Self-rated health at the intersection of sexual identity and union status
Section snippets
Previous research on sexual minority health across union status
A small but growing body of research has begun to examine whether union status gradients occur across sexual minority populations as they do across the general population. A handful of recent national, population-based studies show that same-sex cohabitors experience similar self-rated health when compared to the different-sex cohabiting and disadvantaged health relative to the different-sex married (Boehmer, 2002, Denney et al., 2013, Liu et al., 2013). In addition, recent research from
Socioeconomic status
Fundamental cause theory suggests that socioeconomic status is a key factor linking union status and health (Link and Phelan, 1995, Light, 2004). According to fundamental cause theory, the health disparities of gay and lesbian individuals are due, in part, to social stigma and historically unequal access to legal and institutional benefits of marriage that contribute to socioeconomic disadvantage; socioeconomic disadvantage is in turn associated with increased stress, psychological distress,
Gender
The relationship between union status and health is strongly gendered (Liu et al., 2013, Light, 2004), although this appears less true today than it has been over the past 25 years as the health advantage to marriage has diminished among men (Liu and Umberson, 2008). Straight men benefit more clearly from the social and emotional support mechanisms found in marriage, as well as via women's social control of their health (Umberson, 1987, Umberson, 1992). Some research shows that lesbians appear
Methods
We used the most recently released data from the pooled 2013–2014 Integrated National Health Interview Survey (NHIS) (Minnesota Population Center, 2013). This data set presents a unique opportunity to explore the intersection of sexual identity and union status (i.e., “sexual partnership status”) at the population level. The NHIS is a cross-sectional household survey conducted annually in the United States by the National Center for Health Statistics (NCHS); it is representative of the United
Descriptive results
Table 1 shows descriptive statistics of all analyzed variables by union status. Due to space limitation, our discussion is focused on self-rated health. Descriptive results in Table 1 suggest that the straight never-married (8.3%) are the group least likely to report poor/fair health, followed by straight married (9.6%), straight cohabiting (11.3%), gay/lesbian cohabiting (12.5%), gay/lesbian married (12.8%), gay/lesbian never-married (13.3%), and gay/lesbian previously-married (19.0%).
Discussion
There are clear sexual identity gradients in health, wherein gays and lesbians experience worse health than heterosexual individuals (Institute of Medicine (IOM), 2011, Cochran and Mays, 2007), and robust union status gradients in health wherein the married experience advantaged health over unmarried (Liu and Reczek, 2012). We merge these two research areas to explore self-rated health disparity at the intersection of sexual identity and union status. In doing so we add to the scientific
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