Civil Marriage Is a Healthy Choice

By Peter Beilenson
Sunday, March 15, 2009

This month, the Maryland General Assembly again will hear arguments in favor of granting same-sex couples the ability to legally marry. In this debate, we've heard much about the importance of bestowing legal and economic protections on these couples and their children. But what about the strong body of evidence that married couples fare much better, both physically and psychologically, than unmarried, cohabitating couples? This evidence alone illustrates that denying same-sex couples access to civil marriage is, quite simply, relegating them to inferior health status. As public health advocates, we are deeply troubled that yet another year of inaction by our legislature will compromise the simple good health of thousands of Marylanders.

Compared with unmarried partners, married couples have lower rates of depression and substance abuse, make fewer doctor visits, and suffer lower rates of overall mortality. Elderly married adults have lower health-care costs and have a lower likelihood of needing nursing-home care. Children of married parents do better as well -- experiencing better physical health into adulthood.

Without question, the health advantage of married people is linked to the tangible protections of civil marriage. These protections include shared health insurance, family and bereavement leave, inheritance rights, and Social Security, disability and retirement benefits. In addition, the powerful social support and approval bestowed on married couples solidifies their relationship and enhances the well-being of both the couple and their children. Civil marriage, rather than a civil union or domestic partnership, carries substantive value that counteracts the shame, isolation and stigma that detract from the health status of lesbians and gay men.

The public health implications of this situation can no longer be ignored.

Although the government may not have intended to invest civil marriage with a public health role, in practice, it has become the vehicle for delivering such fortifications. People who are married have access to enhanced protections at those times of greatest human vulnerability: birth, death, illness, disability and unemployment. The government gives special treatment to civil marriage because it shifts the burden of care from the government to the individual and the family. By giving families the tools to take care of themselves, the government efficiently reallocates its responsibility for citizen welfare and invests the married couple in a caretaking role that extends beyond their individual interest. This is the essence of good governance -- providing people with tools to protect and improve the health of their own families.

It is time for the General Assembly to refocus on its charge of stewardship for the public good. Piecemeal legislative protections for same-sex couples are inefficient and fall far short of the simple solution that could remove the disparity. Access to civil marriage improves the health of the community. In the interest of public health, committed same-sex couples should be granted access to this healthy choice.

The writer is health officer of Howard County.

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