Trends in Health Care Access/Experiences: Differential Gains across Sexuality and Sex Intersections before and after Marriage Equality

Rodman E. Turpin, Natasha D. Williams, Ellesse-Roselee L. Akré, Bradley O. Boekeloo and Jessica N. Fish
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Rodman E. Turpin: Department of Epidemiology and Biostatistics, School of Public Health, University of Maryland, College Park, MD 20742, USA
Natasha D. Williams: Department of Family Science, School of Public Health, University of Maryland, College Park, MD 20742, USA
Ellesse-Roselee L. Akré: The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, Dartmouth College, Hanover, NH 03755, USA
Bradley O. Boekeloo: Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park, MD 20742, USA
Jessica N. Fish: Department of Family Science, School of Public Health, University of Maryland, College Park, MD 20742, USA

IJERPH, 2022, vol. 19, issue 9, 1-11

Abstract: Background: Sexual minority adults experience several health care access inequities compared to their heterosexual peers; such inequities may be affected by LGBTQ+ legislation, such as the 2015 national marriage equality ruling. Methods: Using population-based data ( n = 28,463) from the Association of American Medical Colleges biannual Consumer Survey of Health Care Access, we calculated trend ratios (TR) for indicators of health care access (e.g., insurance coverage, delaying or forgoing care due to cost) and satisfaction (e.g., general satisfaction, being mistreated due to sexual orientation) from 2013 to 2018 across sexuality and sex. We also tested for changes in trends related to the 2015 marriage equality ruling using interrupted time series trend interactions (TRInt). Results: The largest increases in access were observed in gay men (TR = 2.42, 95% CI 1.28, 4.57). Bisexual men had decreases in access over this period (TR = 0.47, 95% CI 0.22, 0.99). Only gay men had a significant increase in the health care access trend after U.S. national marriage equality (TRInt = 5.59, 95% CI 2.00, 9.18), while other sexual minority groups did not. Conclusions: We found that trends in health care access and satisfaction varied significantly across sexualities and sex. Our findings highlight important disparities in how federal marriage equality has benefited sexual minority groups.

Keywords: LGBT; healthcare; national; barriers; services; time series (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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