Prevalence of Neurologic Disease Among Those in Same-Sex Relationships: Evidence from the Medical Expenditure Panel Survey

Prior research has shown several health disparities affecting sexual minority people. Research on the neurologic health of sexual minority people has been limited. Our objective was to characterize the prevalence of neurologic disease and utilization of a neurologist among a population of sexual minority people.

We conducted a cross-sectional analysis of sexual minority people, using people in same-sex relationships as a proxy for sexual minority status, from the Medical Expenditure Panel Survey (MEPS) from 2016 to 2020. The MEPS is a government-run survey that uses complex sampling to obtain a nationally representative sample. Our primary outcome was a diagnosis of any neurologic disease. We also completed stratified analyses by sex, race, and ethnicity. Our secondary outcome was visit to a neurologist within the past year. Logistic regression was used to compare the odds of both outcomes in those in same-sex relationships and those in different-sex relationships.

Among 153,313 MEPS participants, there were 61,645 (40.2%) participants in relationships who were included in our sample. Of those, 822 (1.33%) participants were in same-sex relationships. Participants were, on average, aged 51 years (median 50 years, IQR 38-63); nearly 50% reported female sex and mostly non-Hispanic White (67.81%). Among those in same-sex relationships, 22.7% reported a neurologic diagnosis compared with 18.1% of those in different-sex relationships (OR 1.33; 95% CI 1.04-1.71). This difference was maintained with adjustment for age, sex, education, and insurance (OR 1.48; 95% CI 1.15-1.91). There was no significant difference in visit to a neurologist (adjusted OR 1.38; 95% CI 0.91-2.10).

In this nationally representative sample, neurologic disease was more prevalent among those in same-sex relationships compared with those in different-sex relationships. Limited sample size and absent measurements of minority stress limited the etiologic search for factors driving this disparity. There was no significant difference in visit to a neurologist, and both groups reported their overall health as being similar. There is a need for more routine measurement of sexual orientation in neurologic research. This will allow us to detail differences in neurologic disease risk factors, prevalence, and outcomes. The end goal is the identification of opportunities for intervention and advancement of neurologic health equity.