Same-Sex Marriage, General Health, and Health-Risk Behaviors in the U.S.

Marriage is associated with numerous benefits for husband/wife couples in the U.S., including better physical health.  Using results from a web-based survey of members of same-sex couples and same-sex-attracted singles in the U.S. (N=429), I tested whether these “marriage benefits” extend to same-sex marriages, civil unions, domestic partnerships, and cohabiting couples with regard to general health, cigarette smoking, and alcohol consumption.  Although there was no difference among cohabitors in self-rated general health, legal recognition (marriages and civil unions) did provide some benefits in terms of health-related behaviors.  Specifically, same-sex spouses and legal partners were 68% less likely to smoke than singles/daters, but cohabitors were no more or less likely to smoke than singles/daters.  Among those who drank alcohol, spouses and legal partners drank less than couples who were only cohabiting, consuming about 6 fewer alcoholic beverages per month. 

In the U.S., there are diverse views on marriage equality, and the question of whether legal status matters beyond legal rights is a legitimate one.  Does marriage need to be a structurally integrated institution (i.e., a legal status with all rights and benefits) to provide intangible benefits, or can marriage as an ideological institution (i.e., an emotional state) provide the same experience?  To broach this subject, I re-tested the models above using “self-defined marriage” – viewing one’s own relationship as a marriage, regardless of legal recognition.  This measure grouped cohabitors who viewed their relationship as a marriage with legal marriages and partnerships.  Self-defined marriage was also strongly associated with a marriage benefit; self-defined spouses were 47% less likely to be smokers than those who were single or just dating.  I conclude that, although self-definition as a married person did reduce the likelihood of smoking, having a legally recognized relationship proved more beneficial in reducing health-risk behaviors.