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Effect of same-sex marriage laws on health care use and expenditures in sexual minority men: A quasi-natural experiment

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  • Hatzenbuehler, M.L.
  • O'Cleirigh, C.
  • Grasso, C.
  • Mayer, K.
  • Safren, S.
  • Bradford, J.

Abstract

Objectives. We sought to determine whether health care use and expenditures among gay and bisexual men were reduced following the enactment of samesex marriage laws in Massachusetts in 2003. Methods. We used quasi-experimental, prospective data from 1211 sexual minority male patients in a community-based health center in Massachusetts. Results. In the 12 months after the legalization of same-sex marriage, sexual minority men had a statistically significant decrease in medical care visits (mean= 5.00 vs mean=4.67; P=.05; Cohen's d=0.17), mental health care visits (mean= 24.72 vs mean= 22.20; P=.03; Cohen's d=0.35), and mental health care costs (mean= $2442.28 vs mean= $2137.38; P= .01; Cohen's d=0.41), compared with the 12 months before the law change. These effects were not modified by partnership status, indicating that the health effect of same-sex marriage laws was similar for partnered and nonpartnered men. Conclusions. Policies that confer protections to same-sex couples may be effective in reducing health care use and costs among sexual minority men.

Suggested Citation

  • Hatzenbuehler, M.L. & O'Cleirigh, C. & Grasso, C. & Mayer, K. & Safren, S. & Bradford, J., 2012. "Effect of same-sex marriage laws on health care use and expenditures in sexual minority men: A quasi-natural experiment," American Journal of Public Health, American Public Health Association, vol. 102(2), pages 285-291.
    • Handle: RePEc:aph:ajpbhl:10.2105/ajph.2011.300382_2
    DOI: 10.2105/AJPH.2011.300382
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    1. Shuai Chen & Jan C. van Ours, 2022. "Mental health effects of same‐sex marriage legalization," Health Economics, John Wiley & Sons, Ltd., vol. 31(1), pages 42-56, January.
    2. Cheng-Fang Yen & Nai-Ying Ko & Yu-Te Huang & Mu-Hong Chen & I-Hsuan Lin & Wei-Hsin Lu, 2020. "Preference about Laws for the Legal Recognition of Same-Sex Relationships in Taiwanese People Before and After Same-Sex Marriage Referenda: A Facebook Survey Study," IJERPH, MDPI, vol. 17(6), pages 1-18, March.
    3. Huang-Chi Lin & Yi-Lung Chen & Nai-Ying Ko & Yu-Ping Chang & Wei-Hsin Lu & Cheng-Fang Yen, 2020. "Impacts of Public Debates on Legalizing the Same-Sex Relationships on People’s Daily Lives and Their Related Factors in Taiwan," IJERPH, MDPI, vol. 17(22), pages 1-12, November.
    4. Dimitrios Nikolaou, 2023. "Effects of marriage equality legislation on sexual health of the US population," Health Economics, John Wiley & Sons, Ltd., vol. 32(1), pages 107-133, January.
    5. Sansone, Dario, 2019. "Pink work: Same-sex marriage, employment and discrimination," Journal of Public Economics, Elsevier, vol. 180(C).
    6. Hswen, Yulin & Qin, Qiuyuan & Williams, David R. & Viswanath, K. & Brownstein, John S. & Subramanian, S.V., 2020. "The relationship between Jim Crow laws and social capital from 1997–2014: A 3-level multilevel hierarchical analysis across time, county and state," Social Science & Medicine, Elsevier, vol. 262(C).
    7. Marcén, Miriam & Morales, Marina, 2019. "The effect of same-sex marriage legalization on interstate migration in the United States," GLO Discussion Paper Series 435, Global Labor Organization (GLO).
    8. Drydakis, Nick, 2021. "Social Rejection, Family Acceptance, Economic Recession and Physical and Mental Health of Sexual Minorities," GLO Discussion Paper Series 936, Global Labor Organization (GLO).
    9. 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).
    10. Christopher S. Carpenter, 2020. "The Direct Effects of Legal Same-Sex Marriage in the United States: Evidence From Massachusetts," Demography, Springer;Population Association of America (PAA), vol. 57(5), pages 1787-1808, October.
    11. Amy Farmer & Andrew W. Horowitz, 2015. "Same‐sex relationship escalation with uncertain marriage legality: Theory and empirical implications," Southern Economic Journal, John Wiley & Sons, vol. 81(4), pages 995-1011, April.
    12. Anderson, D. Mark & Matsuzawa, Kyutaro & Sabia, Joseph J., 2019. "Marriage Equality Laws and Youth Mental Health," IZA Discussion Papers 12819, Institute of Labor Economics (IZA).
    13. Christopher S. Carpenter & Samuel T. Eppink & Gilbert Gonzales & Tara McKay, 2021. "Effects of Access to Legal Same‐Sex Marriage on Marriage and Health," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 40(2), pages 376-411, March.
    14. Nai-Ying Ko & I-Hsuan Lin & Yu-Te Huang & Mu-Hong Chen & Wei-Hsin Lu & Cheng-Fang Yen, 2020. "Associations of Perceived Socially Unfavorable Attitudes toward Homosexuality and Same-Sex Marriage with Suicidal Ideation in Taiwanese People before and after Same-Sex Marriage Referendums," IJERPH, MDPI, vol. 17(3), pages 1-15, February.
    15. 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.
    16. Michael Earhart & E. Frank Stephenson, 2018. "Same-sex marriage legalization and wedding tourism: evidence from Charleston and Savannah," Journal of Economics and Finance, Springer;Academy of Economics and Finance, vol. 42(3), pages 566-574, July.
    17. Miriam Marcén & Marina Morales, 2022. "The effect of same-sex marriage legalization on interstate migration in the USA," Journal of Population Economics, Springer;European Society for Population Economics, vol. 35(2), pages 441-469, April.
    18. Bai Liu & Shuyan Guo & Bin Ding, 2020. "Technical Blossom in Medical Care: The Influence of Big Data Platform on Medical Innovation," IJERPH, MDPI, vol. 17(2), pages 1-17, January.
    19. Sugiyama, Yuri, 2022. "Can Soft Law Improve the Welfare of Sexual Minorities? The Case of Same-sex Partnership Policy in Japan," CEI Working Paper Series 2022-06, Center for Economic Institutions, Institute of Economic Research, Hitotsubashi University.
    20. Solazzo, Alexa & Brown, Tony N. & Gorman, Bridget K., 2018. "State-level climate, anti-discrimination law, and sexual minority health status: An ecological study," Social Science & Medicine, Elsevier, vol. 196(C), pages 158-165.
    21. 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.
    22. Everett, Bethany G. & Hatzenbuehler, Mark L. & Hughes, Tonda L., 2016. "The impact of civil union legislation on minority stress, depression, and hazardous drinking in a diverse sample of sexual-minority women: A quasi-natural experiment," Social Science & Medicine, Elsevier, vol. 169(C), pages 180-190.
    23. Cook, Jonathan E. & Purdie-Vaughns, Valerie & Meyer, Ilan H. & Busch, Justin T.A., 2014. "Intervening within and across levels: A multilevel approach to stigma and public health," Social Science & Medicine, Elsevier, vol. 103(C), pages 101-109.
    24. 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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