Diversity, Inclusion and Equity, Government, Public Health

Big week at the Supreme Court

July 1, 2013

Forward and backward—It matters for public health

The Defense of Marriage Act (DOMA), the law barring the federal government from recognizing state-legalized same-sex marriages, is unconstitutional, the Supreme Court ruled Wednesday by a 5-4 vote. By declaring DOMA unconstitutional, the Court allowed marriages to continue among gay and lesbian individuals in California. The ruling is a step forward for this country. Marriage should be about commitment and not about gender. Why is the issue relevant to public health? There are many reasons. Without formal marriage, partners may be denied benefits, putting their health at risk and often causing severe financial hardship when a partner dies, and the remaining partner cannot inherit.

The Court’s decision on the Voting Rights Act is appalling. The Supreme Court ruled Tuesday to strike down Section 4 of the Voting Rights Act. The provision cannot be enforced until Congress creates a new formula to determine which states and counties need to have voting law changes cleared by the federal government or in federal court. The decision on the Voting Rights Act came by a 5-4 vote: the opinion in Shelby County v. Holder. The consequences could lead to reduced voting among disadvantaged populations, especially in some parts of the country. This could have the long-term consequence of exacerbating health disparities if the needs of these populations are not reflected in local elections and resulting policies.

As reported in Huffington Post, long-time Congressman John Lewis, an activist proponent of civil rights for many years, reacted with anger, disappointment and outrage. “These men that voted to strip the Voting Rights Act of its power, they never stood in unmovable lines, they never had to pass a so-called literacy test,” he said. “It took us almost 100 years to get where we are today. So will it take another 100 years to fix it, to change it?”

More from UNC News: Court ruling on Voting Rights expected to impact NC—The News & Observer (Raleigh)

Tuesday’s U.S. Supreme Court ruling on the Voting Rights Act could have far-reaching effects in North Carolina – affecting everything from voting districts to voter ID legislation. … But Michael Crowell, an expert on voting law with the University of North Carolina’s School of Government, said Tuesday’s action shifts the burden of proof. “The burden was on the state to show it was not discriminating,” he said. “Now the burden is on the challenger.”

It was a consequential week, and my comments don’t include the case on affirmative action—that’s for another time. Happy Monday and a good July 4th. Barbara



Derrick Matthews


Many thanks for mentioning these decisions and their impacts on health. I'd only like to add that in addition to the structural and tangible benefits that marriage provides to couples mentioned here, the inability to access marriage has additional consequences for the health and well-being of sexual minorities as well. Mark Hatzenbuehler, who many may have had the privilege to hear speak at the 2012 Minority Health Conference, has published some great work in AJPH on the effect of state-level policies and institutionalized discrimination on the well-being of lesbian, gay, and bisexual persons living in the United States. (References below if interested in reading the full studies.) Again, I'd like to express my thanks for bringing additional attention of these decisions through the lens of public health. It is important we remain mindful of how these and other policies influence health, and that we ensure the work and training at the School reflects this understanding so we can eliminate health inequities for all populations. [References as promised!] Hatzenbuehler, M. L., Keyes, K. M., & Hasin, D. S. (2009). State-level policies and psychiatric morbidity in lesbian, gay, and bisexual populations. American Journal of Public Health, 99(12), 2275-2281. Hatzenbuehler, M. L., McLaughlin, K. A., Keyes, K. M., & Hasin, D. S. (2010). The impact of institutional discrimination on psychiatric disorders in lesbian, gay, and bisexual populations: A prospective study. American Journal of Public Health, 100(3), 452-459.

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The views expressed in this blog are Barbara Rimer’s alone and do not represent the views and policies of The University of North Carolina or the Gillings School.