Does marriage improve health?

 
Research shows that married couples often are healthier, both mentally and physically, than singles in similar age and income groups. But is their health better simply because they’re hitched, or are there other factors at play?

The ways married people are healthier

As a group, married men and women have lower mortality rates and fewer chronic and acute health conditions than people who are single, divorced or separated.

A 1990 study, for instance, found that nonmarried men have about a 250 percent greater mortality risk than married men – the nonmarried men who were alive at 48 years old were less likely to reach age 65. Nonmarried women were found to have a 50 percent greater mortality risk than married women.

A 2011 study also found consistent survival advantages for men and women 25 and older who are married – again, with married men having more health advantages over unmarried men than married women do over single women.

Janice Kiecolt-Glaser, PhD, who has spent decades studying the health effects of stress in the Stress and Health Research Program at The Ohio State University Wexner Medical Center, says the marital relationship is a key factor when it comes to health.

“In our work, we’ve found that one of the things that’s most strongly linked to immune function is close personal relationships,” confirms Kiecolt-Glaser, the director of Ohio State's Institute for Behavioral Medicine Research.

Why do married people tend to be healthier?

Single people who are healthier are more likely to become married and stay married than their peers who are in poorer health, so self-selection could be one reason for the health outcomes of married people as a group.

However, the fact is that humans are social animals whose habits are affected by those of other humans, and close study of our bodies reflects that.

Multiple scientific studies show that couples transmit their health habits to each other, whether those habits involve sleep, diet, smoking or exercise. Their habit-sharing leads them to have similar health outcomes, including their major coronary risk factors, such as blood pressure, cholesterol and BMI.

Research examining health outcomes of patients with arthritis shows that people were more active, reported less pain and had more physical function when they were more satisfied with their spouse’s support -- when they had partners who were more involved in managing their illness.

But while those close relationships have great power to influence our health, the effects could be for better or for worse.

Where health is concerned, is it always better to stay married than to get divorced?

When it comes to health effects, the quality of a marriage matters more than the state of being married.

“When relationships are troubled, they can really reverberate in terms of physical health – especially in those close relationships,” Kiecolt-Glaser says.

A recent Ohio State study shows a clear example of how marital conflict leads to poorer health.

“We studied how sleep related to inflammation among married couples, and whether one partner’s sleep affected the other’s inflammation,” says Stephanie Wilson, PhD, lead researcher on the study and a postdoctoral fellow in Ohio State’s Institute for Behavioral Medicine Research.

Researchers already knew that sleep problems are linked with the inflammation that's associated with higher risks of cardiovascular disease, diabetes, arthritis and other chronic illnesses, Wilson says.

When they studied married couples, they found that people who got less sleep had a greater inflammatory response following marital conflict. The people in the study also were more likely to become hostile with each other when both partners had gotten less sleep.

Further research on marital effects for patients with arthritis suggested that, when spousal support is unwanted or perceived as critical or controlling, there can be poorer health consequences. A 2013 study found that male osteoarthritis patients actually were less physically active on days that their wives pushed them to be more active.

So, rather than the institution of marriage itself, it’s the satisfaction and helpful support of marriage that provide health benefits.

If staying in a marriage means living in a state of constant hostility – where there’s no possible resolution through counseling or other means of reconciliation – it could be better for your health to end it.

Research suggests that people in happy marriages fare best, and singles may be able to attain better health than people who are unhappily married. About 10 to 15 percent of divorcees have more health risks because of post-divorce emotional struggles, according to a 2015 study. But most people who divorce do recover quickly.

“A good marriage is important, but it needs regular maintenance,” Kiecolt-Glaser says. “It’s such a central relationship. It can be a source of comfort, but if you lose that closeness and comfort, it can turn into a source of stress.”

>> See the latest published research from Ohio State’s Stress and Health Research Program