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

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, samesex 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 Z3 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.