Effects of Marriage on Physical Health

1. Health Care

Family intactness has a negative (decreasing) influence on an area’s fraction of 25- to 54-year-olds and minors receiving public healthcare,1) and a positive (increasing) influence on an area’s fraction of 25- to 54-year-olds and minors with private healthcare coverage.2) Married men and women are also more likely to have health insurance.3) Furthermore, married individuals occupy hospitals and health institutions less often than others,4) are released from hospitals sooner, on average, than unmarried individuals,5) and spend half as much time in hospitals as single individuals.6) Married individuals are also less likely to go to a nursing home from the hospital.7) Not surprisingly, marriage also affects an individual's health.

2. Lifestyle

A lower fraction of married persons than widowed, divorced or separated, never-married, or cohabiting persons have only “fair to poor health.”8) Married women rate their health better than do divorced, separated, widowed, and never-married women.9) Married individuals smoke and binge-drink less frequently than cohabiters.10) Women who marry lessen their alcohol consumption, while married men whose marriages break up increase their alcohol consumption and cigarette use.11) Married young adults are less likely to be alcoholic than young adults who are not in a romantic relationship.12)

Always-intact married adults are less likely than married, previously divorced adults and unmarried adults to report that they sometimes drink too much alcohol. According to the General Social Survey (GSS), 32.8 percent of always-intact married adults have reported that they sometimes drink too much alcohol, followed by 38.5 percent of married, previously-divorced adults, 43.2 percent of single, divorced or separated adults, and 47.8 percent of single, never-married adults. 13) (See Chart Below)

"Sometimes Drinks Too Much Alcohol" by Marital Status

3. Severe Illnesses

Married men and women have higher survival rates after being diagnosed with cancer, regardless of the stage of the cancer’s progression, than do their unmarried counterparts.14) Married persons’ responses to cancer treatment are better and are comparable to those of people 10 years younger.15) After being diagnosed with prostate cancer, married men live longer.16) Unmarried women with breast cancer are more likely to be diagnosed later and have higher three-year (breast cancer-specific) morbidity.17) Similarly, a smaller ratio of married individuals die of cirrhosis of the liver, lung cancer, tuberculosis, and diabetes than never-married, divorced, and widowed individuals, controlling for age.18) Married people are less likely to die after being hospitalized for a heart attack.19) Always single and widowed men and women have higher stroke risks than married men and women.20) Marriage also has significant benefits for an individual’s mental health.

4. Longevity

Married people have lower mortality rates,21) including lower risk of death from accidents, disease, self-inflicted injuries,22) and suicide.23) Compared to those who are married, those who are divorced/ separated have an 83 percent higher risk of suicide, those who are never married have a 48 percent higher risk, and those who are widowed have a 41 percent higher risk.24) The longer a person’s marriage, the lower is their mortality risk, relative to that of the unmarried.25) Having children further reduces the risk of suicide. Marital unions without children have a 33 percent lower risk of suicide than single adults, whereas marital unions with children experience a 48 percent decreased risk.26)

5. STDs and Pregnancy

Married mothers practice better prenatal care and more consistently avoid harmful substances than unmarried mothers do.27) Married mothers are less likely to have low birth weight children than stably cohabiting mothers or mothers involved in a romantic relationship with their baby’s father.28) Married women have significantly fewer abortions than unmarried women.29)

According to the National Health and Social Life Survey, those in always-intact marriages were least likely to have ever had a sexually transmitted disease (1.3 percent). Sexually transmitted disease is more prevalent in non-intact family structures and among singles: 1.8 percent of those who were always single have had a sexually transmitted disease; 3 percent of those who were divorced or separated have had a sexually transmitted disease and 3.1 percent of those who were divorced and remarried had ever had a sexually transmitted disease.30) (See Chart Below)

Percentage Who Have Ever Had an STD

6. Children's Well-Being

(See Effects of Divorce on Children's Health)

Children and adolescents from intact married families enjoy more emotional and behavioral well-being than children in cohabiting or step families.31) According to the National Survey of Children’s Health, children who live with both biological parents score lower on the behavior problems scale (49.0) than those who live with a biological parent and a stepparent (51.8),32) and children who live with both biological parents or two adoptive parents are more socially developed than those who do not.33) Adolescents who live with both biological parents are less likely to use hard drugs than those living in step-families, those whose parents have divorced, or those raised by a cohabiting single parent.34) Similarly, according to the National Longitudinal Study of Adolescent Health, children who live with both biological parents are less likely to get drunk.35)

Girls raised in intact married families have a later onset of puberty and thus are less likely to experience teenage pregnancy.36)

According to the Adolescent Health Survey (Wave I), female students in Grades 7-12 have an average of 0.71 sexual partners when they live in intact married families, whereas those who have a stepparent or divorced parents have an average of 1.39 and 1.29 sexual partners, respectively.37) (See Chart Below)

Sexual Intercourse Partners for Girls by Family Structure

1)
Specifically, family intactness has a very precisely determinable, negative influence on an area's fraction of 25-to 54-year-olds and minors receiving public healthcare.
Precision has no formal meaning. It indicates how clearly determinable (distinguishable from zero) an influence on an outcome is. Precision is comparable to standard deviation. Low/ no precision indicates a high standard of deviation in which data points spread over a large range of value, signifying that the influence of one variable over another is relatively uncertain. High precision indicates a low standard of deviation in which data points hover around the mean, signifying that the influence of one variable over another is relatively certain. For further elaboration see “Marriage and Economic Well-Being: The Economy of the Family Rises or Falls with Marriage”
Henry Potrykus and Patrick Fagan, “U.S. Social Policy Dependence on the Family, Derived from the Index of Belonging,” (2013). Available at http://marri.us/policy-2013.
2)
Specifically, family intactness has a very precisely determinable, positive influence on an area's fraction of 25-to 54-year-olds and minors with private healthcare coverage.
Henry Potrykus and Patrick Fagan, “U.S. Social Policy Dependence on the Family, Derived from the Index of Belonging,” (2013). Available at http://marri.us/policy-2013.
3)
R.G. Wood, B. Goesling, and S. Avellar, “The Effects of Marriage on Health: Synthesis of Current Research Evidence,” Contract # 233-02-0086 (Washington, D.C.: ASPE, HHS 2007). Available at http://aspe.hhs.gov/hsp/07/marriageonhealth/index.htm. As cited in Jana Staton, “Making the Connection Between Healthy Marriage and Health Outcomes: What the Research Says” National Healthy Marriage Resource Center Research Brief (2009): 1-18. Available at http://www.healthymarriageinfo.org/resource-detail/index.aspx?rid=3649. Accessed 8 September 2011.
Lauren Duberstein Lindberg and Susheela Singh “Sexual Behavior of Single Adult American Women,” Perspectives on Sexual and Reproductive Health 40, no. 1 (March 2008): 1
4)
P.M. Prior and B.C. Hayes, “Marital Status and Bed Occupancy in Health and Social Care Facilities in the United Kingdom,” Public Health 115, (2001): 402.
Lois M. Verbrugge, “Marital Status and Health,” Journal of Marriage and the Family 41, no. 2 (1979): 278.
5)
Howard S. Gordon and Gary E. Rosenthal, “Impact of Marital Status on Outcomes in Hospitalized Patients: Evidence from an Academic Medical Center,” Archives of Internal Medicine 155, (1995): 2467.
6)
Lois Verbrugge and Donald Balaban, “Patterns of Change, Disability and Well-Being,” Medical Care 27, (1989): S128-S147. As cited in Glenn T. Stanton, “Why Marriage Matters.” Available at http://www.ampartnership.org/resourcecenter/news/89-why-marriage-matters.html. Accessed 27 July 2011.
7)
Howard S. Gordon and Gary E. Rosenthal, “Impact of Marital Status on Outcomes in Hospitalized Patients: Evidence from an Academic Medical Center,” Archives of Internal Medicine 155, (1995): 2466, 2468.
8)
Charlotte A. Schoenborn, “Marital Status and Health: United States, 1999-2002,” Advance Data and Statistics no. 351 (2004): 9.
9)
Beth A. Hahn, “Marital Status and Women’s Health: The Effect of Economic Marital Acquisitions,” Journal of Marriage and Family 55, (1993): 502
Simó-Noguera, Carles, et al. “The Effect on Health of Marital and Cohabitation Status.” Revista Española De Investigaciones Sociologicas no. 151 (July 2015): 141, 156.
10)
Theodore D. Fuller, “Relationship Status, Health, and Health Behavior: An Examination of Cohabiters and Commuters,” Sociological Perspectives 53, no. 2 (2010): 236.
11)
Debra Umberson, “Gender, Marital Status and the Social Control of Health Behavior,” Social Science and Medicine 34, no. 8 (1992): 910.
Lois Verbrugge and Donald Balaban, “Patterns of Change, Disability and Well-Being,” Medical Care 27, (1989): S128-S147.
Susan L. Brown, and Lauren N Rinelli, “Family Structure, Family Processes, and Adolescent Smoking and Drinking,” Journal of Research On Adolescence 20, no. 2 (June 2010): 265-266.
12)
Jeremy E. Uecker, “Marriage and Mental Health among Young Adults,” Journal Of Health & Social Behavior 53, no. 1 (March 2012): 67.
13)
This chart draws on data collected by the General Social Survey, 1972-2006. From 1972 to 1993, the sample size averaged 1,500 each year. No GSS was conducted in 1979, 1981, or 1992. Since 1994, the GSS has been conducted only in even-numbered years and uses two samples per GSS that total approximately 3,000. In 2006, a third sample was added for a total sample size of 4,510.
Patrick F. Fagan and Althea Nagai, “'Sometimes Drinks Too Much Alcohol' by Marital Status,” Mapping America Project. Available at http://marri.us/wp-content/uploads/MA-85-87-177.pdf
14)
James S. Goodwin, et al., “The Effect of Marital Status on Stage, Treatment, and Survival of Cancer Patients,” Journal of the American Medical Association 258, (1987): 3127-3128.
Håkon Kravdall, and Astri Syse, “Changes Over Time In the Effect of Marital Status on Cancer Survival,” BMC Public Health 11, no. 1 (January 2011): 806, 814.
15)
James Goodwin, et al., “The Effect of Marital Status on Stage, Treatment, and Survival of Cancer Patients,” Journal of the American Medical Association 258, (1987): 3125-3130. As cited in Glenn T. Stanton, “Why Marriage Matters.” Available at http://www.ampartnership.org/resourcecenter/news/89-why-marriage-matters.html. Accessed 27 July 2011.
16)
A. Krongrad, et al., “Marriage and Mortality in Prostate Cancer,” Journal of Urology 156, no. 5 (November 1996): 1696-1670. As cited in Roger Dobson, “From Cancer to Heart Disease, The Amazing, Life-saving Benefits of Marriage.” Available at http://www.dailymail.co.uk/health/article-1049134/From-cancer-heart-disease-amazing-life-saving-benefits-marriage.html. Accessed 27 July 2011.
Du, KL, et al. “Impact of Marital Status and Race on Outcomes of Patients Enrolled in Radiation Therapy Oncology Group Prostate Cancer Trials,” Supportive Care In Cancer 20, no. 6 (June 2012): 1319, 1321-1322.
17)
Cynthia Osborne, et al., “The Influence of Marital Status on the Stage at Diagnosis, Treatment, and Survival of Older Women with Breast Cancer,” Breast Cancer Research and Treatment 93, (2005): 43-44.
18)
Walter R. Gove, “Sex, Marital Status, and Mortality,” The American Journal of Sociology 79, no. 1 (1973): 54-57.
19)
Vijay Chandra, et al., “The Impact of Marital Status on Survival after an Acute Myocardial Infarction: A Population-based Study,” American Journal of Epidemiology 117, no. 3 (1983): 322.
Liu, Hui, “Till Death Do Us Part: Marital Status and U.S. Mortality Trends, 1986 – 2000,” Journal of Marriage & Family 71, no. 5 (December 2009): 1171.
Philip Andrew Quinones, et al. “Marital Status Shows A Strong Protective Effect on Long-term Mortality Among First Acute Myocardial Infarction-Survivors with Diagnosed Hyperlipidemia – Findings From the MONICA/KORA Myocardial Infarction Registry,” BMC Public Health 14, no. 1 (February 2014): 3,10,12.
Joanna Maselko, et al, “The Intersection of Sex, Marital Status, and Cardiovascular Risk Factors in Shaping Stroke Incidence: Results from the Health and Retirement Study,” Journal Of The American Geriatrics Society 57, no. 12 (December 2009): 2295.
20)
Joanna Maselko, et al, “The Intersection of Sex, Marital Status, and Cardiovascular Risk Factors in Shaping Stroke Incidence: Results from the Health and Retirement Study,” Journal Of The American Geriatrics Society 57, no. 12 (December 2009): 2295.
21)
Lee A. Lillard and Linda J. Waite, “’Til Death Do Us Part: Marital Disruption and Mortality,” American Journal of Sociology 100, no. 5 (1995): 1144.
Jonathan Gardner and Andrew Oswald, “How Is Mortality Affected by Money, Marriage, and Stress?” Journal of Health Economics (2004): 1190-1191.
Richard G. Rogers, “Marriage, Sex, and Mortality,” Journal of Marriage and Family 57, (1995): 520.
Robert M. Kaplan and Richard G. Kronick, “Marital Status and Longevity in the United States Population,” Journal of Epidemiology and Community Health 60, no. 9 (2006): 761-762.
Yuanreng Hu and Noreen Goldman, “Mortality Differentials by Marital Status: An International Comparison,” Demography 27, no. 2 (1990): 239, 246-247.
Shah Ebrahim, et al., “Marital Status, Change in Marital Status, and Mortality in Middle-aged British Men,” American Journal of Epidemiology 142, (1995): 836.
Frans Van Poppel and Inez Joung, “Long-Term Trends in Marital Status: Mortality Differences in the Netherlands 1850-1970,” Journal of Biosocial Science 33, (2001): 288-289.
John E. Murray, “Marital Protection and Marital Selection: Evidence from a Historical-Prospective Sample of American Men,” Demography 37, no. 4 (2000): 519.
Ellen E. Kisker and Noreen Goldman, “Perils of Single Life and Benefits of Marriage,” Social Biology 34, no. 3-4 (1987): 137, 140.
Pekka Martikainen, et al., “Differences in Mortality by Marital Status in Finland from 1976-2000: Analyses of Changes in Marital-Status Distributions, Socio-Demographic and Household Composition, and Cause of Death,” Population Studies 69, no. 1 (2005): 102, 107.
Frank Trovato and Gloria Lauris, “Marital Status and Mortality in Canada: 1951-1981,” Journal of Marriage and the Family 51, (1989): 910, 912.
22)
Robert Coombs, “Marital Status and Personal Well-Being: A Literature Review,” Family Relations 40, (1991): 97-102. As cited in Glenn T. Stanton, “Why Marriage Matters.” Available at http://www.ampartnership.org/resourcecenter/news/89-why-marriage-matters.html. Accessed 27 July 2011.
Kjersti Norgård Berntsen, “Trends In Total and Cause-Specific Mortality by Marital Status Among Elderly Norwegian Men and Women,” BMC Public Health 11, no. 1 (January 2011): 537, 540.
23)
Denney, Justin T., et al, “Adult Suicide Mortality in the United States: Marital Status, Family Size, Socioeconomic Status, and Differences by Sex,” Social Science Quarterly 90, no. 5 (December, 2009): 1174.
24)
Denney, Justin T., et al, “Adult Suicide Mortality in the United States: Marital Status, Family Size, Socioeconomic Status, and Differences by Sex,” Social Science Quarterly 90, no. 5 (December 15, 2009): 1174.
25)
Lee A. Lillard and Linda J. Waite, “’Til Death Do Us Part: Marital Disruption and Mortality,” American Journal of Sociology 100, no. 5 (1995): 1149.
Dupre, ME, AN Beck, and SO Meadows, “Marital Trajectories and Mortality Among US Adults,” American Journal Of Epidemiology 170, no. 5 (September 2009): 546, 549-550. CINAHL Complete, EBSCOhost (accessed June 30, 2015).
26)
Denney, J. T., “Family and Household Formations and Suicide in the United States,” Journal of Marriage and Family 72, (2010): 208, 209.
27)
Rachel T. Kimbro, “Together Forever? Romantic Relationship Characteristics and Prenatal Health Behaviors,” Journal of Marriage and Family 70, (2008): 751-753.
Julien O. Teitler, “Father Involvement, Child Health and Maternal Health Behavior,” Children and Youth Services Review 23, no. 4-5 (2001): 413-414.
28)
Sheryl T. Bird, et al., “Beyond Marital Status: Relationship Type and Duration and the Risk of Low Birth Weight,” Family Planning Perspectives 32, no. 6 (2000): 285.
Julien O. Teitler, “Father Involvement, Child Health and Maternal Health Behavior,” Children and Youth Services Review 23, no. 4-5 (2001): 413.
29)
National Center for Health Services, National Vital Statistics Reports 58, no. 4 (14 October 2009), Table 5, “Pregnancy, Live Birth, and Induced Abortion Rates, by Marital Status and Race and Hispanic Origin: United States, 1990-2005.” As cited in Patrick F. Fagan, Thomas J. Tacoma, Brooke A. Tonne, and Alexander W. Matthews, “The Annual Report on Family Trends: 2011, The Behaviors of the American Family in the Five Major Institutions of Society” (February 2011): 101-102. Accessed 20 July 2011.
30)
Patrick F. Fagan and Althea Nagai, “'Has Ever Had an STD' by Marital Status and Religious Attendance.” Available at http://marri.us/wp-content/uploads/MA-129.pdf. Accessed 19 December 2013.
31)
Susan Brown, “Family Structure and Child Well-Being: The Significance of Parental Cohabitation,” Journal of Marriage and the Family 66, no. 2 (2004): 364. See also Gregory Acs and Sandi Nelson, “The Kids Are Alright? Children Well-Being and the Rise in Cohabitation,” Assessing the New Federalism Policy Brief B-48, (2002): 3.
32)
Patrick F. Fagan, “Behavior Problems and Family Structure,” Mapping America Project. Available at http://downloads.frc.org/EF/EF08K10.pdf
33)
Nicholas Zill, “Children’s Positive Social Development and Family Structure,” Mapping America Project. Available at http://downloads.frc.org/EF/EF09G09.pdf
34)
Patrick F. Fagan, “Family Structure and Adolescent Use of Hard Drugs,” Mapping America Project. Available at http://downloads.frc.org/EF/EF08F26.pdf
35)
Patrick F. Fagan, “Family Structure and Drinking,” Mapping America Project. Available at http://downloads.frc.org/EF/EF08H82.pdf
36)
Bruce J. Ellis, “Timing of Pubertal Maturation in Girls: An Integrated Life History Approach,” Psychology Bulletin 130, (2004): 920-958
Bruce J. Ellis et al., “Does Father Absence Place Daughters at Special Risk for Early Sexual Activity and Teenage Pregnancy?” Child Development 74, (2003): 801-821
Bruce J. Ellis, “Of Fathers and Pheromones: Implications of Cohabitation for Daughters’ Pubertal Timing,” Just Living Together: Implications of Cohabitation on Families, Children, and Social Policy, eds. A. Booth and A. Crouter (Mahwah, NJ: Lawrence Erlbaum Associates, 2002), 169. As cited in Institute for American Values, “Why Marriage Matters: 26 Conclusions from the Social Sciences”: 1-43. Available at http://www.americanvalues.org/pdfs/why_marriage_matters2.pdf. Accessed 1 August 2011.
37)
This chart draws on a large national sample (16,000) from the National Longitudinal Study of Adolescent Health, Waves I and II. This work was done by the author in cooperation with former colleagues at The Heritage Foundation, Washington, D.C.
Patrick F. Fagan, “Family Structure and Sexual Intercourse Partners—Adolescent Girls,” Mapping America Project. Available at http://marri.us/wp-content/uploads/MA-4-6-150.pdf


This entry draws heavily from 164 Reasons to Marry.