Gilbert Gonzales and Lynn A. Blewett are with the Division of Health Policy and Management and the State Health Access Data Assistance Center, School of Public Health, University of Minnesota, Minneapolis.
Am J Public Health. 2014 Feb;104(2):e95-e104. doi: 10.2105/AJPH.2013.301577. Epub 2013 Dec 12.
We examined national and state-specific disparities in health insurance coverage, specifically employer-sponsored insurance (ESI) coverage, for adults in same-sex relationships.
We used data from the American Community Survey to identify adults (aged 25-64 years) in same-sex relationships (n = 31,947), married opposite-sex relationships (n = 3,060,711), and unmarried opposite-sex relationships (n = 259,147). We estimated multinomial logistic regression models and state-specific relative differences in ESI coverage with predictive margins.
Men and women in same-sex relationships were less likely to have ESI than were their married counterparts in opposite-sex relationships. We found ESI disparities among adults in same-sex relationships in every region, but we found the largest ESI gaps for men in the South and for women in the Midwest. ESI disparities were narrower in states that had extended legal same-sex marriage, civil unions, and broad domestic partnerships.
Men and women in same-sex relationships experience disparities in health insurance coverage across the country, but residing in a state that recognizes legal same-sex marriage, civil unions, or broad domestic partnerships may improve access to ESI for same-sex spouses and domestic partners.
我们研究了全国和各州在健康保险覆盖方面的差异，特别是针对同性关系成年人的雇主赞助保险（ESI）覆盖情况。
我们使用美国社区调查的数据，确定了处于同性关系（n=31947 人）、已婚异性关系（n=3060711 人）和未婚异性关系（n=259147 人）的成年人（年龄在 25-64 岁之间）。我们使用预测边际估计了多变量逻辑回归模型和各州 ESI 覆盖的特定相对差异。
与已婚异性关系中的对应者相比，同性关系中的男性和女性获得 ESI 的可能性较低。我们在每个地区都发现了同性关系成年人的 ESI 差距，但在南部地区的男性和中西部地区的女性中，发现了最大的 ESI 差距。在承认合法同性婚姻、民事结合和广泛的国内伙伴关系的州，ESI 差距较小。
全国范围内，同性关系中的男性和女性在健康保险覆盖方面存在差异，但居住在承认合法同性婚姻、民事结合或广泛国内伙伴关系的州，可能会改善同性配偶和国内伙伴获得 ESI 的机会。
