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APHA Scientific Session and Event Listing

Ian V. Maki, MPH¹, William E. Lafferty, MD¹, Annette L. Fitzpatrick, PhD, MA², and Donald L. Patrick, PhD, MSPH³. (1) Department of Health Services, University of Washington, P O Box 357660, Seattle, WA 98195-7660, 206-543-6020, ianmaki@u.washington.edu, (2) Department of Epidemiology, University of Washington, Box 354922, Seattle, WA 98195-4922, (3) Center for Disability Policy & Research, Seattle Quality of Life Group, University of Washington, 146 North Canal Street, Box 358652, # 313, Seattle, WA 98103-8652

Objectives: To investigate population demographic, social determinants of health, and health outcome differences between the nineteen US states that have passed constitutional amendments prohibiting same-sex marriage, and the 31 states that have not passed such bans. Design: An ecological study based upon the population health model of Evans and Stoddart. Methods: State aggregate data from the US Census, CDC and the Kaiser Family Foundation were evaluated by means testing, chi-square analysis and logistic regression. Results: The population of the bans states were significantly more likely to be younger (34.73 v. 36.03 years, p=.02) and have a higher percentage of males (48.79% v. 48.26%, p=.05). People in the ban states had statistically significantly lower household incomes ($41,370 v. $45,940, p=0.01) and were less likely to be college educated (27.78% v. 31.31% p=0.01). They were also more likely to be obese (23.37% v. 21.92%, p=0.04), less likely to report excellent health (20.85% v. 22.35%, p=0.02) and had higher teen birth rates (46.26 v. 38.91 per 1,000,p=0.02). Chi-square analysis indicated the population of the ban states were 42% more likely to fall below the 50 state mean in at least one health indicator. Logistic regression, adjusted for demographic variables, disclosed significant associations between income, education, smoking rates, obesity, excellent health, teen male gonorrhea and ban status. Conclusion: Bans on gay marriage may be associated with poor population health. Future studies should explore mechanisms linking poor population health and constitutional bans on same-sex marriage.

Learning Objectives: At the conclusion of the session, the participant in this session will be able to

• Describe demographic, social determinant of health and health outcome variable differences that are associated with same-sex marriage bans in the US.
• Discuss the relationship between GLBT health and same-sex marriage.
• Articulate possible relationships between poor population health and same-sex marriage bans.

Keywords: Health Disparities, Social Inequalities

Presenting author's disclosure statement:

Not Answered