In this article, we argued that the short-term effects of marital status and marital transitions on health extend to the long term and accumulate over the life course. We tested four specific hypotheses about the way this process unfolds by examining the association between marital biography and four dimensions of health in a nationally representative sample of mid-life adults. Overall, our results provide strong support for our expectations.
We first tested the hypothesis that health in mid-life is related to a person’s history of marital transitions over and above his or her current marital status. We found that, on all the dimensions we examined, currently married persons who have never been divorced or widowed show better health than currently married persons who have ever experienced a marital loss. Previously married persons show poorer health than the continuously married on all dimensions, and poorer health than the remarried on all dimensions but mobility limitations. However, we found little evidence that people with multiple disruptions are in worse health than persons with a single disruption, given their current marital state.
Next, we tested the expectation that, conditional on marital transition history, duration in particular marital states is associated with health. In particular, we tested the parallel hypotheses that, among persons who had been continuously married, people who had been married a greater proportion of their lives would be healthier (hypothesis 2) and that, among people who had experienced at least one marital loss, people who had divorced or widowed a greater proportion of their lives would be in worse health (hypothesis 3). Our results partially support these hypotheses. Contrary to our second hypothesis, we found a negative relationship between age at marriage and chronic conditions and mobility limitations among men who have been continuously married, indicating that these conditions are positively related to duration of marriage. We speculate that differences in both men’s age at marriage and health by social class underlie this finding. In support of our third hypothesis, among those with at least one marital disruption we found a positive relationship between the percent of years since first marriage spent divorced or widowed and both chronic conditions and mobility limitations, conditional on current marital status.
Fourth, we tested the hypothesis that health deficits among persons with a history of marital loss, shorter durations married, or longer durations unmarried would be largest for dimensions of health that reflect experiences over a long period, such as chronic conditions and mobility limitations, and smallest for dimensions of health such as depression that can change relatively quickly in response to marital transitions. Our results again support our expectations. In particular, the health advantage of the continuously married over the remarried appears to be largest for chronic conditions, mobility limitations, and self-rated health, and smallest for depressive symptoms. The percent of years since first marriage spent divorced or widowed was positively associated only with chronic conditions and mobility limitations, the two health conditions that develop slowly.
Our study adds to the growing body of work on the effects of marital biography on health. In particular, our results are suggestive regarding the components of marital biography that influence health over the long term. As we have noted, the relationship between marital biography and health may be due to experiences of marital transitions, experiences in marital states, or both. Furthermore, the relationship may reflect experiences of marriage or experiences of marital loss. Being married may protect or even improve health, getting divorced or becoming widowed may damage health, and being divorced or widowed may damage health. Although our analyses do not provide a definitive resolution to this debate, they do offer some clues, most of which suggest that marital loss may be the dominant factor when considering conditions with long-term etiologies such as chronic conditions and mobility limitations. First, we found that marital loss was positively associated with chronic conditions and mobility limitations regardless of current marital status. Second, we found little support for the argument that health at mid-life is better for persons who have been married longer, at least among those who have been married continuously. If anything, the reverse is true for two health dimensions with long etiologies, where we might expect any relationship to be strongest. At the same time, we find strong and consistent effects of being married on later health; among those who have ever been divorced or widowed, the remarried generally show better health than those who have remained unmarried, and those who spent more time married report fewer chronic conditions and mobility limitations. Those who have never married have more mobility limitations, rate their health as worse, and show more depressive symptoms than the married. Those who have married once and remained married are consistently, strongly, and broadly advantaged.
Our results also point to substantial heterogeneity across health dimensions in the extent to which they reflect accumulated life experience. Some dimensions, such as depressive symptoms, seem to respond both quickly and strongly to changes in current conditions. In contrast, those health dimensions such as chronic conditions that develop slowly over a lengthy period show the imprint of past experiences. This suggests that thinking carefully about the etiology of dimensions of health can yield insight into the social processes that contribute to observed differentials. Similarly, considering both current state and prior marital history seems key to sorting out the impact of marriage on health.
In this article, we have emphasized the potential effects of marital biography on health. However, people with different levels of health may be more or less likely to marry, to experience divorce or widowhood, and to remarry. Poor health, especially poor mental health, can lead to marital dissatisfaction and divorce. Correlation in the health of spouses means that sick people are more likely to become widowed. Although health selection into marriage and health protection from marriage are often discussed as if they are competing explanations, they need not be so. Our reading of the existing evidence suggests that both types of relationships are present and that their magnitude varies by the health dimension under consideration. We see selection not as a threat to our story but as an integral part of the process by which health disparities are generated (Bulatao and Anderson 2004
). Thinking in terms of marital biographies shifts attention to the way these processes interact over the life course to produce patterns of health advantage and disadvantage.