadelphia where the heads of household
were a same-sex couple, representing 8,616 heads of household and their same-sex partners. Of these,
2,024 were female same-sex couple households (0.3% of all Philadelphia households—including single
person households—and 47% of all same-sex partner households) and 2,284 were same-sex male
households (0.4% of all households—including single person households—in Philadelphia and 53% of
all same-sex households). The U.S. Census only includes two sex/gender categories in their statistics, so
no data are available on transgender individuals. The U.S. Census count of those using the same-sex
"unmarried partner" designation is far lower than the PHMC Household Health Survey projections; as
noted earlier, many homosexual/bisexual people are single, and many cohabitating same-sex couples
may not have chosen the unmarried partner designation when filling out census forms in 2000.
12
Geographic Patterns of Same-sex Partner Couples in Philadelphia
Despite the challenges inherent in the census data outlined above, the geographic trends revealed in the
census are important to understanding LGBT populations in Philadelphia. In 2000, at least one same-
sex couple lived in 95% of all Philadelphia census tracts that contained households, with same-sex
couples represented in every neighborhood. However, the concentration of same-sex couple households
varied considerably. On average, about 0.7% of households in Philadelphia were same-sex couple
households—which is a mean of 12 lesbian or gay households per residential census tract.
Some areas have considerably higher than average proportions of same-sex couple households: generally,
these areas included parts of South Philadelphia, Olney, Chestnut Hill, Mount Airy, and West
Philadelphia, and much of center city. For this phase of the project, we have reviewed demographic data
from the census on both the citywide level and the neighborhood-level in order to provide an example of
the types of analysis that might be done for each neighborhood within the city as well as for the city at
large. This analysis presumes that we can benefit from understanding sexual and gender minority
communities both on the micro (neighborhood) and macro (city-wide) levels.
To determine how Philadelphia compares to other cities in the United States, and to see which
neighborhoods had the highest concentrations of unmarried same-sex households, we calculated a series
of indices.
The Gay and Lesbian Indices
The Gay and Lesbian Index is a measure developed by the authors of the Gay and Lesbian Atlas18 to
measure where gay and lesbian couples live relative to the general population. It shows whether gay and
lesbian couples are over- or underrepresented in a particular geographic region. In the Gay and Lesbian
Atlas, these gay and lesbian indices for metropolitan areas were compared to the United States as a
whole. LGBT Assessment staff performed calculations with census data to compare areas within
Philadelphia to Philadelphia as a whole.19 Three different indices were computed:
The Gay Index: (GH/GP) / (TH/TP). This proportion shows how likely an unmarried same-sex
household headed by a man is to live in the census tract in question (compared to the rest of the city). A
Gay Index of 1.0 indicates that such a household is equally likely to live in that tract in comparison to the
city as a whole. A Gay Index of 2.0 indicates that such a household is twice as likely to live in that
census tract when compared to the city as a whole.
The Lesbian Index: (LH/LP) / (TH/TP) This proportion shows how likely an unmarried same-sex
household headed by a woman is to live in the census tract in question (compared to the rest of the city).
A Lesbian Index of 1.0 indicates that such a household is equally likely to live in that tract in comparison
to the city as a whole. A Lesbian Index of 2.0 indicates that such a household is twice as likely to live in
that census tract when compared to the city as a whole.
18
Gates and Ost, p. 57
19
The calculations needed to create the gay and lesbian indices are as follows:
Number of unmarried same-sex households headed by a man in the census tract in question = GH
Number of unmarried same-sex households headed by a woman in the census tract in question=LH
Number of unmarried same-sex households headed by a man in the City of Philadelphia= GP
Number of unmarried same-sex households headed by a woman in the City of Philadelphia= LP
Number of households (total) in the census tract in question= TH
Number of households (total) in the City of Philadelphia=TP
13
The Gay/Lesbian Index: {(GH+LH)/(GP+LP)} / {(TH/TP) This proportion shows how likely an
unmarried same-sex household headed by a man or a woman is to live in the census tract in question
(compared to the rest of the city). A Gay/Lesbian Index of 1.0 indicates that such households are equally
likely to live in that tract in comparison to the city as a whole. A Gay/Lesbian Index of 2.0 indicates that
such households are twice as likely to live in that census tract when compared to the city as a whole.
Philadelphia Compared to Other Metropolitan Areas
According to Gates and Ost’s analysis comparing unmarried same-sex couples in the largest US cities to
the US as a whole, Philadelphia ranks approximately in the middle of the top 50 cities in the United
States in terms of its Gay and Lesbian indices.20
Table 1: Philadelphia in comparison to other cities and communities in the United States
Philadelphia City Rank among top Rank among 1,360
Indices 50 US cities communities in the US
(as compared to the US) with 50 or more same-
sex couples.
Gay and Lesbian couples 1.30 29 290
Gay Male couples 1.36 29 233
Lesbian couples 1.23 29 412
The rankings among the 50 top cities show that, despite the large population size of Philadelphia, it has
not attracted as many unmarried same-sex couples as some cities of similar size.21 Although
Philadelphia ranked at #29 in the largest 50 cities nationwide for both gay male couples and lesbian
couples, Philadelphia ranked considerably lower for lesbian couples compared to gay male couples when
all 1,360 communities in the United States with 50 or more same-sex couples were considered. This is
due to the national trend of same-sex female couples settling outside cities at a higher rate than same-sex
male couples.
20
Gates and Ost, pp. 206-7
21
For instance, compared to Philadelphia’s 29th ranking, San Francisco ranks 1st among the top 50 cities, Boston 9th, San
Diego 13th, Los Angeles 15th, New York City 22nd, and Houston 23rd.
14
Regional Distribution
Figure 2: County of residence of

homosexual/bisexual and heterosexual adults in
southeastern Pennsylvania
Homosexual
Philadelphia Heterosexual
/Bisexual
Bucks
19%
20%
44%
Chester 39%
10%
14%
Delaware
11%
16% Montgomery 11%

16%
Source: PHMC SEPA Household Health Survey, 2004. Only sexually active people are included in this analysis
The PHMC Household Health Survey data indicate that a preponderance (44%) of the
homosexual/bisexual population who live in the southeastern Pennsylvania region22 live in Philadelphia
County. The remaining 56% of the population are divided among the 4 suburban counties, with 19%
living in Montgomery County, 16% in Bucks County, 11% in Chester County, and 10% in Delaware
County. The distribution is significantly different from the distribution of the heterosexual population in
SEPA. Major differences in residence between the homosexual/bisexual group and the heterosexual
group are residence in Philadelphia and Delaware county: The homosexual/bisexual group is more likely
to live in Philadelphia (44% of this population lives in Philadelphia, compared to 39% of the
heterosexual population in SEPA), and more of the heterosexual group lives in Delaware county (14% of
this population compared to only 10% of the homosexual/bisexual group).
The 4 suburban counties were collapsed to allow easier comparison to Philadelphia, and subpopulations
within the homosexual/bisexual population were compared within these geographic areas.
Sex differences in regional distribution
Within the homosexual/bisexual group, more of the males lived in suburban SEPA counties than females
(p<.001). While a majority of the homosexual/bisexual females in the region lived in Philadelphia (53%
compared to only 40% of the males), the majority of the homosexual/bisexual males instead lived in the
suburban counties (60% compared to 47% of the females).
22
This region includes Philadelphia, Bucks, Chester, Delaware, and Montgomery counties.
15
Figure 3: Sexually active homosexual/bisexual adults in
southeastern Pennsylvania counties
County Percentage
Homosexual/Bisexual
Bucks 4.8%
Chester 4.3%
Delaware 3.3%
Montgomery 4.5%
Philadelphia 5.6%
All Counties 4.8%
Note that about 15% of the adults in each county are not sexually active so their sexuality cannot be determined.
Source: PHMC SEPA Household Health Survey, 2004.
Overall, 4.8% of the sexually active population in southeastern PA reported having same-sex partners or
both male and female partners. Philadelphia County had the highest prevalence, with nearly 6% of the
population reporting homosexual/bisexual behavior. The prevalence of the homosexual/bisexual
population in Bucks, Chester, and Montgomery counties were close to the Southeastern Pennsylvania
mean, with Delaware county prevalence lower than the others.
Figure 4: Philadelphia and suburban county residence

of homosexual/bisexual and heterosexual men and
women in southeastern Pennsylvania
Homosexual/ Hom osexual/

Bisexual Bisexual
Women Men
Philadelphia
53% 40%
47%
Suburban SEPA
Counties 60%
Source: PHMC SEPA Household Health Survey, 2004. Only sexually active people are included in this analysis
16
Age differences in regional distribution
Within the homosexual/bisexual group, those living in Philadelphia skew much younger than the
suburban county-dwellers. 30% of the Philadelphia dwellers in this population are 18-29, while only
20% are 50 or older. In contrast, suburban county dwellers show a skew toward the older end, with 35%
of the suburban homosexual/bisexual population 50+, and only 24% in the 8-29 range.
Racial/ethnic differences in regional distribution

There were also significant differences in residence within the homosexual/bisexual group by race.
Generally, the racial breakdown of the homosexual/bisexual population in both the suburban counties
and Philadelphia reflect the population trends in the respective counties, with the suburban county
homosexual/bisexual population being strongly majority White (86%). When looking within the major
racial/ethnic groups White, Black, and Latino homosexual/bisexuals were much more likely to live in
Philadelphia than their heterosexual peers (30% of homosexual/bisexual Whites live in Philadelphia
compared to 23% of their heterosexual peers; 86% of homosexual/bisexual Blacks live in Philadelphia
compared to 77% of their heterosexual peers; and 82% of homosexual/bisexual Latinos lived in
Philadelphia compared to 68% of their heterosexual peers. Only the Asian and “Other” racial/ethnic
homosexual/bisexual groups were equally likely to live in Philadelphia versus Suburban counties.
Income differences in regional distribution

Within the homosexual/bisexual group, county of residence was significantly related to income, with
those living in suburban counties reporting higher income than those living in Philadelphia. A similar
relationship is seen between county of residence and household income for the heterosexual population.
For the homosexual/bisexual group, 25% of those living in Philadelphia had incomes under $15,250,
compared to only 9% of the suburban group. On the other end of the scale, only 28% of the Philadelphia
group had household incomes over $60,000, while 66% of the suburban group reported these higher
incomes.
Family structure differences in regional distribution

Within the homosexual/bisexual group, those living in the suburban SEPA counties were significantly
more likely to report being married or living with a partner (64% compared to 46% of the Philadelphia
homosexual/bisexual group). A similar relationship is seen in the heterosexual group with 78% of
suburban heterosexuals reporting being married or living with a partner compared to 56% of heterosexual
adults in Philadelphia. However, county of residence was unrelated to the presence of children in the
household within the homosexual/bisexual group.
Philadelphia Neighborhoods with High Concentrations of Same-Sex Couples
Three appendices (See Appendix B, C and D on Page 67) show the census tracts that rank highest for
gay/lesbian index, lesbian index, and gay index. In this way, it is possible to clearly see the
neighborhoods and census tracts that have the highest concentrations of same-sex unmarried households
for each gender and in total.23 These rankings may be seen as evidence of locales where same-sex
23
Some caveats must be born in mind: these neighborhoods may be different in some ways from neighborhoods with fewer
unmarried same-sex couple households. For example, we would expect neighborhoods with many students or younger people
to have a smaller concentration of unmarried same-sex couple households even though there might be quite a large
concentration of same-sex singles in the neighborhood’s households.
17
unmarried households exist in higher concentrations compared to other parts of the city; thus we look at
these neighborhoods as places of interest for our project.
Overall, same-sex couples were most concentrated in areas of eastern Center City (including Bella Vista,
Washing West, and Northern Liberties), West Mount Airy, and Graduate Hospital. However, there are
substantial differences between where same-sex female couples are concentrated compared to where
same-sex male couples are. Although there are similar numbers of male and female same-sex couples,
most of the census tracts on these lists are locations where male couples live: this is because the same-sex
male couples in Philadelphia were more concentrated than the female same-sex couples, who were more
spread out in the neighborhoods. The same-sex female couples were most concentrated, (outside West
Mount Airy and Chestnut Hill) in the Cedar Hill section of West Philadelphia, Fern Rock, Germantown,
and South Philadelphia. There are no census tracts that made the top ten most concentrated for both the
female couples and the male couples.
Same-Sex Couples in Context
For both the city as a whole and for its neighborhoods, social and demographic data including race,
education, income and crime were mapped and presented alongside maps showing concentration of
same-sex couples. By comparing the same-sex couple concentrations on the map to these other factors, it
is possible to see visually how various demographic factors correlate to high or low concentrations of
same-sex couples.
Same-sex couples in Philadelphia neighborhoods

It is also important to note the breadth of neighborhoods that show at least moderate concentrations of
same-sex unmarried couples. These neighborhoods are areas where same-sex unmarried couples may
become increasingly concentrated; looking to the future, it may be useful to compare maps of the 2010
census to see changes in populations of same-sex couples within these neighborhoods. These
neighborhoods are in every part of the city, including locales not traditionally associated with gay and
lesbian couples: Fern Rock, Olney, the far Northeast, the Cobbs Creek area of West Philadelphia,
Overbrook, sections of North Philadelphia, and Frankford.
Neighborhoods with high gay and lesbian indices reflect the biases noted earlier: by the nature of the
data, only couples who are willing to identify themselves as being in a same-sex relationship can be
included. Future research may show that some of the neighborhoods that have low indices in fact have
high numbers of homosexual and bisexual people who do not identify as a member of a same-sex
unmarried couple on the census, or are not cohabiting with a partner. For instance, though some
neighborhoods of University City have low gay and lesbian indices, they may have sizable populations of
homosexual and bisexual single people.
Gender differences in geographic locations of same-sex couples

In reviewing the maps that show Philadelphia’s concentration (Map 1) and number (Map 2) of same-sex
unmarried partner households by Philadelphia census tract, as well as male same-sex unmarried
households and female same-sex unmarried households separately (Maps 3 and 4)24 it is clear that there
are strong concentrations of same-sex unmarried households in many neighborhoods throughout the city,
including Mount Airy and Germantown, Center City, West Philadelphia, and South Philadelphia. There
are also clear differences between the male and female maps, as with the top ten census tracts discussed
above. These differences reflect a pattern shown in other cities; namely that female same-sex unmarried
households are less likely than male same-sex unmarried households to congregate in the central,
24
The city-wide maps are located on page 19.
18
downtown area of a city.25 Thus, in Philadelphia, we find female same-sex unmarried households more
likely than male same-sex unmarried households to be living in Mount Airy, Germantown, and West
Philadelphia, while male same-sex unmarried households are more likely than their female counterparts
to be found in the neighborhoods of Center City and more centralized areas of South Philadelphia and
Northern Liberties. Studies26 have shown that lesbians are more likely than gay men to raise children,
and that gay men have higher average earnings than lesbians. These differences may help to explain in
part the differences in choice of geographic location.
25
Ibid, p. 28
26
Badgett, M.V. Lee, Money, Myths and Change: The Economic Lives of Lesbians and Gay Men, University of Chicago
Press, Chicago, 2001 and
19
Map 1: Percentage of Same-Sex Unmarried Partner Households by Philadelphia census tract
Map 2: Number of Same-Sex Unmarried Partner Households by Philadelphia census tract
Map 3: Number of Female Same-Sex Unmarried Households by Philadelphia Census Tract

Map 4: Number of Male Same-Sex Unmarried Households by Philadelphia Census Tract
20
Comparing Homosexual and Bisexual Residents of Philadelphia with
Heterosexual Residents
Three sources of data are discussed in this comparison section.
Using the PHMC Household Health Survey, people with partners of the same sex or both sexes (those
with homosexual or bisexual behavior) in Philadelphia, were compared with other sexually active people,
first using the balance weight to determine statistical significance, and then using the projections to show
the full impact. As described previously, the PHMC Household Health Survey is a very broad data set,
so these data are far-ranging.
Using the full census data, areas with above-average proportions of same-sex partners were compared
with areas that had average or below-average proportions on basic demographic variables.
Finally, using 2003 Philadelphia YRBS data, information about homosexual/bisexual youth is presented.
These data are very limited due to sample sizes. This is the only Philadelphia-specific information about
LGBT youth available.
Demographics
Sex
Figure 5:
Sex of Adults in Philadelphia by Sexual Orientation
60% 55%
49% 51%
50% 45%
40%
30%
20%
10%
0%
Homosexual/Bisexual Heterosexual
Male Female

Only persons who reported being sexually active are included in this analysis
Although Philadelphia's adult population is very close to half male and half female, PHMC Household
Health Survey data indicate that there is a small but significant difference (p<.05) between the two
populations of sexually active adults. A majority (55%) of the homosexual/bisexual population in
Philadelphia is male, and 45% is female. In comparison, the heterosexual population is 49% male and
51% female.
Data from the US census shows a similar picture: 53% of the individuals living in same-sex couple
households are male, and 47% are female; again, compared to the population of all adults, which are 45%
male and 55% female, somewhat more of the Philadelphia adults in same-sex partner households are
21
male. Nevertheless, Philadelphia's homosexual/bisexual population is fairly balanced along male-female
lines; this appears to be different from some other major US cities with large populations of homosexual
and bisexual people (such as New York City, Washington DC, and Los Angeles), where urban centers
tend to be more disproportionately populated with gay men rather than lesbians. In fact, a higher
proportion of southeastern PA homosexual/bisexual women lived in Philadelphia County—significantly
more than men. (See Figure 4 in the Regional Distribution section for more information.)
To compare the male and female homosexual/bisexual populations, further analysis was done with
PHMC Household Health Survey data, looking at how other variables change according to sex. These
are presented in later sections, according to topic area.
Age
Figure 6:
Age of Adults in Philadelphia by Sexual Orientation
35% 33%
30%
30% 26% 25% 25%
25% 22%
20% 20%
20%
15%
10%
5%
0%
18-29 30-39 40-49 50+

According to the PHMC Household Health Survey projections, the homosexual/bisexual population
tends to be younger on average than the heterosexual population. The bisexual and homosexual
population skews younger than the heterosexual population in Philadelphia. The median age for the
homosexual/bisexual population was 39, while the median age for heterosexuals was 43. Nearly a third
of the homosexual/bisexual population in Philadelphia is in the 18-29 bracket, compared to a quarter of
the heterosexual population; more than a quarter (26%) of the homosexual/bisexual population is 30-39
compared to 22% of the population with heterosexual partners; a full quarter of the homosexual/bisexual
population is 40-49 compared to only a fifth of the heterosexual group in this age bracket; and only 20%
of the homosexual/bisexual population is 50 and over, compared to a full third (33%) of those with
heterosexual partners.
Within the homosexual/bisexual group, there are no significant differences in age between males and
females. Both males and females in the homosexual/bisexual group are skewed to the younger age
groups in the same way, with only 19% of the homosexual/bisexual men and 21% of the
homosexual/bisexual women in the 50+ age group. In contrast, both male and female heterosexuals are
skewed toward the older age groups, as is seen for the heterosexual population as a whole.
22
U.S. Census data indicate that same-sex couples tend to live in census tracts with fewer children under 18
(24% of the population in these areas are children) compared to areas with lower than average
proportions of same-sex couples (where 27% of the population is children under 18). This is a small but
significant difference. Despite a smaller number of children, the median age is younger in areas with
higher than average proportions of same-sex couples: 33.7 years old compared to 35.1 years old in the
tracts with fewer same-sex couples. Tracts with higher than average numbers of same-sex couples also
had a much higher proportion of adults under 45: 44% compared to 37% in the areas with fewer same-
sex couples.
Because characteristics of populations often vary according to age, the adult homosexual/bisexual
population was split into 2 categories: adults 40 and older, and adults 18-39; the differences between
these groups were compared with those heterosexuals of the same age groupings. Outcomes from these
analyses are presented in future sections, according to topic area.
Data from the Youth Risk Behavior Survey
Figure 7:
Sex of Sexual Partners of High School Students in
Philadelphia
80%
67% Same-sex partners
70%
60% only
60% 54%
50% Both sex partners
41%
40% 35%
28% Heterosexual
30%
partners only
20%
No sex partners
10% 3%2% 4%2% 2%2%
0%
Overall Males Females
Source: 2003 Youth Risk Behavior Survey, Philadelphia High School Survey. Data provided with permission of
School District of Philadelphia..
The Youth Risk Behavior Survey is conducted every other year in a random sample of public high
schools of Philadelphia by the School District of Philadelphia in conjunction with the CDC. In 2003, the
Philadelphia YRBS surveyed a sample of 1,437 high school students. This survey included an item
asking whether the respondent's sexual partners were male or female (see Figure 7). Overall, 68% had
sex only with opposite-sex partner, 3% of the students had sex only with same-sex partners, and an
additional 2 % reported sex with both same-sex and opposite-sex partners. Over a third of the students
had not become sexually active yet, with male students more likely to report sexual experiences. 28% of
male students and 41% of female students had abstained from sex in their lifetime. Only 2% of each the
males and female student groups reported having sex with both males and females, but more of the males
(4% compared to 2% of the females) reported sex only with same-sex partners. This apparent difference
decreases when only sexually active students are included in the analysis: of the sexually active female
students, 4% had sex with only females and 3% had sex with both males and females for a total of 7% of
female students exhibiting bisexual or homosexual behavior. Among sexually active male students, 6%
23
had sex with males and 2% with both males and females for a total of 8% of sexually active male
students exhibiting homosexual/bisexual behavior.
Students under 16 were more likely to have not yet become sexually active (45% of all students,
including 34% of the males less than 16, and 54% of the females under 16) and were less likely to report
sex with partners of the same or both sexes (3% of all students under 16 reported sex with either same-
sex or both males and females compared to 6% 16 and older). Due to the small sample size of students
who reported same-sex or both-sex partners (a total of 71 students), further analysis of these data by race
or other factors was not possible.
Race and ethnicity
Figure 8:
Race/Ethnicity of Adults in Philadelphia by Sexual
Orientation
50% 45% 45%

43% White non-
45% 40% Latino
40%
Black non-
35% Latino
30%
Latino (total)
25%
20%
Asian non-
15% Latino
10% 7% 6%
5% 6% Other
5% 1% 1%
0%
According to the PHMC Household Health Survey, the population of all Philadelphia adults 18 and older
is 45% White non-Latino, 40% Black non-Latino, 7% Latino, 6% Asian, non-Latino, and 5% other non-
Latino. When comparing sexually active adults by sexual orientation (see Figure 8), there are no
significant differences between the racial and ethnic of the homosexual/bisexual population and
heterosexual adults in Philadelphia. (Figure 8)
There were no significant differences in race/ethnicity by sex or age within the homosexual/bisexual
group. However, among the heterosexual population, the White population skews older, with 63% of the
White group age 40 or older while the other racial/ethnic groups have at least 50% of their population in
the under-40 group. In contrast, within the homosexual/bisexual group, the race and ethnic distribution
remains the same in both the 40+ and under-40 groups.
To get a better understanding of differences that may exist in the homosexual/bisexual population by
race, additional analyses were done comparing the two major racial/ethnic groups in Philadelphia, non-
Latino Black and non-Latino White (which will be referred to as "Black" and "White"). These will be
presented in future sections according to topic area. Unfortunately, due to sample size restrictions, other
racial/ethnic groups could not be used for these analyses.
24
US census data indicate that same-sex couples live in diverse neighborhoods: again, people in same-sex
couples live in all areas of Philadelphia. The racial distribution of areas with higher-than-average
proportions of same-sex couples tend to be similar to the other tracts in Philadelphia.
Educational attainment
Figure 9:
Educational Attainment of Adults in Philadelphia by
Sexual Orientation
40% 38%
Less than high
35% 31% school
30% High School

24% Grad
25% 21% 22%
19% Some College
20%
15% 12% 12% 11% 10% College grad
10%
5% Post-college
0%
Philadelphia's adult population displays substantial diversity in educational attainment. The

homosexual/bisexual adult population is no exception; as with heterosexual adults, there are substantial
numbers of homosexual/bisexual people at every level of educational attainment. One in ten people in
both the homosexual/bisexual group (12%) and the heterosexual group (11%) have not achieved a high
school diploma. Of the homosexual/bisexual group, less than a third (31%) have a high school education
while 38% of heterosexual people did so. About 20% of both groups have some college but did not earn
a Bachelor's degree; 24% of the homosexual/bisexual population and 19% of the heterosexual group
finished their education with a bachelor's degree and about 1 in 10 in each group or post-graduate work
(12% of the homosexual/bisexual group and 10% of the heterosexual group) went on to graduate work.
There were not statistically significant differences in educational attainment between the two groups.
25
Figure 10:
Educational Attainment of Adults in Philadelphia by
Sexual Orientation and Race
45% 41% 40%
40% 38%
36%
35%
30% 24%
24%
25% 22%
19% 20% 22%
20% 17% 15%
15% 15% 14% 15%
15%
10% 6% 6% 5% 5%
5%
0%
White White heterosexual Black Black heterosexual
homosexual/bisexual homosexual/bisexual
Less than high school HS grad Some college College Grad Post college

In Philadelphia, the trends of educational attainment vary by race, with more White adults reporting
higher educational attainment than their Black peers. Within the homosexual/bisexual population,
diversity in level of education still exists for each racial group. However, as with the heterosexual
population, the White population’s attainment is significantly skewed toward more years of education,
while the Black population’s attainment is skewed toward fewer years (p<.001). Within the Black
population, there is no significant difference between the heterosexual and homosexual/bisexual
population’s educational attainment. However, within the White population, more of the
homosexual/bisexual group were college grads (36% compared to 22%) and had completed post-
graduate work (19% compared to 15%, p>.05) compared to the heterosexual population. There were no
significant differences within the homosexual/bisexual group between those under 40 and 40+, or
between males and females.
According to the census data, areas with more than average proportions of same-sex couples also had a
much higher proportion of college degrees among adults 25 or older: In the tracts with higher than usual
numbers of same-sex couples, 29% of adults 25+ were college graduates, compared to only 14% of the
adults 25+ in the tracts with average or lower numbers of same-sex couples. Same-sex couples may find
tracts with a more educated adult population to be more tolerant than those with a less-educated
population.
26
Employment status
The majority of Philadelphia adults are employed full time or are full time students (Figure 11); This is
true for both the homosexual/bisexual and heterosexual population. However, the same-sex group is
even more likely to be a full time worker or student (68%) compared to the heterosexual group (54%),
(p<.05). Smaller groups in both populations are employed part time, unemployed, retired/homemaker, or
unable to work.
Figure 11:
Employment Status of Adults in Philadelphia by
Sexual Orientation
80%
68% Full time
70% worker/student
60% 57%
Part time
worker
50%
Unemployed
40%
30%
Retired/
20% 16% Homemaker
9% 7% 10% 6% 11% 9%
10% 7% Unable to work
0%

When comparing the under 40 and 40+ age groups in the homosexual/bisexual population, more of the
older group was retired (19% compared to 3%); or unable to work (10% compare to 4% of the younger
group), while more of the 18-39 group was employed or a student full time (73% compared to 61% in the
older group), working part time (10% compared to 8%) or unemployed (10% compared to 3% of the
older group) (p<.005). These differences were similar to the differences between the two age groups in
the heterosexual population. Lastly, there were no significant differences in employment status among
the homosexual/ bisexual group by sex or race.
27
Household Income, Poverty, and Food Insecurity
Household income
In Philadelphia, as in other diverse cities, there is a wide degree of variation in household income.
According to the PHMC Household Health Survey, homosexual and bisexual people in Philadelphia
appear to be somewhat more stratified in terms of income than heterosexuals (See Figure 12): although
both homosexuals and heterosexuals have a wide distribution of income, the homosexual/bisexual
population has more clusters around the lowest, highest and median groups while the heterosexuals have
a more even distribution between the 5 income categories represented here (p<.05). Both groups had a
median household income in the $30,000-32,500 range in 2004.
Figure 12:
Household Income Distribution of Adults in
Philadelphia by Sexual Orientation
35%
31% Less than
30% 28% $15,250
25%
24%24%25% $15,205-$24,000
20%
20%
16% $24,001-$37,000
15%
14%
11%
10%
9% $37,001-$60,000
5% Over $60,000
0%

Within the homosexual/bisexual population, both Black and White populations remain diverse in regard
to household income, with substantial representation at all income levels (See Figure 13). However, as in
the heterosexual population, there is also a substantial disparity by race; far more of the Whites in the
homosexual/bisexual group live in households earning higher incomes. Nearly half of the White
homosexual/bisexual population lived in a household earning more than $60,000 in 2003; although 16%
of homosexual/bisexual White respondents lived in households earning very low incomes, the income for
the White populations for both sexual orientation groups skews higher than incomes for the Black
populations (p<.05 for the homosexual/bisexual population, p<.001 for the heterosexual population).
There were no significant differences between sexual orientation groups within the White or Black
populations.
28
Figure 13:
Household Income Distribution Adults in Philadelphia by
60%
49%
50%
38%
40% 37%
29%
30% 26% 22%
20% 22% 21% 21%
18% 19%
20% 16%
14% 15%
11% 11%
9% 8%
10% 4%
0%
White homosexual/ White heterosexual Black homosexual/ Black heterosexual
bisexual bisexual
Less than $15,250 $15,205-$24,000 $24,001-$37,000 $37,001-$60,000 Over $60,000

Within the homosexual/bisexual group, there were no significant differences in household income
distribution between the under-40 group, and the 40+ group, or between the males and females.
The census tracts with a higher than average same-sex couple population had an average per capita
income of $19,680 and a median household income of $31,708 for 1999. This is a substantially higher
income than the $15,492 per capita income calculated for the tracts with fewer same-sex couples. Even
more striking, the median household income for the areas with fewer same-sex couple households is only
$26,430. However, the median income may not tell the whole story: the two types of areas both have
27% of households located in them earning under $15,000 per year and an additional 28% earning in the
$15,000 to $34,999 range. The real difference in the income distribution between these two areas
appears to be on the highest end of the income scale: twice as many households make over $100,000 per
year in the areas with more same-sex couples than the areas where same-sex couples were less likely to
live. However, nothing can be said about whether these high earners were in same-sex couples or not.
Comparing the census data to the PHMC Household Health Survey data, it appears that although
homosexual/bisexual people may have similar earnings to heterosexual Philadelphians, they may be more
likely to live in more affluent areas, at least when coupled; coupled homosexual/bisexual Philadelphians
may have higher household incomes than single members of the population; or higher-income
individuals may be more likely to choose the "unmarried partner" designation to describe their
relationships.
Poverty and receipt of assistance

According to the PHMC Household Health Survey, homosexual/bisexual and heterosexual populations
were equally likely to receive assistance: about 12% of both groups received SSI; 7% received SSDI;
4% received GA; 12% received Food Stamps; 9% received energy assistance; and 7% received WIC.
About 10% of both groups had incomes under the poverty line in 2004, representing over 6,000
homosexual/bisexual individuals in Philadelphia living in households under the poverty line.
29
Figure 14:
Household Poverty status of Adults in Philadelphia by
All heterosexual
10%
All homosexual/bisexual
12%
Household Black heterosexual

13%
income below
100% of Black homosexual/bisexual
poverty line 18%
4% White heterosexual
4% White homosexual/bisexual
0% 5% 10% 15% 20%

However, there is significant variation in poverty status by race within both the homosexual/bisexual
group and the heterosexual group. In both groups, Black Philadelphians are more likely to live in
households with incomes below the poverty line (Figure 14) than are White Philadelphians of either
group (p<.001 of heterosexual and p<.005 for homosexual/bisexual group). However, there was no
significant difference between the under-40 and the 40+ groups or between males and females within the
homosexual/bisexual population.
Food insecurity and other unmet needs due to inability to pay
Figure 15:
Food Security Indicators among Adults in
Cut down meals 11%

due to money,
past year 16%
Skipped meals 7%
due to money,
past year 13%
0% 2% 4% 6% 8% 10% 12% 14% 16% 18%
Homosexual/bisexual Heterosexual
30
In the PHMC Household Health Survey, there is a set of items about whether respondents did not fulfill
needs because of cost. A substantial minority of both sexual orientation groups reported missing meals,
skipping needed medical and dental care, and skipping prescriptions due to cost. Eleven percent of each
group was sick but did not seek care due to cost in the past year; 17% of each group did not fill a
prescription due to cost in the past year; and nearly a quarter lacked dental care due to cost. However,
the homosexual/bisexual group was significantly more likely to report cutting meals or skipping meals
due to cost than heterosexuals (See Figure 15): 16% of the homosexual/bisexual group reported cutting
meals compared to 11% of the heterosexual group (p=.02); 13% of the homosexual/bisexual group
reported not eating due to lack of money in the past year compared to 7% of the heterosexual group
(p<.01)
Figure 16:
Food Security Indicators Among Adults in
Philadelphia by Sexual Orientation and Race
14%
Cut down meals 17%
due to money, 8%
past year 15%
9%
Skipped meals 17%
due to money,
5%
past year
7%
0% 2% 4% 6% 8% 10% 12% 14% 16% 18%

Black heterosexual
Black homosexual/bisexual
White heterosexual
White homosexual/bisexual
When race is added to this analysis (see figure 16), the White heterosexual group is significantly less
likely to cut meals due to cost than Black heterosexuals (p<.001) or White homosexual/bisexuals (p<.05).
However, there were not significant differences within the homosexual/bisexual group by race for cutting
meals. In regard to skipping meals altogether, the Black homosexual/bisexual group was more likely to
skip meals than their White homosexual/bisexual peers (borderline significance, at p=.055) and
significantly more likely to skip meals compared to their Black heterosexual peers (p<.05). Black
heterosexuals were also more likely to skip meals completely due to cost than their White heterosexual
peers (p<.001). The difference in food insecurity by race is likely related to the income differences also
present by race.
Citizenship and Language Barriers

Immigration and citizenship
Overall, about 13% of Philadelphia adults were born outside the United States according to PHMC
Household Health Survey data. Of these, 87% are now US citizens. Neither of these varies in a
statistically significant way by sexual orientation.
31
There were no significant differences in citizenship by age within the homosexual/bisexual population by
age, between males and females, or between Black and White populations.
Languages spoken at home

A substantial minority of Philadelphia adults speaks a language other than English at home: 16% of the
homosexual/bisexual population and 20% of those with heterosexual partners speak another language.
Over 20 other languages are represented, but the other language spoken most often by both
homosexual/bisexual and heterosexual people is Spanish, with about 40% reporting speaking Spanish at
home. Other frequently mentioned languages spoken at home by this group of homosexual/bisexual
adults included Vietnamese, Chinese languages, Italian, and French.
There were no significant differences by age, between males and females, or between the Black and
White populations within the homosexual/bisexual populations related to languages spoken at home.
Housing and Household Structure of Homosexual and Bisexual Philadelphians
Renting and home ownership
Figure 17:
Home Ownership Among Adults in Philadelphia by
Sexual Orientation
70% 65%
60% 55%
Rent home
50% 45%
40% 35%
30%
20%
Own home
10%
0%

According the 2000 US Census, 53% of occupied housing units are owner-occupied. In the PHMC
Household Health Survey, 65% of adults reported living in a housing unit that they owned. However,
many Philadelphia adults do not own their homes; furthermore, the SEPA Household Health database
data show that homosexual/bisexual Philadelphians are a group less likely to own a home and more
likely to live in a renting household compared to heterosexual Philadelphians: Nearly half (45%) of
homosexual/bisexual adults rent their home, while only a third of heterosexual adults do. Furthermore,
same-sex couples in the census are more likely to live in areas that have more renters. Tracts with higher
than average same-sex couples had 51% of the occupied housing units occupied by renters, in contrast to
only 37% of the tracts with lower concentrations of same-sex couples. Renting instead of owning may
32
put homosexual and bisexual Philadelphia residents at disproportionate risk for housing insecurity as
rents rise in the area, especially if these renting households are small.
Figure 18:
80% 74%
70%
57% 52% 57%
60%
48%
50% 43% 43%
40%
30% 26%
20%
10%
0%
White homosexual/ White heterosexual Black homosexual/ Black heterosexual
bisexual bisexual
Rent home Own home

There were not significantly differences in home ownership between the Black and White groups, within
the homosexual/bisexual population (See Figure 18). However, among heterosexuals, significantly more
of the White population own their homes compared to Black residents (74% compared to 57%).
Furthermore, White heterosexuals are significantly more likely to own their home than their homosexual
peers (57% of whom own their home). Of the 4 groups, Black homosexual/bisexual adults were the least
likely to own their own home (only 52% did). However, there is not a significant difference in home
ownership within the Black population between the homosexual/bisexual group and the heterosexual
group.
33
Figure 19:
Sexual Orientation and Age Group
90%
74% 77%
80%
70% 60%
60% 52%
48%
50% 40%
40%
30% 26%
23%
20%
10%
0%
18-39 18-39 Heterosexual 40+ Homosexual/ 40+ heterosexual
Homosexual/Bisexual Bisexual
Rent home Own home

With increasing age comes increasing home ownership rates regardless of sexual orientation. Within the
homosexual/bisexual adult population, 74% of the 40+ group reported owning their home compared to
only 40% of the under-40 group. When comparing home ownership within the age group, there is no
significant difference in home ownership between the homosexual/bisexual and heterosexual groups.
However, in the younger age group, significantly fewer of the under-40 homosexual/bisexual population
owned a home; this group is the only population segment investigated where a majority of the group
renting rather than owning. This group may be uniquely vulnerable to changes in rental markets, or may
face challenges in the process of home ownership. Finally, there are no significant variations in home
ownership between males and females within the homosexual/bisexual population.
34
Household composition: adults in household
Figure 20:
Number of Total Adults in Household in Philadelphia
by Sexual Orientation
60%
49% 1 adult
50%
40%
40%
2 adults
29%
30%
23% 21% 20% 3 adults
20%
9% 10%
10%
4 + adults
0%

The size of Philadelphia households varies substantially for all populations. However, most adults live
with either only one other adult or as the only adult in the household. More of the homosexual/bisexual
adults live in households with only one adult. Furthermore, compared to heterosexuals, more
homosexual/bisexual adults live in household where they are the only person. Nearly 20% of the
homosexual/bisexual population lives in households of only one person, compared to 13% of the
heterosexual group. Even more are the only adult in the household: nearly 30% of the
homosexual/bisexual group are the only adult in the household, representing over 14,000
homosexual/bisexual people who are the only adult in their household, compared to only 20% of the
heterosexual group.
There were no significant differences in the number of adults the household within the
homosexual/bisexual population for those under 40 and 40+; males and females, or Black and White
Philadelphians.
35
Marital and relationship status
Figure 21:
Family Characteristics Among Adults in Philadelphia by
Sexual Orientation
57%
Married or living
with partner 48%
38%
Children in
household 29%
27%
Caretaking for
elder 28%
0% 10% 20% 30% 40% 50% 60%

Respondents to the PHMC Household Health Survey were asked about marital status.
Homosexual/bisexual people were significantly more likely to report being single (41%) than
heterosexuals (32% of who reported single status) (see Figure 21, P<.05)) . However, nearly half of the
homosexual/bisexual population is living with a partner (23%) or married (25% consider themselves
married—though we do not know if these are unions with a same-sex partner or an opposite sex partner).
More heterosexuals (a total of 57%) are committed and living with a partner, though more (48%) are
married and fewer (9%) are unmarried and living with a partner.
Figure 22:
Family Characteristics Among Adults in Philadelphia by
Married or living 46%

39%
with partner 67%
54%
44%
Children in
44%
household 28%
7%
31%
Caretaking for 40%
elder 26%
17%
0% 10% 20% 30% 40% 50% 60% 70%
Black heterosexual
White heterosexual
36
However, being married or living with a partner varies by race and sexual orientation (see Figure 22):
Although there are not significant differences between the Black homosexual/bisexual adults and the
White homosexual/bisexual adults, there are differences by race among heterosexuals. Most White
heterosexuals were married or living with a partner (67%), significantly more than either the White
homosexual/bisexual group (54% of whom were married or living with a partner) or the Black
heterosexual adults (46% of whom were married or living with a partner, p<.05).
Children in the household

The PHMC Household Health Survey data show that both homosexual/bisexual people and heterosexual
people often live in households that include children (See Figure 21); although slightly more households
where heterosexuals live included children (38%), a large minority of homosexual/bisexual people also
live where there are children—30% of the same-sex partner group, representing over 15,000
homosexual/bisexual adults, lives in a household that includes a related child or children. Unfortunately,
the type of relationship of the respondent to the child can't be determined.
Black Philadelphians, whether heterosexual or straight, were more likely to have related children in their
household than were White adults (see Figure 22), with 44% of both Black groups reporting children,
compared to 28% of the White heterosexual group and only 7% of the White homosexual/bisexual group.
Among the White population, heterosexuals were significantly more likely than the homosexual/bisexual
group to live with related children. However, there were no differences within the homosexual/bisexual
group between the under-40 group and the 40+ groups, or between males and females.
Elder care-taking responsibilities

Many adults in Philadelphia have elder care-taking responsibilities. A quarter of both the heterosexual
(27%) and homosexual/bisexual (28%) groups help provide care for a family member or friend aged 60
or older (See Figure 21). These responsibilities varied by race among Philadelphia adults (See Figure
22): 40% of Blacks in the homosexual/bisexual group had these responsibilities, compared to 17% of
their White homosexual/bisexual peers (p<..005). Black adults in the heterosexual population were also
more likely to report elder care-taking responsibilities compared to White heterosexuals (p<.005).
Within the homosexual/bisexual population, there were not differences between those under-40 and 40+;
or between males and females. However, among heterosexuals, females were significantly more likely to
report elder care responsibilities than were males; 43% of heterosexual females had these responsibilities,
compared to only 43% of males (p<.05).
37
Health Care Access for Homosexual and Bisexual People
Health insurance and health plans

In 2004, most Philadelphia adults reported some type of health insurance coverage in the SEPA
Household Health Survey. The majority of these adults (58%) was insured by work, school, or a union,
with the remaining adults insured by a private policy, Medicare, Medicaid, Adult Basic (PA’s state
insurance program for lower income adults), other groups, or a combination of coverage types.
However, this means that a substantial minority of adults in SEPA (12%) did not have any health
insurance coverage at all. There was no significant variation in having health insurance by sexual
orientation (See Figure 23). Although 89% of homosexual/bisexual adults reported some type in heath
insurance, there were over 5,600 uninsured homosexual/bisexual adults in Philadelphia. The most
frequently mentioned reasons that currently or recently uninsured homosexual/bisexual adults gave for
their status included: unemployment or a workplace that didn't offer insurance; available coverage was
prohibitively expensive; insurance is unnecessary; and health problems caused eligibility problems.
Figure 23:
Access to Medical Care Among Adults in Philadelphia by
Sexual Orientation
Health visit within 83%

past year 78%
Has medical 87%

Insurance 89%
Has regular 85%

medical provider 89%
0% 20% 40% 60% 80% 100%
Most Philadelphia adults are insured though work, school, or a union: 61% of homosexual/bisexual
adults reported receiving health insurance this way. The next most largest group of insured adults
received insurance thorough a family member or were self-insured: about a quarter of
homosexual/bisexual people in Philadelphia are insured this way. The most common type of health plan
was an HMO: about half of the insured homosexual/bisexual population has this type of plan, compared
to 31% who use a PPO plan, and 18% who have a fee-for-service plan. Eighty-five percent of the
insured do have prescription coverage: however, this means that an additional 6,400
homosexual/bisexual people in Philadelphia do not have this coverage.
Within the homosexual/bisexual population, there were no differences in medical insurance status
between Black and White groups (See Figure 24). This is different from the heterosexual population,
where significantly more Black Philadelphians lacked insurance (14% did not have insurance compared
to 9% of White heterosexuals, p<.001).
38
Younger adults are significantly less likely to have health insurance than heir older counterparts. Within
the homosexual/bisexual group, those in the 40+ group were significantly more likely to have health
insurance than the younger adults (95% of the 40+ group compared to 84% of the under-40, p<.05), a
difference similar to the difference between age groups in the heterosexual population. There was no
significant difference in the type of health insurance plan within the homosexual/bisexual group by age
group. Finally, there were no significant differences in insurance between males and females in the
homosexual/bisexual group.
Sources of regular medical care and past-year heath care experiences
Most Philadelphia adults reported that they had a “usual” place to go to receive health care. Compared to
heterosexual adults in Philadelphia, homosexual/bisexual adults were slightly more likely to report
having place they consider a “usual” place (See Figure 23). About 90% of the homosexual/bisexual
population in Philadelphia has this regular medical provider, compared to 85% of those with heterosexual
partners (p<.05). In both sexual orientation groups, about 80% of those with a regular provider said that
this location was a doctor's office, with the remaining 20% split between locations such as community
health centers, emergency rooms, hospital clinics, and other locations. Although they were more likely
to report a regular place, the homosexual/bisexual population may be likely to have actually received
recent care (See Figure 24); 78% of those with same-sex partners had visited a health care professional in
the past year, compared to 83% of those with heterosexual partners (borderline significance, p=.07).
Figure 24:
Access to Medical Care Among Adults in Philadelphia by
87%
Health visit within 87%
past year 83%
73%
71%
Regular provider is 74%
doctor's office 94%
85%
0% 20% 40% 60% 80% 100%

Black heterosexual
Black hom osexual/bisexual
White heterosexual
White hom osexual/bisexual
Within the homosexual/bisexual group, there was no significant difference between Black and White
groups in having a “regular” place to go to the doctor. However, of those who identified a regular place,
there was a borderline difference (p=.075) in type of location within the homosexual/bisexual group, with
more of the White homosexual/bisexual group citing a doctor's office as the type of place (85%
compared to 74% of the Black homosexual/bisexual group, see Figure 24). This difference mirrors one
39
in the heterosexual population. Additionally, within the White population, the homosexual/bisexual
group is significantly less likely to have a doctor's office as the regular place (94% of the White
heterosexual group with a regular place cited a doctor's office, p<.05).
When comparing past-year health care visits by race, Black adults, regardless of sexual orientation, were
more likely to report a past-year medical visit compared with their White peers (See Figure 24). The
difference by race among the homosexual/bisexual group was striking, with 87% of the Black
homosexual/bisexual adults reporting such a visit (compared to 73% of the White group). This may be
related to health status (see figures 30 and 31), as people who are in poorer health are more likely to
obtain medical care. In addition, the White homosexual/bisexual group was significantly less likely to
report past-year health care visit then their White heterosexual counterparts (p<.05).
Philadelphia adults over age 40, regardless of sexual orientation, were more likely to report a regular
source of care than their under-40 counterparts. Within the homosexual/bisexual group, 95% of the 40+
group reported a regular place compared to 85% of the under-40 group (p<.001). There was no
difference in the type of place cited as this regular source between the two age groups. However, more
of those 40+ reported a past-year medical visit (85% compared to 73% of the under-40 group) ((p<.001).
These differences may be a result of older adults' health status.
Overall, Philadelphia adults did not show differences medical care place or recent visits by sex.
Similarly, within the homosexual/bisexual group, males and females did not show differences in
reporting a regular source of medical care; nor were there differences in type of place among those who
identified this source. However, there is a significant difference between the two groups of males; males
in the homosexual/bisexual group to were more likely to report a regular place than their heterosexual
peers (88% compared to 81% of heterosexual males, p<.05). However, when comparing past-year visits
by sex within the homosexual/bisexual groups, female adults are more likely to report a past-year visit,
with 85% of females reported a visit in this time frame, compared to only 73% of homosexual/bisexual
males (p<.05).
40
Health promotion and disease prevention
Figure 25:
Medical Screenings* Among Adults in Philadelphia by
Sexual Orientation
56%
Prostate Exam
30%
37%
Colonoscopy
28%
56%
Colorectal screen
53%
0% 10% 20% 30% 40% 50% 60%
*Screenings as appropriate for age group and gender
Homosexual and bisexual people in Philadelphia appear to be less likely to receive some types of
screening tests in some cases than heterosexuals. In many cases, both groups receive inadequate
screenings (See Figure 25). For example, equal proportions of the 50+ group in both the heterosexual and
homosexual/bisexual populations had received appropriate blood stool tests for the purpose of screening
for colorectal cancer. However, this was only about 55% of each group, leaving a sizable minority of
both groups without screening.
The 50+ homosexual/bisexual population was less likely to receive a sigmoidoscopy or colonoscopy
(28%) in the recommended 5 year time period compared to their heterosexual peers (37%), who
themselves were unlikely to receive the screening. (p<.05) It is possible that this discrepancy in the age-
related screenings is related to the age difference between the two groups: although this analysis is
limited to participants age 50 or older, the distribution of the 50+ group of heterosexuals is older than the
50+ homosexual/bisexual group.
Philadelphia adults were much more likely to receive other types of routine screenings, which should be
offered to all adults 18 and older; this is true for adults in both sexual orientation groups. Although
members of the homosexual/bisexual group were slightly but significantly less likely to have received a
recent blood cholesterol check (64% compared to 70% of the heterosexual group, p<.05), past-year blood
pressure reading were about 85% for each group.
41
Figure 26:
Medical Screenings* Women in Philadelphia by Sexual
Orientation
33%
Osteoporosis Screen
20%
85%
Pap Smear
67%
73%
Breast exam
53%
65%
Mammogram
36%
0% 10% 20% 30% 40% 50% 60% 70% 80% 90%
Screenings as appropriate for age group and gender
Homosexual and bisexual women seem particularly at risk for missing recommended health screenings;
the rate of nearly every female-specific standard test is significantly lower for the homosexual/bisexual
women than for the heterosexual women (See Figure 26). Although few women 45 and older obtained
the recommended osteoporosis screening, homosexual/bisexual women were less likely than their
heterosexual peers to obtain this screening. Only one in five (20%) of the homosexual/ bisexual women
45+ received the recommended osteoporosis screening, compared with one in three (33%) of
heterosexual women. Of the women over 40, who should receive a mammogram annually, two thirds
(65%) of the heterosexual group received one in the recommended time, compared to only about one
third (35%) of the women with same-sex partners. This pattern continues with the women's health
screenings that women of all ages should receive: only half of the women with same-sex partners had
received a breast exam from a health professional in the recommended time (compared with 73% of the
heterosexual women), and only two-thirds of the women has received a pap smear in the recommended
time (compared to 85% of the heterosexual group).
Due to limited sample sizes in the older age groups, data about screenings is not available for smaller
groups of homosexual/bisexual adults. However, past PHMC Household Health Survey reports have
detailed underserved populations that lack screenings, including many cases of racial and ethnic
minorities missing appropriate screenings. It is expected that these groups within the
homosexual/bisexual population are equally, if not more, at risk of experiencing these same barriers as
their heterosexual peers.
Mental Health Status and Care Among Homosexual/Bisexual People
Mental health status and care

The homosexual/bisexual population appears to seek mental health care and support more than the
heterosexual population. About a third of the homosexual/bisexual group talked to a professional (such
as a psychologist, psychiatrist, social worker, or member of the clergy) in the past year compared with a
quarter of the heterosexual group (See Figure 27)
42
Figure 27:
Mental Health Care Among Adults in Philadelphia by
Sexual Orientation
Needed mental 4%
health care but
could not pay 10%
Has mental health 13%

condition 19%
Talked to 24%
professional about
problems 33%
0% 5% 10% 15% 20% 25% 30% 35%

About a fifth (19%) of the homosexual/bisexual group had been diagnosed with a mental health condition
in their lifetime, compared to 13% of the heterosexual group (p<.05). About half of adults in each sexual
orientation group with a mental health diagnosis were receiving treatment for this diagnosed condition at
the time of the interview (See Figure 27).
Figure 28:
Mental Health Care Among Adults in Philadelphia by
Needed mental 3%
4%
health care but could 4%
not pay 16%
12%
Has mental health 12%
condition 14%
30%
Talked to 28%
30%
professional about
23%
problems 36%
0% 5% 10% 15% 20% 25% 30% 35% 40%

Black heterosexual
White heterosexual
When considering race and sexual orientation together, there appear to be complicated relationships in
regard to mental health care. Overall, White heterosexual adults were least likely of all 4 of the groups to
43
report talking to a professional; this category again includes a wide range of professionals, such as clergy
member, as well as counselors, social workers, psychiatrists, and psychologists (see Figure 28). Within
the homosexual/bisexual group, differences between Black and White adults were not statistically
significant. However, within the White population, significantly more members of the
homosexual/bisexual group reported talking to someone about their problems (36% compared to only
23% of the heterosexual group). When comparing mental health diagnosis rates for race and sexual
orientation, more than twice as many White homosexual/bisexual adults was reported a mental health
condition diagnosis than any of the other groups; (30% of White homosexual/bisexual adults had been
diagnosed compared to 12% of the Black homosexual/bisexual group and 14% of the White heterosexual
group). When taking a closer look at the homosexual/bisexual group with a diagnosis, there was no
significant difference between the two racial groups in receipt of past-year care for the diagnosed
condition. However, the difference in diagnosis rates nevertheless seems to indicate differential access to
care between racial groups, perhaps due in part to attitudinal factors. See below for a discussion of the
ability to pay for mental health care by race and sexual orientation.
Within the homosexual/bisexual group, there were no significant differences between the 40+ and under-
40 groups in talking to a professional about problems, with a third of both groups reporting talking to a
professional. Nor was there a significant different within this group in terms of mental health condition
diagnoses or past-year treatment for the condition.
There were no differences within the homosexual/bisexual group between males and females related to
talking to a professional, receiving a diagnosis, receiving care for diagnosed mental health conditions.
Missing mental health care due to cost

People with same-sex partners were three times as likely to lack desired mental health care due to cost:
10% of the homosexual/bisexual group, representing nearly 5,000 Philadelphians, were not able to access
desired mental health care for financial reason, compared with only 3% of those with heterosexual
partners (See Figure 27).
When comparing ability to pay by race and sexual orientation, very few Black respondents of either
group reported financial barriers to receiving mental health care (See Figure 27). Instead, within the
homosexual/bisexual group, four times as many of the White homosexual/bisexual group reported that
they were unable to get needed and desired mental health care due to cost (16% compared to 4% of the
Black homosexual/bisexual group, p<.05; and 4% of the White heterosexual group, p<.05).
When comparing age groups and sexual orientation on missing mental health care due to cost, the under-
40 group was significantly more likely to report not receiving needed mental health care due to cost (14%
of the under-40 group compared to the 5% of the older group). This difference in financial accessibility
to desired mental health care due to age was not seen in the heterosexual population.
There were no differences within the homosexual/bisexual group between males and females and the
unavailability of mental health care due to cost.
Health Status, Disability, and Chronic Conditions among Homosexual/Bisexual People
The PHMC Household Health Survey includes detailed information about health status and health
conditions that Philadelphians may experience. Again, to provide as fair a comparison as possible, only
sexually active populations are included here: those who had not had sex in the past year may be more ill
than those included in this group, but nothing can be assumed about the sexuality of these individuals.
44
Health status and chronic conditions
Figure 29:
Selected Health Conditions of Adults in Philadelphia
by Sexual Orientation
32%
Allergies
38%
High blood 26%
pressure 19%
10%
Diabetes
7%
Any Chronic 23%

Condition 23%
0% 10% 20% 30% 40%


Like heterosexual Philadelphians, most homosexual/bisexual Philadelphians are in good or excellent

health (77%), but a substantial minority (23% of each group) is in fair or poor health. Nearly a quarter of
the people in each group, representing 11,800 homosexual/bisexual people and 204,300 heterosexual
people, have chronic health conditions (See Figure 29), such as arthritis (about 20% of each group);
diabetes; high blood pressure (about a quarter of each group) or high cholesterol (20% of each group). In
addition, many Philadelphians have asthma (15% of both groups) and/or allergies (about one third of
each group, see Figure 29).
45
Figure 30:
Self-assessed Health Status Adults in Philadelphia by
70%
61%
60%
47% 48%
50% 43%
40% 36% 36%
27%
30% 23% 23% 24%
18%
20% 13%
8% 5%
10%
3% 1%
0%
White White Heterosexual Black Black Heterosexual
Homosexual/Bisexual Homosexual/Bisexual
Excellent health Good health Fair health Poor health

However, self-assessed health status does vary by race and age. Looking at racial differences (see figure
30) within both the homosexual/bisexual group and the heterosexual group, the White subgroups skew
more toward “excellent" health, and the Black subgroups skew more towards “fair” health (p<.001 for
the heterosexual group, p <.05 for the homosexual/bisexual group). There were no differences within the
homosexual/bisexual group in overall prevalence of chronic conditions between Black and White groups.
Health status of Philadelphia adults varied significantly by age group (see Figure 31). Within the
homosexual/bisexual group, the under-40 group more likely to report "excellent" health (36% compared
to only 18% of the 40+ group), and the 40+ group skewing toward the "fair" and "poor" end of the scale
(with 40% reporting fair or poor status compared to only 12% of the under-40 group). About twice as
many of the 40+ group reported a chronic condition (33% compared to 17% of the under-40 group).
Similar relationships between health and age are seen in the heterosexual population.
46
Figure 31:
Self-assessed Health Status Adults in Philadelphia by
Sexual Orientation and Age
60%
52%
48% 47%
50% 44%
38%
40% 36% 31%
30% 24%
23%
18%
20%
13%
10% 6%
10% 7%
2% 2%
0%
Under-40 Under-40 Heterosexual 40+ 40+ Heterosexual
Homosexual/Bisexual Homosexual/Bisexual
Excellent health Good health Fair health Poor health

Sensory and physical disabilities

The PHMC Household Health Survey data indicates that about 5% of each group has a sensory
impairment, representing 45,000 heterosexual people and over 2,000 homosexual/bisexual people. An
additional one in 7 in each group has a physical disability, representing 116,000 heterosexual
Philadelphians and over 6,000 homosexual/bisexual Philadelphians. Thus there are equal proportions of
the heterosexual population and the homosexual/bisexual population that have sensory or physical
disabilities.
Physical Activity, Nutrition, and Overweight

In Philadelphia, as in the rest of the United States, physical activity, nutrition, and weight are health
indicators of increasing interest. The PHMC Household Health Survey covered a number of topics
related to obesity, physical activity, and obesity.
Physical activity
In Philadelphia, only about half of all adults meet a recommended standard of 30 minutes of aerobic
physical activity of 30 minutes or longer on 3 or more days a week (See Figure 32). However, the
homosexual/bisexual group were significantly more likely (p=.03) to meet the recommended 3+ days of
exercising 30 minutes or longer than heterosexuals, with 62% of homosexual/bisexual adults meeting this
standard compared to 53% of their heterosexual peers. In contrast, the heterosexual group was
significantly more likely to report discussing exercise with a doctor (p<.005), with 39% having such a
discussion compared to only 29% of homosexual/bisexual adults.
47
Figure 32:
Exercise Among Adults in Philadelphia by Sexual
Orientation
53%
Exercised 3+
Days
62%
Discussed 39%
exercise with
doctor, past year 29%
0% 10% 20% 30% 40% 50% 60% 70%
Within both groups, there is variation by age (see figure 33), which was magnified among the
homosexual/bisexual group: 71% of the under-40 homosexual/bisexual adults exercised 3+ days a week,
compared to only 49% of their 40+ counterparts. Additionally, the under-40 homosexual/bisexual group
was significantly more likely to exercise 3+ days than their heterosexual peers (58% of whom exercised
3 times a week). However, the 40+ groups in each sexual orientation category were more likely to
discuss exercise with a doctor.
Figure 33:
Exercise Among Adults in Philadelphia by Sexual
Orientation and Age Group
50%
Exercised 3+ 49%
Days 58%
71%
46%
Discussed
43%
exercise with
32%
doctor, past year 18%
0% 10% 20% 30% 40% 50% 60% 70% 80%

40+ heterosexual
40+ homosexual/bisexual
18-39 heterosexual
18-39 homosexual/bisexual
48
There were no differences within the homosexual/bisexual group between Black and White groups, or
males and females where these exercise variables were concerned.
Fruit and vegetable consumption and grocery store quality
Very few Philadelphia adults ate a recommended 5 or more servings of fruits or vegetables per day:
Among the homosexual/bisexual and heterosexual adults, less than 13% of both groups said they met this
standard. However, very few of these adults did not perceive that it was difficult to find produce in their
neighborhood (5-9%), and the majority said that their local grocery store was of "good" or "excellent"
quality (about 81% of both groups). It is not clear why adults do not consumer the recommended
produce servings.
However, there were differences in fruit and vegetable consumption among Philadelphia adults by race
and sexual orientation. Within the homosexual/bisexual group, significantly more of the White group
(20% compared to 7% of the Black group) consumed 5+ more fruits and vegetables per day. However,
there was no significant difference in the assessment of the neighborhood grocery stores between the two
groups. There were no differences in fruit and vegetable consumption by age, but twice as many females
met the 5+ fruit and vegetable threshold (19% compared to 9% of males), despite no significant
difference in the assessment of the quality of grocery stores.
Obesity and overweight
A majority of Philadelphia adults fall into "overweight" or "obese" categories for their reported height
and weight. There were no significant differences in obesity and overweight between the
homosexual/bisexual group and the heterosexual group: 55%-60% were in those categories. Nor were
there significant differences in obesity and overweight within the homosexual/bisexual group between
Black and White groups, under-40 and 40+ groups, or between males and females.
49
Substance Use
Alcohol use
Figure 34:
Alcohol Use Among Adults in Philadelphia by Sexual
Orientation
Had 5+ drinks 7%
on 5+ days 13%
Used alcohol, 52%

past month 67%
0% 20% 40% 60% 80%

Most Philadelphia adults reported consuming at least some alcohol in the past 30 days. Compared to
heterosexual adults, more homosexual/bisexual adults reported alcohol consumption in this time period.
A full two-thirds (67%) of the homosexual/bisexual group had at least one drink in the past month,
compared to just over half (52%) of the heterosexual group. In addition, the homosexual/bisexual group
appears to be at increased risk for problematic binge drinking—13% of the group with same-sex partners,
representing 6,500 people, reported binge drinking (having 5 or more drinks in one day) 5 or more times
in the past month, compared to only 7% of those with heterosexual partners (p<.01).
Figure 35:
Alcohol Use Among Adults in Philadelphia by Sexual
Orientation and Race
5%
Had 5+ drinks on 8%
5+ days 9%
18%
38%
Used alcohol, past 55%
month 61%
82%
0% 10% 20% 30% 40% 50% 60% 70% 80% 90%
Black heterosexual
White heterosexual
50
When comparing alcohol consumption among Philadelphia adults by race and sexual orientation, more
White adults of both sexual orientation groups consumed alcohol in the past 30 days compared to their
Black peers. Within the homosexual/bisexual population, significantly more of the White
homosexual/bisexual group (82%) had consumed alcohol in the past 30 days compared to the Black
group (55%, p<.001) (see Figure 36). Furthermore, within the White population, the
homosexual/bisexual group was significantly more likely to report past-30-day alcohol use compared to
their heterosexual peers (p<.001). The difference between the Black homosexual/bisexual group and the
Black heterosexual group had borderline significance (p=.055). In addition, at least twice as many
White homosexual/bisexual adults exhibit potentially problem drinking compared to any other of
presented racial/sexual orientation groups, with 18% of all of this group reporting drinking 5+ drinks on
5 or more days in the past 30 days, compared to only 8% of the Black homosexual/bisexual group (p<.
05) and 9% of the White heterosexual group (p<.001). Within the heterosexual group, significantly more
of the White population reported this threshold of alcohol use as well (p<.001). Finally, within the
homosexual/bisexual group, there were no significant differences between the under-40 and 40+ groups
in alcohol use; nor are there differences between males and females in this group.
51
Tobacco Use
Figure 36:
Tobacco Use Among Adults in Philadelphia by Sexual
Orientation
Smoked 100+ 48%

cigarettes in life 53%
27%
Currently smokes
36%
Currently smokes 20%

every day 27%
0% 10% 20% 30% 40% 50% 60%

Many Philadelphians have a history of smoking: about 50% of both the heterosexual only group and the
homosexual/bisexual group have smoked at threshold level of at least 100 cigarettes in their lifetime.
About a third of Philadelphians are current smokers, and a quarter of both groups of Philadelphians
smoke cigarettes every day, including over 13,500 homosexual/bisexual Philadelphians. An additional
2,000 (4%) of homosexual/bisexual people in Philadelphia use other forms of tobacco.
When comparing race and sexual orientation, significantly more of White Philadelphia adults of both
sexual orientation groups had reached the threshold of smoking 100+ lifetime cigarettes. Among the
White homosexual/bisexual group, 63% reached this threshold compared to only 46% of the Black
group. Furthermore, within the White group, the homosexual/bisexual population is significantly more
likely to have reached 100+ cigarettes than their White heterosexual peers. However, when current
smoking is considered, there are not differences by race; instead, more of the White homosexual/bisexual
population has quit smoking. It appears that despite differences in lifetime smoking, current smoking
cessation efforts within homosexual/bisexual populations needs to target both major racial groups in
Philadelphia.
When comparing tobacco smoking behaviors by age and sexual orientation, there are differences by age.
Within the homosexual/bisexual group, there is a significant difference in smoking by age: the 40+ group
was more likely to have ever smoked 100+ cigarettes (64% compared to 44% of the younger group).
However, many in the older group have quit, so that only 32% of the 40+ group still smokes, compared
to 37% of the under-40 group. However, equal proportions of the 40+ and under-40 groups still smoke
every day, with 28% of the older group and 26% of the younger group reporting daily smoking. Finally,
there were no differences in smoking behaviors between males and females within the
homosexual/bisexual group.
52
Figure 37:
Tobacco Use Among Adults in Philadelphia by Sexual
Orientation and Race
47%
Smoked 100+ 46%
cigarettes in life 55%
63%
30%
29%
37%
23%
every day 20%
28%
0% 10% 20% 30% 40% 50% 60% 70%
Black heterosexual
White heterosexual
Safety and Violence

Gun ownership and safety
According to the PHMC Household Health Survey, many Philadelphians have guns, but
homosexual/bisexual Philadelphians are less likely to own a firearm than are heterosexuals; fewer than
9% of the homosexual/bisexual group has a firearm, while 14% of heterosexuals own a firearm. Firearm
owners in both groups are equally likely to lock their firearm-80% of both groups lock their firearm(s).
Figure 38:
Violence and Gun Ownership Adults in Philadelphia
by Sexual Orientation and Race
6%
Experienced
7%
physical violence 4%
in past year 6%
13%
14%
Gun in household
16%
4%
0% 2% 4% 6% 8% 10% 12% 14% 16% 18%

Black heterosexual
White heterosexual
When comparing sexual orientation ad race together, White homosexual/bisexual adults were the groups
that was least likely to own a gun, with only 4% reporting a firearm in the household. The other 3 groups
53
were not significantly different from each other; 16% of the White heterosexual group reported a gun in
their household, and 14% of the Black homosexual/bisexual group (see Figure 38). Females in the
homosexual/bisexual population were more likely (p<.05) to own a gun than males (14% of the
homosexual/bisexual females reported gun ownership compared to 5% of males). Gun ownership within
the homosexual/bisexual population did not vary by age.
Experiences of violence
In the PHMC Household Health Survey data, 6% of Philadelphians in both the heterosexual group and
the homosexual/bisexual group had experienced physical violence in the past year, defined as being
shoved, slapped, beaten, forced into sexual activity or threatened or hurt with a knife or gun by friends,
family members, or strangers. Of these Philadelphians who had experienced violence, over a quarter of
each group had experienced violence at the hands of an intimate partner. This finding strongly suggests
that intimate partner violence is not only a problem for heterosexual couples. However, there are few
resources in Philadelphia for individuals experiencing abuse from a same-sex partner, especially for men
who are the victims of violence.
When examining experiences of violence by race and sexual orientation together, White heterosexual
adults are the group that stands out, because they are less likely to have experienced violence in the past
year; only 4% of this group had such and experience, compared to 6%-7% of the other three groups (See
Figure 38). This difference is small but statistically significant. Within the homosexual/bisexual
population, there was no significant difference in by race. Thus it appears that race and sexual minority
status may increase the risk of violent experiences.
Within the homosexual/bisexual group, more of those under-40 reported experiencing violence (with
11% of the under-40 group reporting such an experience, compared to only 1% of the 40+ group. There
was no difference in experiences of violence between males and females for the homosexual/bisexual
group.
There has been some attention paid to hate crimes prevalence in this population. Although the FBI
collects data on hate crimes due to sexuality, there is no statute enforcing the collection of these data in
Pennsylvania. No hate crimes due to sexual orientation were reported to the FBI from Pennsylvania in
2004; therefore, data from Pennsylvania about hate crimes is inconclusive with regards to these
populations.
54
Social Capital
During the past decade, health researchers have focused on a relatively new concept known as “social
capital”. Simply put, this is a measure of community connectedness, measured by elements such as
participation in group, trust in neighbors, and a sense of belonging. Available data to present here
includes group participation and volunteering; neighborhood tenure and integration; and religious
affiliation.
Community participation and volunteering
Figure 39:
Community Participation Among Adults in
Participate in 40%
community
groups monthly 40%
Volunteered time, 46%

past year 53%
0% 10% 20% 30% 40% 50% 60%

About 40% of both homosexual/bisexual and heterosexual people participated in groups at least once a
month in the past year. Close to half of both homosexual bisexual (53%) and the heterosexual (46%)
groups had also volunteered their time in the past year; this is a borderline significant differences (p=.07)
in past-year volunteering. Within the homosexual/bisexual group, there were no differences in group
participation or volunteering between Black and White population, under-40 and 40+ groups, or males
and females.
55
Neighborhood tenure and integration
Figure 40:
Length of Time in Neighborhood of Adults in
60%
49% 1 year or less
50%
39%
40% 36% 2-5 years
30% 27%
6-10 years
20%
14% 16%
11%
10% 8%
More than 10
years
0%

All Philadelphia adults tend to live in the same neighborhood for a long time. However, heterosexual
populations tended to live in their current neighborhood longer. Nearly twice as many (14%) of the
homosexual/bisexual group had lived in their current neighborhood under one year (compared to 8% of
the heterosexual group); and 49% of the heterosexual group had lived in their current neighborhood for
more than 10 years, compared to 39% of the homosexual/bisexual group (p<.001).
This difference may be age-related, as within the homosexual/bisexual group, the 40+ group is skewed
toward longer neighborhood tenure, and there are not significant differences between heterosexual and
homosexual/bisexual groups within either the under-40 or 40+ age groups.
The homosexual/bisexual group was more likely to say that their neighbors had ever worked together
(p=.03), with a quarter of the homosexual/bisexual group responding positively to this item, compared to
only 66% of the heterosexual group. However, there were no differences in trust in the neighbors or
belief that neighbors are willing to help each other between the homosexual/bisexual and the
heterosexual groups.
56
Religious affiliation
Figure 41: Religious Affiliation of Adults in

60%
Protestant
49%
50%
Catholic
40% Jewish
32%
30%
30% 27% Muslim
24%
Buddhist
20%
13%
9% Other
10% 5% 4% 3% 6%
3% 4% 2% No Affiliation
0%
A majority of Philadelphia adults have a religious affiliation; of these an overwhelming majority are
Christian. Among sexually active adults, top affiliations included were Protestant Christian (with 49% of
the heterosexual adults and 27% of the homosexual/bisexual adults reporting this affiliation); and
Catholic Christian (32% of heterosexual group and 24% of the homosexual/bisexual group).
However, compared to the heterosexual population, three times as many people in the
homosexual/bisexual group reported no affiliation (30% compared to 13% of the heterosexual people,
p<.001). An addition al 10% of the homosexual/bisexual group reported an “other” affiliation, compared
to only 6% of the heterosexual group. It appears that the main difference between the homosexual/
bisexual group and the heterosexual group is that some individuals in the homosexual/bisexual group
disaffiliated themselves with Christian denominations, and instead feel no affiliation, or have affiliated
with groups outside the 5 major world religions. Nevertheless, more than half of the
homosexual/bisexual population in Philadelphia (a total of 51%) are affiliated with either Catholic or
Christian groups, representing over 25,000 Catholic or Protestant Christian homosexual/bisexual adults
in Philadelphia.
Religious affiliation varies significantly by race for all Philadelphia adults: these differences are reflected
in the homosexual/bisexual population. Most striking is that far more Black homosexual/bisexual adults
chose Protestant/Baptist/Christian (44% compared to only 15% of Whites) while more of the White
homosexual/bisexual group chose a Catholic affiliation (33% compared to 9% of the Black group). In
addition, White homosexual/bisexual adults were more likely then their Black peers to say that they had
no religious affiliation (38% compared to 27%) while twice as many of the Black group (13%) said that
they belonged to an "other" religious group (compared to 6% of the White group).
57
Religious affiliation varies by age group within the homosexual/bisexual population. First, a sizable
minority in the under-40 group was reported no affiliation (37% compared to only 21% of the older
group). In contrast, adults 40+ were more likely to be affiliated with the two Christian categories, with
32% choosing a Protestant/Baptist/other Christian affiliation (compared to 23% of younger group) or a
Catholic affiliation (28% compared to 20% of the younger group).
There were also significant differences in religious affiliation between males and females. Males were
more likely to have a Protestant/Baptist/Other Christian affiliation (32% compared to 21% of the
women)—a striking finding, since among heterosexuals, females were significantly more likely to report
this affiliation than were men (43% of heterosexual females compared to 35% of heterosexual males).
Within the homosexual/bisexual group, males were also more likely to report no affiliation (35%
compared to 25%). However, females were twice as likely to report an “other” affiliation (14%
compared to 6% of males). A quarter of both groups reported a Catholic affiliation.
58
Defining Gaps in the Data
There are several gaps in the data; these include data on sexual identity, gender identity, racial and ethnic
minorities, and youth.
Sexual Identity
One gap is that available data sets such as the census, the YRBS, and the SEPA Household Health
Survey do not collect information on sexual identity. This lack of identity-based measures, which was
discussed earlier in the report, has an important influence on recommendations for future work. In
particular, the lack of information about identity categories means that caution must be applied when
attempting to apply the behavioral data to factors that are more cultural and social in nature. Thus, many
of the issues that might be of greatest concern to project stakeholders are not directly addressed. For
example, LGBT community-specific participation, political action, being part of a community “market”,
and the impact of community-specific social networks, are disconnected from the available data.
Table 1: The value of identity-based data for stakeholder-related concerns
Community Community
Participation Political
Action
Behavior Identity Friendship/ Experience

Intimacy of being part
of a
“market”
Community
Social Community
Networks Health
Outcomes
Data cannot be
analyzed by factors
associated with
cultural identity
Racial and Sexual Minority Populations Within LGBT Communities

Another issue that is important when considering an assessment of LGBT communities is the presence of
minority populations within the populations. People with LGBT identities or behavior are already a
small minority of the population as a whole; therefore, it can be extremely difficulty to look at smaller
subgroups. Subgroups that have very small sample sizes include, among others, sexual minorities within
the LGBT population such as individuals with bisexual behaviors or identity and minority racial or ethnic
groups.
59
Transgender and gender identity
No data on gender identity or transgender population in Philadelphia were included in this report.
However, this population is an important one to consider in an assessment of LGBT minorities, as a full
understanding of the dynamics of homosexual/bisexual sexual and gender identity is enhanced by a better
understanding of the sexual and gender identities of transgender individuals and populations, which are
frequently omitted or neglected in studies like these. One new study of transgender people in
Philadelphia is at press, and project staff continue to work to obtain access to local data sources about
this population. In addition, because of the great diversity of the transgender population in terms of
gender identity and other factors, substantial data gaps around gender issues are likely to remain.
Older Adults
The sample of homosexual/bisexual older adults (>65 years) is too small to allow us to provide detailed
analysis of this important community. Future research would benefit from better understanding this
generation that was so strongly impacted by the AIDS epidemic and that was one of the first generations
to live as adults in the context of gay liberation.
Youth populations
In this report, Philadelphia-specific data from the Youth Risk Behavior Survey (YRBS), conducted by
the Centers for Disease Control are presented. These data enable us to better understand and compare the
boys and girls who have reported same-sex sex, other-sex sex, and no sex at all. However, the YRBS
data have an extremely small sample size; therefore, future research should build on these basic data.
Racial and ethnic minority populations

Understanding the racial dynamics of LGBT communities in Philadelphia will be of great value to all of
the project’s stakeholders, including government, foundations, community-based organizations, and
corporations. Though our initial data analysis only provides a limited view of race dynamics in LGBT
communities, we are clear that our next round of data analysis will provide a much richer understanding
of these dynamics and communities.
However, in Philadelphia there is very little we can say about LGBT people from racial and ethnic
groups other than African American and Caucasian populations because the sample sizes of other races
and ethnicities are very small. As we make recommendations, we will consider how best to include other
racial and ethnic minority populations in future work given small sample sizes.
60
Community Input and Feedback
Assessment staff met with numerous groups and individuals to receive feedback about Phase I of our
study. Representatives of regional businesses, foundations, government agencies, and community non-
profits provided suggestions for the ongoing work of the project. These meetings provided useful insights
into how the assessment’s analysis might be best used by these groups, as well as recommendations for
the future direction of the project.
The groups agreed that the project was very useful for their own strategic planning purposes and should
be continued in order to provide ongoing and longitudinal data about LGBTI populations. In addition,
they urged that the existing report be widely presented to community groups and other stakeholders in
order to insure that its results and recommendations can have as wide an impact as possible.
Participants recommended that the Assessment’s results also be presented in various formats, with
focused presentations targeted at subpopulations (especially communities of color, women, and other
subpopulations within the data). They also suggested areas for future research, including hate crimes and
violence statistics, the impact of law and public policy, marriage and family trends, income and spending
patterns, and geographic patterns (including the apparent aggregation of sexual minority populations
along business corridors such as Germantown Avenue, Frankford Avenue, and 52nd Street.
Community Assessment staff summarized the recommendations of these groups and presented them to
the original planning group of stakeholders (consisting of representatives of the City of Philadelphia, the
Philadelphia Foundation, and PHMC) and, with input from this steering group, developed
recommendations for the future of the project.
Recommendations
The LGBT Community Assessment project set out in its first year to evaluate existing data about LGBT
populations in the city of Philadelphia. This initial analysis provides a valuable picture of, in particular,
the homosexual and bisexual populations of the city, and points to important trends in health, housing,
community geography, social capital, and other areas that are important for a better understanding of
these communities. This assessment also points to numerous data gaps, including gaps around sexual
and gender identity (particularly transgender populations), understanding of some racial and ethnic
groups (particularly Latino and Asian populations), and perspective into age cohorts (particularly youth
and elders).
The LGBT Assessment’s first year report gives an important picture of the diverse LGBT communities
of Philadelphia, and serves as a foundation for future research which may build upon these initial
analyses in order to continue to provide the city and its various sectors (government, business,
foundation, and non-profit) with an analysis that can be used to better target services, to develop strategic
plans, and to understand better the key dynamics at work within these communities.
The following recommendations outline a number of projects that would serve to address 1) the
continuing collection of data about groups for which we have information (homosexual and bisexual men
and women, as well as same-sex unmarried couples) and 2) the gradual implementation of data collection
61
(where possible) about communities for which there are significant gaps (transgender populations, youth,
non-African American communities of color, single men and women, etc.).
Short-term goals include completion of an annual report, publication of documents on a website,

successful advocacy with an agency to add appropriate sexual or gender identity questions; long-term
goals include establishment of an ongoing clearinghouse of data and analysis about the identities,
behaviors, and cultures of LGBT populations for use by a broad range of stakeholders.
Our discussions with stakeholders, including potential funders from the government, foundation, and
non-profit sectors, have pointed to a number of areas that would be help achieve our shorter term goals,
including further exploration of currently identified disparities between homosexual/bisexual and
heterosexual populations, identification of additional disparities, advocacy for and assistance with
strategies to better survey LGBT populations, dissemination of information to stakeholders for use in
strategic planning, program development, grant writing, marketing, etc. Below is an outline of some
short-term projects that are important parts of an ongoing LGBT Community Assessment. The projects
are presented below in order of priority, with an expectation that either existing funding or new funding
would be most accessible for the projects listed first.
A. A web-based portal for reports from the project and ongoing dissemination of report
findings: This portal would allow both viewing and analysis of collected LGBT Assessment data
by community groups, foundations, government, business, and other stakeholders. The portal
could be sponsored by any of these stakeholders.
! The portal would serve as a central site for dissemination of all LGBT Community
Assessment documents and also allow feedback from viewers of the site. One model for the
site is http://www.gaydemographics.org/, a national portal of data on same-sex unmarried
couples. This site includes featured data, articles and websites of interest, and opportunities
for feedback.
! The project could seek volunteer design of the website (including flash movies, interactive
maps, and other eye-catching graphics). This would minimize cost, and staffing of the project
could insure regular updating of information available on the site.
! The website would be hosted at an independent website that could be provided by a local
community-based internet service provider. Project staff would insure that the completed
website would be introduced at a widely promoted launching of the site.
! In addition to the website and community meetings mentioned above, Community

Assessment data should be published in appropriate journals and presented at local, regional,
and national conferences.
We recommend that this project be given first priority for completion so that the current
report, community feedback, and ongoing efforts could be publicized to stakeholders and
potential funders, and that existing analysis would be available for use by stakeholders
B. A workshop providing case examples showing community based organizations /

foundations/ government how best to use these data as a part of their strategic planning.
62
! A technical assistance workshop that would serve both to publicize the work of the
assessment and to assist local agencies and organization to make best use of its data and
analysis.
! The presentation would highlight demographics, health disparities, community participation,
and other issues of concern to agencies and organizations. The presentation also would
highlight the high-concentration same-sex couple neighborhoods and make suggestions for
how to target services/marketing/ programs to those neighborhoods.
C. A focused and targeted assessment of particular segments of the LGBT communities and
subpopulations (youth, transgender, seniors, people of color, etc.) that would identify
disparities with regard to health, housing, education, and other areas. We recommend both
a quantitative and qualitative approach to further this data collection.
Representatives from foundations reported that they were particularly interested in further
information about LGBT youth. Areas of particular interest over the next year could focus on
collecting data from the school district, youth-serving government agencies (including DHS) and
non-profits.
Representatives of the Philadelphia Department of Health reported a particular interest in the

health disparity data from our 2006 report, and are interested both in more detailed research into
these disparities as well as identification of additional health disparities that require attention from
the health department.
! Initial Qualitative Research: Because of the relatively small number of potential respondents
to a quantitative study, qualitative studies of hard-to-reach subpopulations would be
particularly useful in filling in some of the gaps in our analysis. In particular, focus groups
and key informant interviews would help us better to understand some of the subpopulations
which are not visible in our current data. Funding should be sought to support qualitative
study of at least one such subpopulation each year, with completed analysis being added to
the existing body of the LGBT assessment.
! Ongoing Quantitative Research: The next iteration of the PHMC Southeastern Pennsylvania
Household Health Survey (2006) is currently being conducted. We expect data from the
survey to be available by March 2007. It will be valuable to incorporate the data from the
new survey, and to compare it to the data presented here. The 2006 Household Health Survey
also includes new questions on sex and gender identity, so the analysis can include a richer
understanding of LGBT populations.
D. Inclusion of sexual and gender identity questions in regional surveys and research.
This project would work with local research organizations, government agencies, and
community-based organizations to assess the extent to which questions about sexual and gender
identity and behaviors are being appropriately asked and to make recommendations to these
organizations about how such questions could be incorporated into existing research instruments.
! Community Assessment staff would make contact appropriate agencies, research

organizations, and others who are collecting data both on LGBT and general populations to
explore whether sexual and gender identity questions would be appropriate in the context of
their research or data collection. A particular effort would be made with government agencies
63
to see whether these data are being collected and to recommend inclusion of appropriate
questions.
! This project could be funded as part of project C, above, with the idea that improved data
collection would provide useful data to the city’s health department, other agencies and
funding sources. In addition, the project would work with local community based
organizations to standardize 1-3 questions about sexual and gender identity that could be used
uniformly in community based organizations, foundations, government agencies, and other
organizations serving LGBT communities.
! This project would involve working with local LGBT-serving agencies to established unified
questions regarding sexual and gender identity and/or behaviors. Establishing these unified
questions would allow the LGBT Community Assessment (and other stakeholders) to get a
profile of the LGBT population receiving services from community based organizations and
other agencies.
! Philadelphia’s Office of Emergency Shelter and Services has led the way in adapting its
intake and evaluation forms in order to better collect data about the city’s transgender
populations. The model that was used at OESS could be exported to many other city agencies
or funded CBOs. Project staff should work closely with the Mayor’s LGBT Advisory
Committee in order to decide which city offices and agencies should be prioritized for
improvement of data collection in intake and evaluation forms with regard to LGBT
populations.
Conclusion
The LGBT Community Assessment project set out in its first year to evaluate existing data about LGBT
populations in the city of Philadelphia. This initial analysis provides a valuable picture of, in particular,
the homosexual and bisexual populations of the city, and points to important trends in health, housing,
community geography, social capital, and other areas that are important for a better understanding of
these communities. The first year of work also points to numerous gaps, including gaps around sexual
and gender identity (particularly transgender populations), understanding of some racial and ethnic
groups (particularly Latino and Asian populations), and perspective into age cohorts (particularly youth
and elders).
Community stakeholders, including those from the business, foundation, government and non-profit
sectors, have weighed in strongly on the importance of the project, and have given valuable
recommendations about next steps for further research and dissemination of the Assessment’s findings.
Using these recommendations, Assessment staff have made recommendations about next steps for the
project.
The LGBT Assessment’s first year report gives an important though preliminary picture of the diverse
LGBT communities of Philadelphia, and points to strategies for helping to further clarify this picture.
The Assessment’s report serves as a foundation for future research which may build upon these initial
analyses in order to continue to provide the city and its various sectors (government, business,
foundation, and non-profit) with an analysis that can be used to better target services, to develop strategic
plans, and to understand better the key dynamics at work within these communities.
64
Appendices
65
Appendix A: City of Philadelphia Neighborhoods, Philadelphia Planning Commission
1. Allegheny West 24. Germantown 47. Pennypack Park

2. Belmont 25. Girard Estates 48. Pennypack
3. Brewerytown 26. Grays Ferry 49. Point Breeze
4. Bridesburg 27. Haddington 50. Poplar
5. Bustleton 28. Harrowgate 51. Powelton
6. Byberry 29. Hartranft 52. Rhawnhurst
7. Cedar Park 30. Holmesburg 53. Richmond
8. Cedarbrook 31. Hunting Park 54. Riverfront
9. Center City East 32. Juniata Park 55. Roxborough
10. Center City West 33. Kensington 56. Schuykill
11. Chestnut Hill 34. Kingsessing 57. Somerton
12. Cobbs Creek 35. Lawncrest 58. South Philadelphia
13. East Falls 36. Logan 59. Strawberry Mansion
14. East Germantown 37. Manayunk 60. Tacony
15. East Mount Airy 38. Marconi Plaza 61. Tioga
16. East Oak Lane 39. Mayfair 62. University City
17. Eastwick 40. Mill Creek 63. West Kensington
18. Elmwood 41. North Central 64. West Mount Airy
19. Fairhill 42. Ogontz 65. West Oak Lane
20. Fairmount 43. Olney 66. West Torresdale
21. Fishtown 44. Overbrook 67. Wharton
22. Fox Chase 45. Oxford Circle 68. Wissahickon Park
23. Frankford 46. Pennsport 69. Wynnefield
Methodological Note: The following variables from the 2000 U.S. Census were mapped for all of the
above neighborhoods. Neighborhood maps are available by contacting Chris Bartlett at
bartlett.cd@gmail.com .
Population: Total population
Sexual Orientation: Total numbers of same-sex unmarried households; Percent of same-sex unmarried
households; rate of same-sex unmarried households by sex.
Race/Ethnicity: African American; Asian; Caucasian; Latino.
Education: High School Diploma; Bachelor’s Degree
Income: Household Income, Percent of population below 200% of the poverty rate,
Housing: Residential property rates; owner occupancy rate residential sale median price; those spending
more than 30% on owned property; renter occupancy rates; those spending more than 30% of income on
rentals; average rent paid.
Crime: Rate of burglaries; all serious crimes against persons
Disability: Rate of adults with a physical or sensory disability.
66
Appendix B: Most Concentrated Same Sex Unmarried Couples Census Tracts
(with at least 20 male or female couples)
(Tract Number) Neighborhood Name (Geographic Area) Rank Gay /
Lesbian Index
h
(11) Pine East: (Spruce to South, Broad to 11 ) 1 5.54
(233) West Mount Airy: (Germantown to McCallum, West Allens to West Ellet) 2 5.29
th
(17) Queen Village Middle: (Fitzwater to Christian, 6 to Front) 3 4.62
th
(18) Bella Vista Middle: (Fitzwater to Christian, Broad to 6 ) 4 3.74
st
(14) Graduate South: (South to Catherine, 21 to Broad) 5 3.69
th rd
(130) Northern Liberties: (Poplar to Spring Garden, 6 to 3 ) 6 3.45
th
(16) Queen Village North: (South to Fitzwater, 6 to Front) 7 3.42
(15) Bella Vista North: (South to Fitzwater, Broad to 6th) 8 3.38
(12) Pine West (Spruce to South, Schuykill River to Broad) 9 3.25
th
(25) South Philadelphia (Christian to Wharton, 6 to Front) 10 3.11
Appendix C: Most Concentrated Female Same Sex Unmarried Couples

(with at least 10 female couples)
(Tract Number) Neighborhood Name (Geographic Area) Rank Lesbian Index
(233) West Mount Airy: (Germantown to McCallum, West Allens to West Ellet) 1 8.76
(237) West Mount Airy: (Germantown to Greene, West Sedgwick to West Johnson) 2 3.13
th th
(79) Cedar Hill (Pine to Baltimore, 45 to 50 ) 3 3.12
(240) Germantown (Wayne to Wissahickon, West Rittenhouse to West Queen) 4 2.57
(276) Fern Rock: (Godfrey to Chew, Broad to 8th) 5 2.41
(247) East Germantown (Sprague to Belfield, Chelten to Penn) 6 2.25
rd th
(135) Poplar (Poplar to Fairmount, 23 to 17 ) 7 2.16
(207) East Falls (Henry to Kelly Drive, School House Lane to Roosevelt Blvd) 8 2.09
(257) Chestnut Hill (Stenton to Germantown, Winston to Cresheim Valley) 9 2.02
th
(41) South Philadelphia (Mifflin to Oregon, 10 to 5th) 10 2.02
Appendix D: Most Concentrated Male Same Sex Unmarried Couples

(with at least 10 male couples)
(Tract Number) Neighborhood Name (Geographic Area) Rank Gay Male
Index
(11) Pine East: (Spruce to South, Broad to 11h) 1 9.04
(17) Queen Village Middle: (Fitzwater to Christian, 6th to Front) 2 7.00
(14) Graduate South: (South to Catherine, 21st to Broad) 3 5.89
(15) Bella Vista North: (South to Fitzwater, Broad to 6th) 4 5.69

(130) Northern Liberties: (Poplar to Spring Garden, 6th to 3rd) 5 5.42
(12) Pine West (Spruce to South, Schuykill River to Broad) 6 5.20
(18) Bella Vista Middle: (Fitzwater to Christian, Broad to 6th) 7 4.92
(24) South Philadelphia: (Christian to Ellsworth, Broad to 6th) 8 4.46
(16) Queen Village North: (South to Fitzwater, 6th to Front) 9 4.37
(25) South Philadelphia (Christian to Wharton, 6th to Front) 10 4.35
67
Acknowledgements
We'd like to thank the following individuals who assisted us in our work:
Andrew Swinney, and Melissa DeShields of the Philadelphia Foundation and Perry Monastero and Bob
Morrison of the Delaware Valley Legacy Fund for their commitment and steady assistance with the
Assessment; Bradley Breuer, who created the maps; Judith Peters, MBA, School District of
Philadelphia, and Clara Hagnere, Ph.D, Temple University Department of Public Health, who helped us
access the YRBS data; Lynette Campbell, formerly of the Philadelphia Foundation, who envisioned and
provided key resources to initiate the project; Michael Hinson, Assistant Managing Director of the City
of Philadelphia, who envisioned the project and provided steady and most valuable guidance and
assistance throughout the process; Ben Singer and Jessica Xavier, who helped us think through issues
related to transgender populations; Michelle Schmidt, who explained the work of the Center City
District; Lisa Bond of PHMC, who helped us think through strategic planning issues; Francine Axler
and other PHMC Community Health Database staff for their help with the PHMC Household Health
Survey data; Gary Gates of the UCLA School of Law and author of the Gay and Lesbian Atlas, who
helped us in initial planning; Stewart Landers of JRI Health for sharing research from other cities; and
Patrick Egan of University of California, Berkeley, who helped us in thinking through the importance of
issues related to identity.
Special thanks to the members of the Philadelphia LGBT Assessment Coalition:
Jerry MacDonald, Caring People Alliance; Dorena Kearney, The COLOURS Organization, Inc.; Gloria
Casarez, The Gay and Lesbian Latino AIDS Education Initiative; Pedro J. Rivera, PNC Advisors;
Dennis Green, PNC Advisors; Ninah Harris, The LGBT Center at University of Pennsylvania; Nurit
Shein, The Mazzoni Center; Carolyn Thompson, Mountain Meadow Country Experience; Kevin Trimell
Jones, University of Pennsylvania; Valerie V. Gay, PNC Advisors; Robert Schoenberg, The LGBT
Center at University of Pennsylvania; John Cunningham, Delaware Valley Legacy Fund; James
O’Toole, City of Philadelphia; Lanette Swopes, US Census Bureau; and Robert Morrison, Delaware
Valley Legacy Fund.
We are also most grateful to our steady supporters within the government of the City of Philadelphia:
John F. Street, Esq., Mayor, City of Philadelphia; Carmen Paris, Interim Health Commissioner; Joe
Cronauer, Deputy Health Commissioner; John Cella, Director, AIDS Activities Coordinating Office;
and Jane Baker, Health Administrator for Program Services, AIDS Activities Coordinating Office.
Funding for Phase I of the Project was received from the Philadelphia Foundation and the City of
Philadelphia, AIDS Activities Coordinating Office (AACO), Philadelphia Department of Public Health.
We'd also like to thank the numerous individuals, community groups, foundations, government
agencies, and businesses that participated in conversations about the LGBT Assessment.
68

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Philadelphia LGBT Assessment

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The Philadelphia LGBT Community Assessment

Prepared by Philadelphia Health Management Corporation

October 27, 2006

Data Sources .................................................................................................................................................9

Prevalence of Homosexual/Bisexual Populations in Philadelphia .............................................................12

Geographic Patterns of Same-sex Partner Couples in Philadelphia ...........................................................13

Comparing Homosexual and Bisexual Residents of Philadelphia with Heterosexual Residents................21

Defining Gaps in the Data...........................................................................................................................59

Community Input and Feedback.................................................................................................................61

Genesis and Structure of the LGBT Assessment

Uses for LGBT Community-Level Data5

Existing Research with LGBT Populations Outside of Philadelphia:

Existing Research of LGBT Populations in Philadelphia:

The New Territory Explored by the LGBT Community Assessment

By comparison, Philadelphia’s Community Assessment is the first assessment, to our knowledge, to

Behavior and Identity

Methodological issues with the census

Limitations of the "unmarried partner" designation

Potential bias in use of the "unmarried partner" designation

The PHMC Household Health Survey

PHMC Household Health Survey Methodology

The Youth Risk Behavior Survey (YRBS)

Source: PHMC SEPA Household Health Survey, 2004..

The Gay and Lesbian Indices

Philadelphia Compared to Other Metropolitan Areas

Figure 2: County of residence of

16% Montgomery 11%

Sex differences in regional distribution

Figure 4: Philadelphia and suburban county residence

Homosexual/ Hom osexual/

Racial/ethnic differences in regional distribution

Income differences in regional distribution

Family structure differences in regional distribution

Philadelphia Neighborhoods with High Concentrations of Same-Sex Couples

Same-Sex Couples in Context

Same-sex couples in Philadelphia neighborhoods

Gender differences in geographic locations of same-sex couples

Map 3: Number of Female Same-Sex Unmarried Households by Philadelphia Census Tract

Three sources of data are discussed in this comparison section.

Source: PHMC SEPA Household Health Survey, 2004.

18-29 30-39 40-49 50+

Source: PHMC SEPA Household Health Survey, 2004.

Data from the Youth Risk Behavior Survey

Race and ethnicity

50% 45% 45%

30% High School

Philadelphia's adult population displays substantial diversity in educational attainment. The

Source: PHMC SEPA Household Health Survey, 2004.

Source: PHMC SEPA Household Health Survey, 2004.

Source: PHMC SEPA Household Health Survey, 2004.

Less than $15,250 $15,205-$24,000 $24,001-$37,000 $37,001-$60,000 Over $60,000

Source: PHMC SEPA Household Health Survey, 2004.

Poverty and receipt of assistance

Household Black heterosexual

0% 5% 10% 15% 20%

Source: PHMC SEPA Household Health Survey, 2004.

Food insecurity and other unmet needs due to inability to pay

Cut down meals 11%

0% 2% 4% 6% 8% 10% 12% 14% 16% 18%

0% 2% 4% 6% 8% 10% 12% 14% 16% 18%

Citizenship and Language Barriers

Languages spoken at home

Housing and Household Structure of Homosexual and Bisexual Philadelphians

Renting and home ownership