Administrative Claims Data Show Increased Morbidity Risk For US Adults In Same-Sex Versus Different-Sex Relationships

Studies have found that sexual minority populations more often report worse overall health, lower health-related quality of life, and greater risk for disability than their heterosexual counterparts. This study used a novel approach to identify people in same-sex relationships, using insurance administrative claims data, and compared the prevalence of morbidity in that population with its prevalence in the population of those in different-sex relationships. This observational retrospective cohort study used the Merative MarketScan Research Database, which pooled data from private insurers from the period 2016-22. We identified 340,728 people in same-sex relationships, making this one of the largest studies on sexual minority populations to date, and found that they had higher Elixhauser morbidity scores than their counterparts in different-sex relationships. Sexual minorities experienced a greater prevalence of mental health morbidities (that is, depression, psychoses, and alcohol and drug use disorders) than their peers in different-sex relationships, with adjusted prevalence risk ratios (PRRs) ranging from 1.23 to 2.07. Sexual minority men also were more likely to have HIV (PRR: 93.62) and lymphoma (PRR: 1.34) than their male counterparts in different-sex relationships. These findings support the survey literature that has documented that sexual minority populations experience greater mental health and HIV-related morbidity, and they offer a novel approach to identifying members of sexual minorities.