Same-Sex Marriage Laws Reduce Doctor Visits and Health Care Costs

Gay men lead healthier, less stress-filled lives when states offer legal protections to same-sex couples, according to a new study examining the effects of the legalization of same-sex marriage in Massachusetts. The study, “Effect of Same-Sex Marriage Laws on Health Care Use and Expenditures in Sexual Minority Men: A Quasi-Natural Experiment,” is online in the American Journal of Public Health.

“Our results suggest that removing barriers to marriage improves the health of gay and bisexual men,” said Mark L. Hatzenbuehler, PhD, lead author of the study and a Robert Wood Johnson Foundation Health & Society Scholar at the Mailman School. It also saves money in healthcare costs.

In the 12 months following the 2003 legalization of same-sex marriage in Massachusetts, gay and bisexual men had a significant decrease in medical care visits, mental healthcare visits, and mental healthcare costs, compared with the 12 months before the law change. This amounted to a 13% reduction in healthcare visits and a 14% reduction in healthcare costs. These health effects were similar for partnered and single gay men.

Among HIV-positive men, there was no reduction in HIV-related visits, suggesting that those in need of HIV/AIDS care continued to seek needed healthcare services.

For the study, researchers surveyed 1,211 patients from a large, community-based health clinic in Massachusetts that focuses on serving sexual minorities. Examining the clinic's billing records in the wake of the approval of Massachusetts' same-sex marriage law, researchers found a reduction in hypertension, depression, and adjustment disorders—all conditions associated with stress.

“These findings suggest that marriage equality may produce broad public health benefits by reducing the occurrence of stress-related health conditions in gay and bisexual men,” Dr. Hatzenbuehler said.

Previous studies have documented that excluding lesbian, gay, and bisexual individuals from marriage has a stressful impact on this population. Dr. Hatzenbuehler's study is the first study to examine whether same-sex marriage policies influence healthcare use and healthcare expenditures among sexual minorities. Lesbians were not included in the survey due to insufficient sample size among the patients who visit the clinic.

“This research makes important contributions to a growing body of evidence on the social, economic, and health benefits of marriage equality,” Dr. Hatzenbuehler said.

The research  was supported by the Fenway Institute, the Eunice Shriver National Institute of Child Health and Human Development, and the Robert Wood Johnson Foundation Health and Society Scholars program.*

* The research findings presented here are those of the researcher and are not necessarily the views of the Robert Wood Johnson Foundation.