Prejudice still exists in the world, unfortunately; and it may lead to an increased chance of premature death, according to recent research.

In a new study, researchers from Columbia University’s Mailman School of Public Health found that lesbian, gay, and bisexual (LGB) people living in communities with high levels of anti-gay sentiment actually have shorter life spans than those living in more tolerant places. Their life expectancy is, on average, 12 years less than those who live elsewhere, the authors found.

“The results of this study suggest a broadening of the consequences of prejudice to include premature death,” Mark Hatzenbuehler, the lead author of the study and assistant professor of Sociomedical Sciences, said in a press release.

The researchers began gathering data in 1988, using the General Social Survey, which is one of the major sources of social indicator data in the social sciences. They tried to measure how prejudiced an area was compared to others. They also linked information on sexual orientation and community-level prejudice to mortality data using the National Death Index.

When the study was completed, 92 percent of LGB participants who lived in low-prejudice areas were alive, while only 78 percent of those living in high-prejudice areas were alive. “Our findings indicate that sexual minorities living in communities with higher levels of prejudice die sooner than sexual minorities living in low-prejudice communities, and that these effects are independent of established risk factors for mortality, including household income, education, gender, ethnicity, and age, as well as the average income and education level of residents in the communities where the respondents lived,” Hatzenbuehler said in the press release. “In fact, our results for prejudice were comparable to life expectancy differences that have been observed between individuals with and without a high school education.”

But what was causing their premature deaths? The authors found that suicide, homicide or violence, as well as cardiovascular disease — all of which could be associated with stress or mental illness — were higher among sexual minorities in high-prejudice communities.

The authors suggest that where homicide and violence-related deaths are elevated, oftentimes the environment is more hostile or prejudiced. Likewise, cardiovascular disease is often associated with stress. Twenty-five percent of deaths among LGB in high-prejudice communities had to do with cardiovascular disease, compared to 18.6 percent elsewhere. “Psychosocial stressors are strongly linked to cardiovascular risk, and this kind of stress may represent an indirect pathway through which prejudice contributes to mortality,” Hatzenbuehler noted in the press release. “Discrimination, prejudice, and social marginalization create several unique demands on stigmatized individuals that are stress-inducing.”

Hatzenbuehler’s previous research has also focused on social stigma and how it affects health, as well as how social environments lead to suicide attempts in LGB youth.

Source: Bellatorre A, Lee Y, Hatzenbuehler M, et al. Structural stigma and all-cause mortality in sexual minority populations. Social Sciences & Medicine. 2014.