The landmark United States Supreme Court decision that same-sex marriage is a fundamental right guaranteed by the Fourteenth Amendment to the U. S. Constitution has important implications regarding the health and care of older Americans.
Studies show that denying same-sex couples the right to marry has a negative impact on their mental health, according to a 2006 report by Herdt & Kertzner. And a growing body of evidence suggests that policies conferring protections to same-sex couples are linked to lower health care and mental health care utilization, as well as to decreased health care spending.
There also are numerous studies confirming the health benefits of marriage for older heterosexual couples. “Married persons, on the whole, tend to have lower rates of fatal and nonfatal diseases, physical functioning problems, and disability compared to all other marital status groups,” reported Amy M. Pienta et al. in Health Consequences of Marriage for the Retirement Years, published in the Journal of Family Issues in 2000.
And there is evidence that married people have lower rates of depression, substance abuse, and alcoholism, and tend to live longer than their single counterparts.
In addition, the ruling in Obergefell v. Hodges (read the full Supreme Court decision) has significant implications for the provision of health care. By legally recognizing the relationship, the Supreme Court has conferred the rights afforded to heterosexual married couples under federal law to their same-sex married counterparts.
Sometimes it takes a story to make sense of these things. In 2009, I read a heartbreaking story, Kept from a Dying Partner’s Bedside, authored by Tara Pope-Parker in the New York Times. Lisa Marie Pond and Janice Langbehn were a couple for 20 years when Ms. Pond suffered a massive stroke. Ms. Langbehn identified herself as both the partner and health care proxy, but was not allowed to see her longtime partner, participate in care decisions, or be advised of her partner’s condition—even as other spouses and children were allowed to come and go into the trauma treatment area. Lisa Marie Pond died after being transferred to another facility, without her partner’s knowledge.
As a result of the Supreme Court decision, same-sex spouses can no longer be denied access into intensive care units and other areas of the hospital routinely limited to immediate family members. And the ruling affords same-sex couples the same rights as heterosexual married couples with respect to living together, if they so choose, in assisted living facilities and continuing care retirement communities.
Access to a spouse’s retirement benefits, survivor benefits under Social Security, family medical leave, and the ability to automatically inherit a shared home and possessions in the absence of a will are among the other benefits now extended to older same-sex couples.
For additional information and resources, go to How Medicare is affected by marriage equality, developed and maintained by the Medicare Rights Center, and Talk Before You Walk, produced by SAGE.
Also, check out the work of The National Health, Aging, and Sexuality Study: Caring and Aging with Pride over Time, the first-ever, ongoing national project designed to better understand the health and well-being of lesbian, gay, bisexual, and transgender (LGBT) adults 50 years of age and older. Dr. Karen I. Fredriksen-Goldsen, a John A. Hartford Foundation Geriatric Social Work Faculty Scholar and director of the Healthy Generations Hartford Center of Excellence at the University of Washington, is Principal Investigator of the study project.