ECU Systematic Review explains higher incidence of respiratory diseases in LGB community

A systematic research review conducted recently at East Carolina University sheds light on why sexual minorities have a greater chance of developing respiratory diseases.

Dr. Joseph Lee, assistant professor in ECU’s Department of Health Education and Promotion in the College of Health and Human Performance, set out to learn more about why sexual minorities experience respiratory diseases at a higher rate, he had a hunch their environments played a big part. However, data about where lesbian, gay and bisexual people are most likely to live wasn’t readily available.

Dr. Joseph Lee, assistant professor in ECU’s Department of Health Education and Promotion in the College of Health and Human Performance.

So he partnered with Kerry Sewell, research librarian for ECU’s Laupus Library, University of New Mexico graduate student Kasim Ortiz and international collaborator and human geographer, Dr. Thomas Wimark from Stockholm University in Sweden to conduct a systematic review – a formal research study that follows a clear-cut model to find, assess and examine research that tried to answer a similar question.

“The limited data available on lesbian and gay lives meant that it was critically important to identify high-quality information from multiple disciplines,” Lee said. “

“When there are such gaps in the literature, it’s important to use systematic research methodologies to bring together all of the existing evidence in one place,” said Sewell. “Outcomes of a systematic review can present a reliable depiction of what is known and what remains uncertain.”

The team found 51 quantitative papers addressing the topic from multiple fields and found clear evidence of a pattern that LGB people are more likely to live in urban areas, as well as in areas with more air pollution and more tobacco retailers. The data also suggests that even when LGB people live in more prosperous regions, they’re living in poorer neighborhoods than their heterosexual counterparts.

“This review helps us explain the role of geography in why LGB people are more likely to have respiratory diseases and smoke than their straight counterparts,” Lee said.

These findings not only expand understanding of why certain health disparities exist, Lee said, but can also lead to improved health programs, health education and promotion campaigns for the LGB community.

Lee added the findings would not have been possible without collaboration from a medical librarian.

Librarians in Laupus Library’s Systematic Review Service have unique skills that ensure the search for published studies is thorough, guarding against biased findings or recommendations that inform patient care, health care decision-making, research and policy.

“I’m pleased that the Laupus Systematic Review Service was able to bring state-of-the-art systematic review methods to pull together evidence from multiple fields, journals and even languages to inform health programs and future research,” Sewell said.

The review was published on June 27 by PLOS One, a peer-reviewed scientific journal of the Public Library of Science, where it became immediately accessible to the public at no cost.

“This article is a terrific example of how including a librarian on the research team enhances the outcomes of the scholarly product,” said Laupus Library Director, Beth Ketterman. “We are very proud of the Systemic Review Service at Laupus Library, and encourage our ECU researchers to utilize this unique librarian skill set so that we can continue to partner in quality contributions to the health literature.”

No data was available on studies of transgender and transsexual populations, pointing to the need for continued research.

Read the full review at

Learn more about Laupus Library’s Systematic Review Service at