Study shows that marriage policy has meaningful effects on access to health care
Vanderbilt University researchers have shown that legalizing same-sex marriage has improved access to health care for many gay men. This is one of the first studies to examine the effect legal marriage has on the health of LGBT individuals.
“This is an important question to study. Recent research has shown that LGBT individuals often face barriers to accessing health services including lack of insurance, stigma, and discrimination. And, as a result, they can experience poor health outcomes,” said Christopher Carpenter, professor of economics. He led the trans-institutional research team and is the lead author on the paper. “A very large body of research in economics and sociology demonstrates that marriage is protective for health for heterosexual individuals, but ours is the first to show that marriage policy has meaningful effects on health care access for sexual-minority men.”
The study was released as a National Bureau of Economic Research working paper last month. Carpenter and his colleagues in the departments of economics and medicine, health and society at Vanderbilt University and the department of health policy at Vanderbilt University School of Medicine analyzed the access to health care data. It includes 16 years of data from the Centers for Disease Control and Prevention’s Behavioral Risk Factor Surveillance System. The database includes information about United States residents’ health-related risk behaviors, chronic health conditions, and use of preventive services.
Survey did not specifically ask respondents their sexual orientation
The CDC survey did not specifically ask respondents their sexual orientation. But researchers were able to deduce from related responses in the survey. The household structure showed a sizable percentage of adults in same-sex adults homes. They deduced they were LGBT and are likely in same-sex relationships.
“We found that lesbian, gay, or bisexual adults were more likely to get married after having access to legal same-sex marriage. And for men, that is associated with a statistically significant increase in the probability that they have health insurance, have a usual source of care, and have a routine health check-up,” said co-author Gilbert Gonzales Jr., assistant professor of health policy.
The group was surprised to not see a similar effect for lesbian adults. But they plan on future research to better examine the cause for that difference. Another surprising finding was that while there was increased health insurance coverage and health care access for gay men, no actual health effects were seen in any of the populations examined.
“For example, mental health was not improved. And there were no changes in negative health behaviors such as cigarette smoking or heavy drinking,” Gonzales said. “That might mean that it’s too soon to see some of these changes. Legalized, same-sex marriage is a fairly recent phenomenon in the United States.”
The next step is to analyze more comprehensive data to see whether they are able to uncover other health impacts related to marriage.
Study suggests that more research is needed
“If not, this suggests that same-sex marriage laws are not enough to positively impact the health of LGBT people,” said Gonzales. “There is still a lot of room for change in the policy environment to ensure the safety and well-being of these populations. But more research is needed.”
In addition to Carpenter and Gonzales, the study team includes co-investigators Tara McKay, assistant professor of medicine, health and society, and Samuel Eppink, Ph.D. candidate in economics at Vanderbilt University. The team received extensive feedback on the study from the Vanderbilt LGBT Policy Lab. Carpenter directs the Lab. They were supported under the Trans-Institutional Programs program as part of the Vanderbilt University Academic Strategic Plan.
The study was also supported by a $400,000 grant from the Robert Wood Johnson Foundation to Vanderbilt University. It was used to analyze the health impacts of recent laws and public policies affecting LGBT individuals. It also studied local economic and business outcomes.