Same-sex cohabitors less healthy than those in heterosexual marriages, study suggests

"Past research has shown that married people are generally healthier than unmarried people," said Hui Liu, lead author of the study and an assistant professor of sociology at Michigan State University. "Although our study did not specifically test the health consequences of legalizing same-sex marriage, it's very plausible that legalization of gay marriage would reduce health disparities between same-sex cohabitors and married heterosexuals."

The study, which appears in the March issue of the Journal of Health and Social Behavior, compares the self-rated health of 1,659 same-sex cohabiting men and 1,634 same-sex cohabiting women with that of their different-sex married, different-sex cohabiting, unpartnered divorced, widowed, and never-married counterparts. The study of white, black, and Hispanic 18 to 65-year-olds used pooled, nationally representative data from the 1997 to 2009 National Health Interview Surveys (NHIS). NHIS respondents rated their overall health as excellent, very good, good, fair, or poor. As part of their study, Liu and her co-authors, Corinne Reczek, an assistant professor of sociology at the University of Cincinnati, and Dustin Brown, a doctoral candidate in the Department of Sociology and the Population Research Center at the University of Texas at Austin, divided the respondents into two groups: those who reported excellent, very good, or good overall health and those who reported fair or poor overall health.

"When we controlled for socioeconomic status, the odds of reporting poor or fair health were about 61 percent higher for same-sex cohabiting men than for men in heterosexual marriages and the odds of reporting poor or fair health were about 46 percent higher for same-sex cohabiting women than for women in heterosexual marriages," Liu said.

As for why same-sex cohabitors reported worse health than people of the same socioeconomic status in heterosexual marriages, Liu said there could be several reasons. "Research consistently suggests that 'out' sexual minorities experience heightened levels of stress and higher levels of discrimination, and these experiences may adversely affect the health of this population," Liu said. "It may also be that same-sex cohabitation does not provide the same psychosocial, socioeconomic, and institutional resources that come with legal marriage, factors that are theorized to be responsible for many of the health benefits of marriage."

According to the researchers, it is possible that providing same-sex cohabitors the option to marry would boost their measures of self-rated health because they would experience higher levels of acceptance and lower levels of stigma. "Legalizing same-sex marriage could also provide other advantages often associated with heterosexual marriage -- such as partner health insurance benefits and the ability to file joint tax returns -- that may directly and indirectly influence the health of individuals in same-sex unions," Liu said.

The researchers also found that same-sex cohabitors reported better health than their different-sex cohabiting and single counterparts, but these differences were fully explained by socioeconomic status. "Without their socioeconomic status advantages, same-sex cohabitors would generally report similar levels of health as their divorced, widowed, never-married, and different-sex cohabiting counterparts," Liu said.

Interestingly, the study suggests that the pattern of poorer self-rated health of same-sex cohabitors in comparison with those in heterosexual marriages does not vary by gender and race-ethnicity. In contrast, results comparing same-sex cohabitors with different-sex cohabiting and single women, but not men, revealed important racial-ethnic patterns. "After we controlled for socioeconomic status, black women in same-sex cohabiting relationships reported worse health than black women of any other non-married union status, while white women in same-sex cohabiting relationships actually reported better health than both white women in different-sex cohabiting relationships and divorced white women," said Liu, who explained that black women in same-sex cohabiting relationships may experience significant social discrimination and homophobia, and such stressors may shape their health in especially detrimental ways.