Last week the 10th U.S. Circuit Court of Appeals found that same-sex couples in Oklahoma have a right to marry. Ten years ago, when Massachusetts was at the epicenter of a national debate over whether the marriages of same-sex couples should be legally recognized, we heard a lot of dire warnings about what would happen if marriage equality was enacted.
We heard that the institution of marriage would be irreparably damaged. We heard that children would be harmed. We heard that the sky would fall.
None of this came to pass. In fact, just the opposite happened. Families and communities have been strengthened by marriage equality in ways we never imagined a mere 10 years ago. Consider that one of the side effects of marriage equality has been to improve public health and lower the costs of health care.
A 2012 American Journal of Public Health study based on data from a community health center in Boston found that in the 12-month period after marriage equality was enacted in Massachusetts, gay and bisexual men experienced a 13 percent drop in medical care visits, and a 13 percent drop in appointments related to mental health. As a result, general medical health care costs in the 12-month period after same-sex marriages became legal in Massachusetts were 10 percent lower than what they were in the 12-month period before the advent of marriage equality. Costs related to mental health care were 14 percent lower.
Social factors such as race, socioeconomic status, and the environment in which one lives, have major impacts on health. Generally speaking, people with higher incomes are healthier than people who live in poverty. Much of the policy interventions to deal with such health disparities have focused on increasing access to health care. Yet evidence is rapidly accumulating that legislative and public policy changes that reduce inequality may also positively impact health in significant ways.
As Oklahoma grapples with this issue, and as we move into a second decade of marriage equality, we can do so with the confidence that the legal recognition of the marriages of same-sex couples strengthens families — and the communities in which they live — in myriad ways. When this effect is multiplied across the 19 states (plus the District of Columbia) which also now recognize the legal marriages of same-sex couples, you can see just how powerful equality can be.
Mayer, a medical doctor, is founder, co-chairman and medical research director of The Fenway Institute, the research, training and health policy division of Fenway Health. Safren is an affiliated investigator at the Fenway Institute and director of behavioral medicine in the Department of Psychiatry at Massachusetts General Hospital. Mayer and Safren were researchers on the 2012 American Journal of Public Health study.