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Structural stigma and sexual orientation disparities in healthcare use: Evidence from Australian Census-linked-administrative data

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  • Saxby, Karinna
  • de New, Sonja C.
  • Petrie, Dennis

Abstract

This study explores the extent to which structural stigma (which encompasses sociocultural and institutional constraining factors) is associated with sexual orientation disparities in healthcare service and prescription medicine use. Using the responses to the 2017 Australian Marriage Law Postal Survey, we use the regional percentage of votes against legalising same-sex marriage as a measure of structural stigma. We then map these results to Census-linked-administrative data, including 83,519 individuals in same-sex relationships – one of the largest administrative datasets to date where individuals in same-sex relationships are identified. Controlling for regional and individual-level confounders, we find that structural stigma is associated with increased use of nervous system medications (which largely comprise antidepressants) but reduced GP visits for both females and males in same-sex relationships. More regional stigma is also associated with reduced use of pathology services and anti-infective prescriptions for males in same-sex relationships. Altogether, our results suggest that individuals in same-sex relationships living in stigmatised regions are in poorer health but are less likely to access primary healthcare.

Suggested Citation

  • Saxby, Karinna & de New, Sonja C. & Petrie, Dennis, 2020. "Structural stigma and sexual orientation disparities in healthcare use: Evidence from Australian Census-linked-administrative data," Social Science & Medicine, Elsevier, vol. 255(C).
    • Handle: RePEc:eee:socmed:v:255:y:2020:i:c:s027795362030246x
    DOI: 10.1016/j.socscimed.2020.113027
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    1. Sean Urwin & Thomas Mason & William Whittaker, 2021. "Do different means of recording sexual orientation affect its relationship with health and wellbeing?," Health Economics, John Wiley & Sons, Ltd., vol. 30(12), pages 3106-3122, December.
    2. Yazbeck M & Xu H & Azocar F & Ettner SL, 2020. "Spousal Peer Effects in Specialty Behavioral Health Services Use: Do Spillovers Vary by Gender, Subscriber Status and Sexual Orientation?," Discussion Papers Series 630, School of Economics, University of Queensland, Australia.
    3. Karinna Saxby, 2022. "Australia's LGBTIQ Research Data Landscape," Australian Economic Review, The University of Melbourne, Melbourne Institute of Applied Economic and Social Research, vol. 55(2), pages 290-308, June.
    4. Samia Badji & Anne Kavanagh & Dennis Petrie, 2023. "The impact of Disability Insurance reassessment on healthcare use," Health Economics, John Wiley & Sons, Ltd., vol. 32(7), pages 1581-1602, July.
    5. Peter Butterworth & Sonja C. de New & Chris Schilling & Karinna Saxby & Dennis Petrie & Clement Wong, 2021. "Dynamics of Mental Health and Healthcare Use among Children and Young Adults," Australian Economic Review, The University of Melbourne, Melbourne Institute of Applied Economic and Social Research, vol. 54(1), pages 130-142, March.

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