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Cohabitation and Self-rated Health: The Role of Socioeconomic Status and Sexual Minority Status among U.S. Cohabitors

This study examines whether health disparities between same-sex and different-sex cohabitors differ depending on socioeconomic status (SES). Previous research showed that SES mediates health disparities between different-sex and same-sex cohabitors, but less is known about its role as a potential moderator. Using data on cohabitors from the Integrated Public Use Microdata Series (IPUMS) National Health Interview Surveys (2007–2018), this study examines how the SES-health gradient shapes health disparities for same-sex and different-sex cohabitors. Average adjusted predictions from multinomial logistic regression models show that higher income-to-needs ratio is associated with improvements in self-rated health for same-sex cohabiting women relative to different-sex cohabiting women. However, results are mixed for men. As income-to-needs ratio increases, same-sex cohabiting men have higher probabilities of “excellent” or “very good” health than different-sex cohabitors; however, their risk of “poor” health increases significantly with higher income-to-needs ratios. Potential explanations related to minority stress, stress proliferation, gendered meanings of self-rated health, and selection are explored. Overall, disparities between same-sex and different-sex cohabitors differ by gender and SES, suggesting socioeconomic diversity should be considered in the study of sexual minority health.