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Relative Risk01:12

Relative Risk

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Relative risk (RR) is a statistical measure commonly used in epidemiology to compare the likelihood of a particular event occurring between two groups. This metric is important for evaluating the relationship between exposure to a specific risk factor and the probability of a particular outcome. It plays a crucial role in medical research, public health studies, and risk assessment. Relative risk quantifies how much more (or less) likely an event is to occur in an exposed group compared to an...
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Bias in Epidemiological Studies01:29

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Biases can arise at various stages of research, from study design and data collection to analysis and interpretation. Recognizing and addressing these biases is essential to ensure the validity and reliability of epidemiological findings.Broadly speaking, biases in epidemiology fall into three main categories: selection bias, information bias, and confounding. A more detailed description of possible biases is:  
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Like autosomes, sex chromosomes contain a variety of genes necessary for normal body function. When a mutation in one of these genes results in biological deficits, the disorder is considered sex-linked.
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Hazard Ratio01:12

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The hazard ratio (HR) is a widely used measure in clinical trials to compare the risk of events, such as death or disease recurrence, between two groups over time. It reflects the ratio of hazard rates—the instantaneous risk of the event occurring—between a treatment group and a control group. This measure provides valuable insights into the relative effectiveness of a treatment by assessing how the risk of an event differs between the two groups.
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Sexually Transmitted Infections01:26

Sexually Transmitted Infections

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Sexually transmitted infections (STIs) are diseases transmitted primarily through unsafe sexual interactions. Bacteria, viruses, or parasites cause them and can result in severe health complications if untreated.ChlamydiaThe bacterium Chlamydia trachomatis is responsible for the disease Chlamydia, the most common STI in the United States. This peculiar pathogen requires human cells to reproduce, residing intracellularly. The initial infection often goes unnoticed because it typically does not...
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Odds Ratio01:09

Odds Ratio

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The odds ratio (OR) is a statistical measure used extensively in epidemiology and research to quantify the strength of association between exposure and outcome across different groups. Unlike relative risk, which compares the probabilities of an event occurring, the odds ratio compares the odds of an event occurring in the exposed group to the odds of it occurring in the unexposed group. The odds, in this context, are calculated as the probability of the event happening divided by the...
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Updated: Sep 16, 2025

Inverse Probability of Treatment Weighting Propensity Score using the Military Health System Data Repository and National Death Index
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Administrative Claims Data Show Increased Morbidity Risk For US Adults In Same-Sex Versus Different-Sex

Landon Hughes1, Gilbert Gonzales2, Sarah McKetta3

  • 1Landon Hughes (LHughes@hsph.harvard.edu), Harvard University, Boston, Massachusetts.

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Summary

Sexual minorities face higher rates of mental health conditions, HIV, and other diseases compared to heterosexual individuals. This study utilized insurance data to identify sexual minorities and confirm these health disparities.

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Area of Science:

  • Public Health
  • Epidemiology
  • Health Services Research

Background:

  • Sexual minority populations report worse health outcomes and quality of life than heterosexual individuals.
  • Existing research often relies on self-identification, which can limit sample sizes and generalizability.

Purpose of the Study:

  • To identify individuals in same-sex relationships using insurance claims data.
  • To compare the prevalence of morbidity between sexual minority and heterosexual populations.
  • To investigate disparities in mental health, HIV, and other conditions.

Main Methods:

  • Retrospective cohort study using the Merative MarketScan Research Database (2016-2022).
  • Identification of individuals in same-sex relationships via insurance administrative claims.
  • Comparison of Elixhauser morbidity scores and prevalence risk ratios (PRRs) between groups.

Main Results:

  • Identified 340,728 individuals in same-sex relationships, one of the largest cohorts to date.
  • Sexual minorities exhibited higher Elixhauser morbidity scores than those in different-sex relationships.
  • Increased prevalence of depression, psychoses, alcohol/drug use disorders (PRRs 1.23-2.07) and HIV (PRR 93.62) in sexual minorities.

Conclusions:

  • Sexual minorities experience significantly higher mental health and HIV-related morbidity.
  • Insurance claims data provide a novel and effective method for identifying sexual minorities in health research.
  • Findings support existing literature and highlight critical areas for targeted health interventions.