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National and state-specific health insurance disparities for adults in same-sex relationships

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  • Gonzales, G.
  • Blewett, L.A.

Abstract

Objectives. We examined national and state-specific disparities in health insurance coverage, specifically employer-sponsored insurance (ESI) coverage, for adults in same-sex relationships. Methods. We used data from the American Community Survey to identify adults (aged 25-64 years) in same-sex relationships (n = 31 947), married opposite-sex relationships (n = 3 060 711), and unmarried opposite-sex relationships (n = 259 147). We estimated multinomial logistic regression models and state-specific relative differences in ESI coverage with predictive margins. Results. Men and women in same-sex relationships were less likely to have ESI than were their married counterparts in opposite-sex relationships. We found ESI disparities among adults in same-sex relationships in every region, but we found the largest ESI gaps for men in the South and for women in the Midwest. ESI disparities were narrower in states that had extended legal same-sex marriage, civil unions, and broad domestic partnerships. Conclusions. Men and women in same-sex relationships experience disparities in health insurance coverage across the country, but residing in a state that recognizes legal same-sex marriage, civil unions, or broad domestic partnerships may improve access to ESI for same-sex spouses and domestic partners.

Suggested Citation

  • Gonzales, G. & Blewett, L.A., 2014. "National and state-specific health insurance disparities for adults in same-sex relationships," American Journal of Public Health, American Public Health Association, vol. 104(2), pages 95-104.
    • Handle: RePEc:aph:ajpbhl:10.2105/ajph.2013.301577_7
    DOI: 10.2105/AJPH.2013.301577
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    Citations

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    Cited by:

    1. Cameron Deal & Shea Greenberg & Gilbert Gonzales, 2024. "Sexual identity, poverty, and utilization of government services," Journal of Population Economics, Springer;European Society for Population Economics, vol. 37(2), pages 1-31, June.
    2. Carpenter, Christopher S. & Gonzales, Gilbert & McKay, Tara & Sansone, Dario, 2020. "Effects of the Affordable Care Act Dependent Coverage Mandate on Health Insurance Coverage for Individuals in Same-Sex Couples," IZA Discussion Papers 13119, Institute of Labor Economics (IZA).
    3. Anup Srivastav & Alissa O’Halloran & Peng-Jun Lu & Walter W Williams & Sonja S Hutchins, 2019. "Vaccination differences among U.S. adults by their self-identified sexual orientation, National Health Interview Survey, 2013–2015," PLOS ONE, Public Library of Science, vol. 14(3), pages 1-21, March.
    4. Russell Spiker, 2021. "Same-Sex, Same Health? Health Concordance Among Same-Sex and Different-Sex Couples," Population Research and Policy Review, Springer;Southern Demographic Association (SDA), vol. 40(6), pages 1313-1340, December.
    5. Carpenter, Christopher S. & Sansone, Dario, 2021. "Cigarette taxes and smoking among sexual minority adults," Journal of Health Economics, Elsevier, vol. 79(C).
    6. Subica, Andrew M. & Link, Bruce G., 2022. "Cultural trauma as a fundamental cause of health disparities," Social Science & Medicine, Elsevier, vol. 292(C).
    7. Diederik Boertien & Daniele Vignoli, 2019. "Legalizing Same-Sex Marriage Matters for the Subjective Well-being of Individuals in Same-Sex Unions," Demography, Springer;Population Association of America (PAA), vol. 56(6), pages 2109-2121, December.
    8. Elliott Isaac, 2018. "Suddenly Married: Joint Taxation And The Labor Supply Of Same-Sex Married Couples After U.S. v. Windsor," Working Papers 1809, Tulane University, Department of Economics.
    9. Eva Elton & Gilbert Gonzales, 2022. "Health Insurance Coverage and Access to Care by Sexual Orientation and Marital/Cohabitation Status: New Evidence from the 2015–2018 National Health Interview Survey," Population Research and Policy Review, Springer;Southern Demographic Association (SDA), vol. 41(2), pages 479-493, April.
    10. Gilbert Gonzales & Jesse M. Ehrenfeld, 2018. "The Association between State Policy Environments and Self-Rated Health Disparities for Sexual Minorities in the United States," IJERPH, MDPI, vol. 15(6), pages 1-11, June.

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