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Health Care Use, Health Behaviors, and Medical Conditions Among Individuals in Same-Sex and Opposite-Sex Partnerships

A Cross-Sectional Observational Analysis of the Medical Expenditures Panel Survey (MEPS), 2003–2011

Blosnich, John R., PhD, MPH; Hanmer, Janel, MD, PhD; Yu, Lan, PhD; Matthews, Derrick D., PhD, MPH; Kavalieratos, Dio, PhD

doi: 10.1097/MLR.0000000000000529
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Background: Prior research documents disparities between sexual minority and nonsexual minority individuals regarding health behaviors and health services utilization. However, little is known regarding differences in the prevalence of medical conditions.

Objectives: To examine associations between sexual minority status and medical conditions.

Research Design: We conducted multiple logistic regression analyses of the Medical Expenditure Panel Survey (2003–2011). We identified individuals who reported being partnered with an individual of the same sex, and constructed a matched cohort of individuals in opposite-sex partnerships.

Subjects: A total of 494 individuals in same-sex partnerships and 494 individuals in opposite-sex partnerships.

Measures: Measures of health risk (eg, smoking status), health services utilization (eg, physician office visits), and presence of 15 medical conditions (eg, cancer, diabetes, arthritis, HIV, alcohol disorders).

Results: Same-sex partnered men had nearly 4 times the odds of reporting a mood disorder than did opposite-sex partnered men [adjusted odds ratio (aOR)=3.96; 95% confidence interval (CI), 1.85–8.48]. Compared with opposite-sex partnered women, same-sex partnered women had greater odds of heart disease (aOR=2.59; 95% CI, 1.19–5.62), diabetes (aOR=2.75; 95% CI, 1.10–6.90), obesity (aOR=1.92; 95% CI, 1.26–2.94), high cholesterol (aOR=1.89; 95% CI, 1.03–3.50), and asthma (aOR=1.90; 95% CI, 1.02–1.19). Even after adjusting for sociodemographics, health risk behaviors, and health conditions, individuals in same-sex partnerships had 67% increased odds of past-year emergency department utilization and 51% greater odds of ≥3 physician visits in the last year compared with opposite-sex partnered individuals.

Conclusions: A combination of individual-level, provider-level, and system-level approaches are needed to reduce disparities in medical conditions and health care utilization among sexual minority individuals.

*Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System

Department of Behavioral and Community Health Sciences, Graduate School of Public Health

Division of General Internal Medicine, School of Medicine

§Department of Infectious Diseases and Microbiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA

Supported by a postdoctoral fellowship to J.R.B. through the Department of Veterans Affairs (VA) Office of Academic Affiliations and the Center for Health Equity Research and Promotion at the VA Pittsburgh Healthcare System. D.D.M. was supported by the National Institute of Mental Health Training Program to Address HIV-Related Health Disparities in MSM (T32MH094174). J.H. was supported by the National Institutes of Health through Grant Number KL2 TR000146. D.K. was supported by supported by K12HS022989 from the Agency for Healthcare Research and Quality, and a Junior Faculty Career Development Award from the National Palliative Care Research Center.

The opinions expressed in this work are those of the authors and do not necessarily represent those of the funders, institutions, the Department of Veterans Affairs, National Institutes of Health, or the US Government.

The authors declare no conflict of interest.

Reprints: John R. Blosnich, PhD, MPH, Department of Veterans Affairs, VA Pittsburgh Healthcare System, Center for Health Equity Research and Promotion, University Drive C (151C-U), Building 30, Pittsburgh, PA 15240-1001. E-mail: john.blosnich@va.gov.

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