For a Healthier America, Demand Marriage Equality


Reducing health disparities is a moral imperative.  The $2.3 trillion dollars spent every year on health care in the U.S. makes it a financial imperative, as well. One way to improve the health of our nation, reduce health disparities, and save precious health care dollars is to allow same sex marriage throughout the United States. In the interest of the public health, we call for repealing the Defense of Marriage Act (DOMA) and re-defining the federal definition of marriage as a legal union between two consenting adults.

Health professionals recognize the link between same sex marriage and health. The American Medical Association, the largest organization of US physicians, recently made it their official policy to promote marriage equality because bans on same-sex marriage contribute to health care disparities for LGBT Americans and their children.  The American Academy of Pediatrics adopted a similar stand because children fair better when their parents are permitted the 1138 rights afforded by civil marriage.  The American Psychological Association has long argued for marriage equality because denying marriage to American citizens undercuts their mental health.

The data on marriage is clear: married people live longer, happier and healthier lives.  Individuals denied marriage rights are less likely to afford health coverage, more likely to incur severe illness when hospitalized, and more likely to need costlier care.  That said, because same sex marriage is only permitted in 5 states (and the District of Columbia) and explicitly banned in 39 states, many individuals are denied the opportunity to realize the benefits of married life.

As public health advocates, it is our responsibility to improve the health of all citizens and to work towards the elimination of state sanctioned health disparities.  For the health of our nation, we demand the repeal of DOMA and the sanctioning of same sex marriage.


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8 Responses to “For a Healthier America, Demand Marriage Equality”

  1. aliceytsai Says:

    Although I agree that marriage may help to reduce health disparity, I don’t believe that granting marriage to same-sex couples could solve the problem. I feel that a lot of health issues have also stemmed from domestic violence of couples and children as victims of divorcing parents, which occur commonly in heterosexual marriage. However, the benefits that come with marriage should be equally granted for homosexual couples in the form of a civil union. Unfortunately, some states in American are just way too conservative to even taking that into consideration because the potential threats in opening doors for further same-sex marriage advocacy. As public health professionals and under the current circumstance, I believe that we should focus more on equal access to health care in reducing health disparity than get involved with same-sex marriage as a civil rights issue. Moreover, if we have yet to resolve issues that rise from heterosexual marriage, how confident are we in resolving potential issues from homosexual marriage in the future?

  2. David Auerbach Says:

    I guess I am old fashioned. I have no problem allowing some type of financial parity between same sex couples, allowing them tax breaks, mandating that insurance and pensions treat them on an equal basis as married couples, etc. However, legally mandating that they be considered married is, to me, ludicrous. Marriage has historically been between a man and a women, and I cannot consider it otherwise. Also, much of the argument n this blog is related to research done on traditionally married couples. There is absolutely no way to generalize this to same sex marriages, which, even if going by the same name, is a significantly different situation.

  3. Paulencia Morris Says:

    I think this is an interesting perspective not often looked at when the same sex marriage issue arises over and over again. It is definitely important as Public Health professionals to advocate for the health rights of all individuals and I think that this area is one which should be researched even further. It would be good to see studies done of the health of same sex married couples with equal rights, versus the health status of same sex married couples who are denied rights. If these studies are done and research shows that what you are proposing is true then this could most definitely build the case for those who are striving to get equal rights who are denied them based on sexual preference. Another thing to thing about, since many people consider the union between man and a woman, “marriage” as sacred, could we not just change the terminology? And instead of fighting for equal rights for married couples would it be more “politically correct” to say for example, “legal unions”? Personally, I feel that equal rights are more important than devaluing a tradition.

  4. public good Says:

    Thank you for your comments. A few points in response:

    1. Mr. Auerbach, not long ago, it was tradition to outlaw inter-racial marriage. Just because it was tradition did not make it right, and nobody would argue today that such unions should be outlawed or distinguished as anything other than marriage. A similar cultural shift is happening in our time that challenges the state in making a fine distinction between equal treatment and equal rights.

    2. A point of clarification. The research sited is regarding BOTH same-sex AND heterosexual couples. Apologies for not siting all relevant material, but we were limited by space. We agree that the issue deserves more scholarship. A book-length analysis that might interest you, examining a recent period of nine years of same-sex marriage is: “When Gay People Get Married: What Happens When Societies Legalize Same-Sex Marriage” by M.V.Lee Badgett, 2009, NYU Press.

    3. Ms. Tsai, your argument implies that public health officials should avoid getting involved in civil rights. However, that perspective is outdated. Among many sources, you can seek information on this issue at the Center for Public Health and Human Rights at our very own Johns Hopkins Bloomberg School of Public Health. There are numerous instances where public health officials have seen fit to fight for human rights to promote public health. An example is the fight to empower women in Botswana, who are victim to HIV in outrageous numbers, in part, because they have lacked the rights to inherit property, open bank accounts and negotiate their own sexual relationships. In America, same-sex couples lack similar rights to inherit the homes they have built with their partners, make end-of-life decisions for their loved ones, or adopt the children they have raised with their partners, and these rights, statutory through civil marriage, are very much connected to their health and well-being.

  5. Deborah Dowell Says:

    Dear public good,

    Thank you for this post. I agree that marriage equality is a social justice and a public health issue. I think it is sometimes difficult for people who have always had the option of marriage to appreciate the many benefits of civil marriage that are not available to part of the population. In addition to the 1,138 federal rights and benefits cited in the post that are available only to people married to someone of the opposite gender, other privileges and financial benefits are provided to married couples by other institutions, states, and private businesses. While equal benefits are sometimes available to same-sex couples, these are not guaranteed and are often denied or only granted after protracted battles. The Defense of Marriage Act prohibits not only recognition of same-sex marriage but also the extension of any federal benefits to same-sex couples. This means that many federal employees cannot provide their partners with health insurance benefits if their partner becomes ill and is unable to work and receive health benefits from their own employer. If a partner stays home to raise a child the employee has not been able to legally adopt, they cannot provide health insurance for their partner’s children. And long term partners cannot receive social security benefits from their partner if they survive them. Yes, we could fight for these benefits one by one, and perhaps achieve them all in another lifetime. But insisting on this strategy simply because marriage between a man and a woman is how it’s always been seems unnecessarily cruel. In addition, it is important to note that overturning the Defense of Marriage Act is a prerequisite to achieving federal benefits for same sex couples, whether same-sex marriage is allowed or not.

    In addition to these practical issues, there are also less easily measured benefits of marriage. As Ted Olson (the conservative lawyer who argued successfully—for now— to overturn California’s Proposition 8) wrote (see, “At its best, [marriage] is a stable bond between two individuals who work to create a loving household and a social and economic partnership….Marriage is a civil bond in this country as well as, in some (but hardly all) cases, a religious sacrament. It is a relationship recognized by governments as providing a privileged and respected status, entitled to the state’s support and benefits. … simply because something has always been done a certain way does not mean that it must always remain that way. Otherwise we would still have segregated schools and debtors’ prisons…. [It] seems anomalous to cite “tradition” as a justification for withholding the status of marriage and thus to continue to label those relationships as less worthy, less sanctioned, or less legitimate…. When we refuse to accord this status to gays and lesbians, we discourage them from forming the same relationships we encourage for others. And we are also telling them, those who love them, and society as a whole that their relationships are less worthy, less legitimate, less permanent, and less valued. We demean their relationships and we demean them as individuals. I cannot imagine how we benefit as a society by doing so.”

    If marriage is not more than the sum of rights and benefits it accords, why bother to restrict it? And if it is more than those rights and benefits, how can denying it to a segment of the population be justified?

  6. ddowell1 Says:

    By the way, I’m not sure why a smiley face appeared in my post here. It is supposed to read “California’s Proposition Eight.”

  7. woorimoon Says:

    This is a very interesting topic for me. Same sex marriage is not even an issue in my culture(I am from East Asia) though I am sure there are many homosexual population there too. Regarding the same sex marrage issue, many other critical factors such as culture, social, religious and political issues are involved. However, I did not think about health equity problem related to same sex marriage and I believe many citizens are not familial with public health perspective as I was. I want to clarify if supporting healthcare for same sex marriage means supporting same sex marriage, too; and I believe it is not. Although many people agree with protecting human rights for the minorities whoever they are, that does not necessarily mean people support their identity or social character. For example, although I worked for North Korea people’s human rights and health protection, I do not believe communism which NK people believe.

    So, health problem should be independent from other factors related to issue. This principle needs to be adapted for this issue too.

    Thank you!

  8. reyneriosepelanoymd Says:

    As a public health advocate, I have to admit, I have never made the connection between marriage equality and better health until this article. My many thanks to publicgood for illustrating the evidence supporting this connection. Your article is a breath of fresh air.

    I do agree that just because something is based on tradition does not make it legitimate. I am not anti-tradition at all. I am only against traditions that debase equality and social justice.

    A number of risky behavior stems from tradition. It is our duty to identify them and modify these behaviors to make our citizens more healthy. In the case of marriage equality, if we only allow civil unions among same-sex couples, we acknowledge the fact that these couples are second-class and inferior. This promotes disparities. I hate to echo this over and over again (and I acknowledge the fact that I am not writing anything new about this topic), marriage equality is social justice. As public health advocates, we are for furthering the cause of social justice. It’s as simple as that.

    I do not buy the idea of “renaming” marriage so it becomes applicable to both same-sex and opposite-sex couples. It’s sweeping the issue under the rug. Thus I agree with repealing DOMA. As Ms Dowell points out, these federal rights should be extended to same sex couples as well. Otherwise, homosexual couples will continue to live in this oppressive environment.

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