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Health Insurance Coverage and Access to Care by Sexual Orientation and Marital/Cohabitation Status: New Evidence from the 2015–2018 National Health Interview Survey

Author

Listed:
  • Eva Elton

    (Vanderbilt University)

  • Gilbert Gonzales

    (Vanderbilt University
    Vanderbilt University
    Vanderbilt University)

Abstract

Disparities in health insurance coverage and access to care are well documented between sexual minority adults and their heterosexual peers. Much less research has examined whether marital status affects access to care by sexual orientation identity. This study used data on nonelderly gay/lesbian adults (n = 1740), bisexual adults (n = 1138), and their heterosexual counterparts (n = 80,329) from the 2015–2018 National Health Interview Survey. Multivariable logistic regression models estimated the differences in health insurance status and access to care between married and cohabiting adults to single adults by sexual orientation. Compared to single adults, married adults were more likely to have private health insurance and less likely to have public health insurance regardless of sexual orientation. Married heterosexual and gay/lesbian adults were more likely to have a usual source of care and less likely to experience delayed or unmet medical care and mental health care due to cost compared to their single counterparts. We found fewer statistically significant differences between married and single bisexual adults and between married and cohabiting adults of all sexual orientations. Our study demonstrates that married gay, lesbian, and bisexual adults are more likely to have private health insurance and fewer financial barriers to care compared to their single counterparts. Given the recent recognition of legal same-sex marriage for sexual minorities, much more research is needed to document if and how marriage affects access to care and health outcomes by sexual orientation.

Suggested Citation

  • 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.
    • Handle: RePEc:kap:poprpr:v:41:y:2022:i:2:d:10.1007_s11113-021-09670-7
    DOI: 10.1007/s11113-021-09670-7
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    References listed on IDEAS

    as
    1. Christopher S. Carpenter & Samuel T. Eppink, 2017. "Does It Get Better? Recent Estimates of Sexual Orientation and Earnings in the United States," Southern Economic Journal, John Wiley & Sons, vol. 84(2), pages 426-441, October.
    2. J Whitehead & John Shaver & Rob Stephenson, 2016. "Outness, Stigma, and Primary Health Care Utilization among Rural LGBT Populations," PLOS ONE, Public Library of Science, vol. 11(1), pages 1-17, January.
    3. Umberson, Debra, 1992. "Gender, marital status and the social control of health behavior," Social Science & Medicine, Elsevier, vol. 34(8), pages 907-917, April.
    4. repec:mpr:mprres:5511 is not listed on IDEAS
    5. Dahlhamer, J.M. & Galinsky, A.M. & Joestl, S.S. & Ward, B.W., 2016. "Barriers to health care among adults identifying as sexual minorities: A US national study," American Journal of Public Health, American Public Health Association, vol. 106(6), pages 1116-1122.
    6. Christopher Carpenter & Samuel T. Eppink & Gilbert Gonzales Jr. & Tara McKay, 2018. "Effects of Access to Legal Same-Sex Marriage on Marriage and Health: Evidence from BRFSS," NBER Working Papers 24651, National Bureau of Economic Research, Inc.
    7. Robert G. Wood & Brian Goesling & Sarah Avellar, "undated". "The Effects of Marriage on Health: A Synthesis of Recent Research Evidence," Mathematica Policy Research Reports d69bf47785bc4154a4e184aa5, Mathematica Policy Research.
    8. repec:mpr:mprres:5512 is not listed on IDEAS
    9. Iwashyna, Theodore J. & Christakis, Nicholas A., 2003. "Marriage, widowhood, and health-care use," Social Science & Medicine, Elsevier, vol. 57(11), pages 2137-2147, December.
    10. 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.
    11. Sabin, J.A. & Riskind, R.G. & Nosek, B.A., 2015. "Health care providers' implicit and explicit attitudes toward lesbian women and gay men," American Journal of Public Health, American Public Health Association, vol. 105(9), pages 1831-1841.
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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. Michael E. Martell & Leanne Roncolato, 2023. "Economic Vulnerability of Sexual Minorities: Evidence from the US Household Pulse Survey," Population Research and Policy Review, Springer;Southern Demographic Association (SDA), vol. 42(2), pages 1-74, April.

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