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Commonwealth of Massachusetts Department of Public Health

A Health Profile of Massachusetts Adults by Sexual Orientation Identity: Results from the 2001-2006 Behavioral Risk Factor Surveillance System Surveys

Prepared by K.J. Conron, ScD1, MPH, M.J. Mimiaga2,3, ScD, MPH, S.J. Landers4,5, JD, MCP
for the Massachusetts Department of Public Health

SUMMARY

A growing body of research indicates that health disparities exist between
gay/lesbian/bisexuals and heterosexuals. For the first time, population-based estimates
of sexual orientation differences in adult health are available in the Commonwealth of
Massachusetts. This report used data collected for the 2001-2006 Massachusetts
Behavioral Risk Factor Surveillance System surveys to compare self-reported health
behavior and status among (n=38,910) heterosexual/straight, gay/lesbian/homosexual,
and bisexual adults ages 18-64. Most (97.1%) self-identified as heterosexual or straight,
while 1.9% identified as gay, lesbian or homosexual, and 1.0% as bisexual.

Results suggest that sexual orientation differences exist with respect to access to
health care, overall health status, cancer screening, chronic health conditions, mental
health, substance use including tobacco smoking, sexual health, and violence
victimization. While gay/lesbian/homosexual adults evidenced poorer health and greater
risk than straight/heterosexuals across several health domains, poorer health was
observed most often for bisexuals. The health profile of gay/lesbian/homosexual
residents was poorer than that of heterosexual/straight residents on: self-reported
health; disability-related activity limitation; asthma; current and past tobacco smoking;
anxious mood; 30-day binge drinking and substance use; and lifetime sexual assault
victimization. In addition, lesbian/homosexual women were more likely to be obese than
their heterosexual/straight female peers. Bisexual residents faired worse than
heterosexual/straight residents in terms of: access to health insurance, as well as
medical and dental providers; heart disease; anxious and depressed moods, 12-month
suicidal ideation; current tobacco smoking, and lifetime and 12-month sexual assault
victimization. In addition, bisexual women were more likely to report disability-related
activity limitation, 30-day illicit drug use, and lifetime intimate partner violence
victimization than heterosexual/straight women.

In several areas (prostate-specific antigen testing; lifetime mammography and 3-
year cervical cancer screening; diabetes; and 12-month intimate partner violence
victimization), no statistically significant sexual orientation differences were observed. In
a few domains, gay/bisexual/homosexuals were engaged in more health protective
behavior than straight/heterosexuals. Gay/lesbian/homosexuals and bisexuals were
more likely than heterosexuals to have been ever tested for HIV than their
straight/heterosexual counterparts. In addition, gay/homosexual men were less likely to
be obese or overweight compared to straight/heterosexual men. They were also more
likely to obtain lifetime colorectal cancer screening and to report recent condom use.

Information on health disparities can inform how public health resources are
allocated to improve health, including identifying areas for intervention development and
future research. As research continues, Massachusetts’ public health programs should
begin to address the sexual orientation-related disparities identified in this report. An
emphasis on the health needs of bisexuals in the Commonwealth is indicated by our
findings.

By Rachel F. Elson
Jun 3, 2009 | Updated: 7:08 p.m. ET Jun 3, 2009

The phones started ringing at the Timberholm Inn in Stowe, Vt., in April, as soon as lawmakers voted to override a gubernatorial veto and allow same-sex marriage in the state. "It doesn’t go into effect till Sept. 1, but people are thinking ahead," says the inn’s co-owner, Susan Barnes. "We’ve got two same-sex weddings booked for October." Those bookings are good news for Barnes, who says the gay-friendly inn takes in a "couple of thousand" dollars with every wedding it hosts. And they are part of the reason some same-sex-wedding advocates are now pointing out a new legalization angle: the economic payoff.

In the five years since legalizing same-sex marriage, Massachusetts has gained $111 million in spending from gay weddings, according to a new study published by UCLA’s Williams Institute, which studies sexual-orientation law and public policy. "That’s money buying flowers, hotels, caterers, hiring a band—all the things that go into a wedding," explains M. V. Lee Badgett, a coauthor of the study.

Typically, same-sex couples spent about $7,400 per wedding, says Badgett, an economist who is also director of UMass Amherst’s Center for Public Policy & Administration, and one in 10 couples spent more than $20,000. And then there were the wedding guests: "We estimated that each same-sex couple was associated with $1,600 in hotel-occupancy tax revenue," she says.

Promises of a gay-wedding payoff are hardly new: back in 2004, a U.S. Congressional Budget Office analysis predicted that the federal government would benefit by nearly $1 billion in increased tax revenue each year if same-sex marriages were legalized in all 50 states and recognized by the federal government.

Still, some economists urge caution in looking for same-sex wedding profits—in particular citing a kind of "first-mover advantage" that benefits states with early gay-marriage laws. (After similar laws were passed in neighboring states Vermont and Maine, New Hampshire became the latest state to legalize same-sex marriage on Wednesday, but the state might not gain as much as did Massachusetts, which has become a destination for gay couples from other states.)

"If you’re the 50th state to allow [same-sex] weddings, you’re not going to get as much of a bump as the first state," says Michael Steinberger, an assistant professor of economics at Pomona College who worked with the Williams Institute on the Massachusetts study. "There’s going to be a bump, but it cannot be as big."

You can view the original article at:
http://www.newsweek.com/id/200365

So are Lynn Adler and Paige Warren.

The gay American couples resettled in Massachusetts, where they are treated — legally and socially — like any other married folks.

They moved in part because they wanted their children to grow up in a welcoming environment.

"There’s a real difference you feel living in Massachusetts," says Schuster, who moved from Los Angeles with Webb and their now 5-year-old twin sons to take a job as a professor of pediatrics at Harvard Medical School. "Gay married couples are now just a part of Massachusetts life."

Adler, who took a job as a professor of plant, soil and insect sciences at the University of Massachusetts at Amherst, married Warren once they moved to the state. They now have a 3-year-old boy.

"There’s a real peace of mind living here. So many of the kinds of worries you have elsewhere — about how you’ll be treated in a hospital situation or getting equal benefits — are just taken off your shoulders," Adler says.

This month marks the fifth anniversary of Massachusetts’ breakthrough — opening marriage to gay couples: More than 12,000 have since tied the knot there.

Three new studies document wonderful results: Gay matrimony has been a $111 million boost to the state’s economy. The average gay couple spends $7,400 on a wedding. Almost one in 10 spends $20,000 or more, according to the Williams Institute.

It’s sparked a migration boomlet, the California think tank reports.

Also, the Massachusetts Department of Public Health found that gay couples say marrying strengthened their relationships and made them more likely to be out:

• Nearly three-quarters of married gay couples now feel more committed to their partners and more accepted by their communities.

• 89 percent said all or most family members support their marriage.

• Of the 28 percent raising children, 93 percent said their kids are happier because of their marriage.

The Williams Institute says the migration of gay couples to Massachusetts is especially noticeable among young, highly skilled professionals like Schuster and Adler, the very workers states need to thrive in the global economy.

Such "creative class" individuals in gay relationships were 2.5 times more likely to move to Massachusetts in the three years after marriage became an option than the previous three years, the institute found.

Study author Gary Gates notes that by attracting very skilled gay workers, same-sex marriage "has the potential to have a long-term positive economic impact."

It can also produce a "coattail effect." Schuster says he has mentioned Massachusetts’ marriage-friendly climate when wooing out-of-state professionals to Harvard.

The strength of that appeal was documented in the state government survey, Gates points out. Half of gay married couples who moved to Massachusetts said "marriage equality or the state’s (gay) rights climate" was a factor. One in five declared that was the only reason they relocated, Gates reports.

The prospect of living in a state offering same-sex marriage was a big plus for Adler and Warren.

Adler had been a biology professor at Virginia Tech, where she couldn’t even put Warren on her health plan.

The couple worried about trying to bring up a child in the state. When Adler accepted her Massachusetts job offer, she wrote to Virginia state legislators: "I am very sad and sorry to be leaving Virginia Tech. … However, the laws of Virginia make it difficult for me to have a long-term future here."

The message for states wanting the best and brightest workers is clear. As talented gay couples plan their futures, they’ll increasingly settle in gay marriage-friendly states.

dprice@detnews.com (202) 662-8736

you can view the original article at:
http://www.detroitnews.com/article/20090527/OPINION03/905270336/Gay-marriage-pays-off-for-Massachusetts

BOSTON (Reuters) - The expansion of legal gay marriage across New England could deliver an economic windfall by attracting a youthful "creative class" of workers to a region with an aging population.

In the past year, Connecticut, Vermont, New Hampshire and Maine have joined Massachusetts, which in 2004 became the first U.S. state to allow same-sex weddings, in blessing gay and lesbian weddings.

That makes the region the first in the United States where same-sex couples can move from one state to another while retaining marriage benefits.

New arrivals include John Visser and Nick Keffer, who recently moved to Hartford, Connecticut, from Raleigh, North Carolina. They plan to wed later this month.

"The sole, only reason why we moved was because it was now legal for us to get married here," said Visser, 42. "No other reason whatsoever other than marriage equality. We were perfectly happy in North Carolina."

New England has long burnished an image of tolerance. Early European settlers in the 17th-century escaped religious persecution, although they imposed their own stern doctrines and sometimes expelled dissenters. Later, the region led the right for the abolition of black slavery.

Five out of the region’s six states now endorse gay weddings after New Hampshire legalized same-sex marriage on Wednesday, leaving Rhode Island as the sole holdout.

The spread of gay marriage could serve as a recruiting tool for universities, health care companies and financial services firms that dominate the region’s economy, experts said.

"It will be a selling point when it comes to trying to lure people with same-sex partners who are being wooed for a job," said M.V. Lee Badgett, a University of Massachusetts economist who studies gay and lesbian issues.

Same-sex couples in the so-called "creative class" were 2.5 times more likely to move to Massachusetts in the three years following the approval of same-sex marriage than they had been in the three prior years, according to a study released in May by the Williams Institute of the University of California.

That study also found that migrants relocating to the state were more likely to be younger and female than before same-sex marriage was approved.

Research shows that heterosexual members of the "creative class" — a group that includes financial whizzes, software programmers and educators — tend to regard states that allow gay marriages as more appealing places to live.

"It broadly suggests you have an environment in which people who are seen as different are accepted," said Gary Gates, the UCLA demographer who was the study’s lead author.

Outside New England, the only other U.S. state to allow gay marriage is Iowa. California for six months last year allowed same-sex weddings before voters put an end to the practice.

REASON TO STAY

The first economic effect Massachusetts felt from gay marriage was a boost in business related to actual wedding ceremonies performed over the past five years.

The 12,167 same-sex couples that have wed and their guests have spent about $111 million on weddings, from flowers and cakes to hotel rooms and meals for out-of-state guests, another Williams Institute study found.

Over the longer term, there could be a greater economic effect if gay couples decide they are unwilling to leave the region to move to states where their marriages would not be recognized. Forty-two of the 50 U.S. states have laws on their books prohibiting same-sex marriages.

"Once these states offer marriage to these families, they will not quickly, willingly or easily accept new assignments, transfers and promotions to states that don’t offer them," said Bob Witeck, chief executive of Witeck-Combs Communications, a Washington-based marketing firm that focuses on gay and lesbian issues. "They’re creating an economic wall in the region that is going to impact the ability of all national employers to move talent around."

Some married gay people said they would not consider moving to a state where their marriage would not be recognized.

"I just wouldn’t do it. It’s pretty straightforward," said Mike Swartz, 41, a vice president at a software company who lives with his husband in Cambridge, Massachusetts.

Some couples said another key factor influencing where they would move is how states recognize their role as parents.

Marie Longo, 45, moved to Massachusetts before the state allowed gay marriage because its laws allowed her now-wife Allison to adopt Longo’s twin daughters.

"Portability is a big issue for those of us now who have lived in a state where we have been legally married and respected and treated just like any other couple," said Longo, who works as a fund-raiser for Gay & Lesbian Advocates & Defenders, a group that lobbies for gay marriage.

Knowing they could move from state to state and still have their marriage recognized made it easier for Visser, an interior designer, and Keffer, a real estate agent, to start a new life in the north, Visser said.

"Connecticut is a very small state," Visser said. "Hartford is the center and it only takes an hour to get to the state border in any direction, so for us to be able to establish ourselves in the surrounding states, it broadens our opportunities. We feel less restriction."

New England has a graying population, particularly in Maine where 14.7 percent of the population is 65 or older, compared to 12.5 percent for the nation as a whole, according to U.S. Census data. Economists and academics say this will take a toll on the region’s economy, both by limiting innovation and growing the demand for government services.

(Editing by Alan Elsner and Jason Szep)

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By Christopher Ramos, Naomi G. Goldberg, and M.V. Lee Badgett
May 2009

May 17th, 2009 marks the 5th year of marriage equality in the state of Massachusetts. To mark this anniversary, the Massachusetts Department of Public Health conducted the largest survey to date of married same-sex couples, the Health and Marriage Equality in Massachusetts (HMEM) survey. During the past year, four other states have extended marriage to same-sex couples and several other states are considering marriage legislation. The HMEM data allows us to address important questions that arise as other states consider whether to extend marriage to same-sex couples. The data provides answers to several key questions: Who is getting married? Why are same-sex couples getting married? What impact has marriage had on same-sex relationships? And, what impact has marriage had on the children of same-sex couples?

This is a nice read and great overview of the battle for marriage equality in Massachusetts.

Click here to download this article (PDF) »

By Stephen Smith, Globe Staff | May 24, 2009

Five years after the first same-sex weddings in Massachusetts, gay and lesbian couples express deeply traditional reasons for deciding to wed and cite equally conventional benefits flowing from marriage, according to a study being released this week.

A significant majority of the 558 gay men and women surveyed said that since marrying, they feel more committed to their spouses, more accepted in their community, and more likely to be open about their sexual orientation at work.

The survey indicates that there is something universal about the legal protections and social advantages afforded by the institution of marriage, said the study’s authors from the University of California, Los Angeles as well as independent researchers. And it suggests, they said, that a ritual once scorned even by many same-sex couples has the power to ease discrimination.

“This really helps us confirm and makes us understand why same-sex couples demand marriage - if it’s just about the legal rights, why wouldn’t they be happy with civil partnerships?” said Stephanie Coontz author of “Marriage, A History.”

“They want access to that word that is so highly valued by our society and by other people.

“It is one thing not to invite your child’s girlfriend or boyfriend to dinner,” said Coontz, a professor at The Evergreen State College in Olympia, Wash. “It is quite another thing not to invite the spouse.”

Same-sex marriages began in Massachusetts on May 17, 2004, after the Supreme Judicial Court declared that gay and lesbian couples had the right to wed. The ruling ignited a political and social maelstrom in Massachusetts and beyond, but since then four other states - Connecticut, Iowa, Maine, and Vermont - have extended marriage rights to same-sex couples. Lawmakers in New Hampshire are currently debating whether to make their state the next to do so.

The study was prepared and paid for by UCLA’s Williams Institute, which examines legal and public policy issues related to sexual orientation and is funded by foundations and individuals, including supporters of gay marriage.

The authors of the survey, which consisted of about 30 questions, said they regarded it as an initial assessment of gay marriage, largely designed to explore issues arising during public debate rather than to delve into more personal aspects of couples’ relationships. For example, researchers asked whether respondents’ children had faced taunting as a result of their parents’ same-sex marriage - only 5 percent had - but did not ask how happily married partners were.

“We’ve been interested in the impact of marriage for a long time,” said Lee Badgett, researcher director of the Williams Institute and senior author of the study. “I’ve been combing the universe for data, but there just aren’t that many places to look at same-sex couples who are literally married.”

The marriage questions were included in a larger online health survey conducted this month by the state Department of Public Health. The agency found potential respondents through a database maintained by the gay rights group MassEquality, which includes donors as well as people identified as being in same-sex marriages, and invitations to participate were e-mailed. About 4 percent responded.

Those surveyed were not a randomly selected population - something that would have been far more costly and difficult to accomplish - so the findings are not representative of the more than 12,000 gay married couples in Massachusetts. But Coontz and a Wellesley College researcher, Michelle Porche, praised it as a robust, well-executed study.

Virtually all of the married men and women who responded - 93 percent - said “love and commitment” were the prime factors in their decision to wed.

Marriage appears to have forged stronger ties between spouses and their families and even colleagues on the job. When asked whether marriage had created a stronger bond with their partners, nearly three-quarters said it had. And families, the gay couples said, reacted with overwhelming acceptance of their marriage: 82 percent said their parents responded positively, while 91 percent indicated siblings were receptive.

Eight of 10 study participants said that being married made them more likely to disclose their sexual orientation to their coworkers and doctors.

“That suggests there’s something powerful about that ritual, about that institution,” Badgett said. “People feel more accepted by society.”

Porche, a senior research scientist at the Wellesley Centers for Women, said the findings mirror those of a smaller, although more intensive, study she conducted by interviewing couples not long after gay marriage was legalized.

“Studies like these help us from afar to get to know people a little bit better,” Porche said. “The more people who have reservations about gay marriage can really meet married same-sex couples and get to know them and their experience, the more they would be open to supporting” the right to marry.

Still, advocates on both sides of the gay marriage debate remain starkly divided in their beliefs.

Kris Mineau, a leader of the failed effort to place a constitutional amendment banning same-sex marriage on the ballot in Massachusetts, said he remained convinced that voters should have the final say on who has the right to marry. And, he said, he has not wavered.

“There’s nothing in that poll that suggests to me any reason why marriage should be changed summarily to meet the personal desires of a small segment of the population,” said Mineau, president of the Massachusetts Family Institute. “I see no reason to do this unless the entire population agrees this is in the best interest of our society.”

Scott Gortikov, executive director of MassEquality, said the study’s findings suggest that the benefits of same-sex marriage extend beyond the couple.

“What the results are saying is that equal marriage makes for a healthier and happier family life and, necessarily, a healthier and happier and more solid society,” Gortikov said.

Jonathan Scott and Mike McGuill had been a couple for a decade when, on Aug. 1, 2006, they awakened and headed to the Pilgrim Monument with their young son and two friends, who’d met them for breakfast. “I said, ‘Before our scrambled eggs, we’re going to get married, I hope that’s OK with you,’ ” Scott recalled.

His mother, Scott said, was married five times, so he’d grown up with a well-honed skepticism. But as his relationship with McGuill deepened and they adopted their son, marriage appeared to provide indispensable legal protection to them as a couple and as parents, said Scott, who participated in the survey.

“And yet, what happened as we were getting married, it was an experience I’d never had before,” said Scott, chief executive of Victory Programs, which helps substance abusers in Boston. “I was so moved at just being in the presence of someone I’d been with 10 years, talking about our love together and our commitment to each other.”

At family gatherings, McGuill felt a keen sense of difference when he watched his married brothers and sisters - until that August morning three years ago.

“Now, I have what they have,” said McGuill, a veterinarian. “I have a marriage. Getting married, there’s nothing revolutionary about it - it’s something you do with the person you love.”

Stephen Smith can be reached at stsmith@globe.com.
© Copyright 2009 The New York Times Company

You can view the original article at:
http://www.boston.com/lifestyle/relationships/articles/2009/05/24/for_gay_couples_married_matters/

But this year, the celebration feels a little bit sweeter for the six couples who will gather Sunday to mark the fifth anniversary of Massachusetts becoming the first state to legalize same-sex marriage. This year, they will also be celebrating the legalization of gay marriage in four other states.

“We’ve been very happy that it’s started to be accepted in other places,” said Maureen Brodoff, one of the plaintiffs in the lawsuit that led to a Supreme Judicial Court decision legalizing gay marriage.

“It’s important to us that same-sex relationships get recognition outside of our home state, and I think that that is happening slowly as people look to the Massachusetts example and see that, you know, the sky didn’t fall, that it’s strengthened families, that it’s brought joy to a lot of families,” Brodoff said.

Brodoff married her longtime partner, Ellen Wade, on May 17, 2004, the first day same-sex couples were allowed to marry.

Since then, more than 12,350 same-sex couples have married in Massachusetts, out of slightly more than 172,000 marriages in the state, according to the latest figures, which run through September 2008.

Opponents say they remain concerned that gay marriage will have a negative effect on children and religious freedom.

Kris Mineau, president of the Massachusetts Family Institute, points to a ruling in a lawsuit filed by Lexington parents who objected to gay families being discussed in their children’s elementary school classrooms.

A federal appeals court dismissed the lawsuit, saying the inclusion of books that included gay people or relationships did not violate the parents’ First Amendment right to free exercise or religion.

Mineau also cited the 2006 decision by the Boston Archdiocese’s Catholic Charities to stop providing adoption services because state law required it to consider same-sex parents when looking for adoptive homes.

“These are foretelling events,” Mineau said. “We’ve always said it’s going to take a generation for the full impact of this radical social experiment to take effect, but there are certainly these telling signs.”

The couples who led the fight to legalize gay marriage say their unions have been just like anyone else’s. They raise children together, they buy homes together and they have their share of problems. One of the seven couples who brought the landmark lawsuit is now in the midst of a divorce. Julie and Hillary Goodridge filed for divorce in February after separating in 2006.

Another one of the couples, Rob Compton and David Wilson, said they have watched over the past five years as acceptance in their community has grown. Between them, they have five adult children from previous marriages, and six grandchildren under the age of 10.

“Once people started telling their personal stories, it really has changed the perception of what gay and lesbian couples look like, how they behave, how important they are to the families they’re in,” Wilson said.

Compton said he’s been surprised by how quickly other states have accepted same-sex marriage. Connecticut, Iowa, Maine and Vermont have all legalized gay marriage this spring. New Hampshire Gov. John Lynch said this week that he will sign a bill to make his state the sixth state if lawmakers revise it to strengthen protections for churches opposed to gay marriage.

Five years ago, Compton said, part of the debate in other states was whether to grant civil unions — as Vermont had already done — or marriage to same-sex couples.

“But what’s happening today is that the default position is no longer civil unions … it’s now moving to — maybe we should consider marriage,” he said.

“We started the dialogue and then people picked it up and moved it across the states,” he said. “But it needed to start somewhere.”

By DENISE LAVOIE | Associated Press Writer
10:31 AM CDT, May 16, 2009

View the original article at:
http://www.chicagotribune.com/news/chi-ap-ma-gaymarriage-anniv,0,6561873.story

The study was one of two by the Williams Institute at the UCLA School of Law showing the state has significantly gained as a result of the legalization five years ago of gay marriage.

The state’s Supreme Judicial Court ruled in 2003 that banning same-sex marriage was unconstitutional and gay and lesbian couples began marrying the following year.

That made Massachusetts the state with the longest record of same-sex marriage and research over the past five years has provided an insight into what other states could expect as a result of marriage equality.

One study by the Williams Institute looked at money spent by same-sex couples at their weddings. The other examined the impact of people moving to Massachusetts because of the law.

The survey of married same-sex couples shows that the typical gay or lesbian couple spent $7,400 on their weddings in Massachusetts, with one in ten couples spending more than $20,000. The study’s analysis of state data on hotel occupancy tax payments confirms the boost from out-of-state guests at these weddings.

“Florists, caterers, hotels, bakers, restaurants, and many other businesses have gotten a share of the $111 million spent on the 12,000-plus weddings of same-sex couples,” noted economist M. V. Lee Badgett, a study co-author and director of the Center for Public Policy & Administration at the University of Massachusetts Amherst.

“Allowing gay couples to marry won’t end the recession, but their spending still helps in tough times for businesses.”

The second study, found that Massachusetts gained a competitive edge in attracting young, highly educated “creative class” professionals who are in same-sex relationships.

“Data from the U.S. Census Bureau’s American Community Survey show that same-sex couples in the ‘creative class’ were 2.5 times more likely to move to Massachusetts after 2004 than before,” notes Gary J. Gates, Williams Distinguished Scholar at UCLA’s Williams Institute and the author of one study.

“The timing of this movement to Massachusetts suggests that those couples were flocking to the first state to allow them to marry.” Gates argues that this infusion of younger and highly educated same-sex couples could help improve the long-term economic prospects for Massachusetts.

The findings of the two studies confirm the predictions made in previous studies. They also indicate that other states allowing gay couples to marry-including Connecticut, Iowa, Vermont, and Maine-will see similar economic gains the authors said.

Published on: 05.18.2009 12:15pm EDT
By 365gay Newscenter Staff

View the original article at:
http://www.365gay.com/news/study-gay-marriage-cash-cow-for-mass/

Published: 18 May 2009 04:45 pm
By: Andrew Sullivan and Richard Florida

View the original article at:
http://andrewsullivan.theatlantic.com/the_daily_dish/2009/05/benefits-of-marriage-equality.html