Marriage may not always be as beneficial to health as
experts have led us to believe, according to a new study.
Researchers made two discoveries that explain why: First,
marriage provides less protection against mortality as health deteriorates,
even though it does seem to benefit those who are in excellent health.
Secondly, married people tend to overestimate how healthy they are, compared to
“We believe marriage
is still good for the health of some people, but it is not equally protective
for everyone,” said Hui Zheng, lead author of the study and an assistant
professor ofsociology at The Ohio State University. “For those who are already
in poor health, marriage doesn’t seem to provide any extra benefits.”
Same for men and
The results generally held true for both men and women. They
were also similar for all types of unmarried people, including divorced,
widowed and never married, as well as separated people.
Zheng conducted the study with Patricia Thomas of the
University of Texas at Austin. Their results appear in the March 2013 issue of
the Journal of Health and Social Behavior.
The researchers used data on about 789,000 people who
participated in the National Health Interview Survey from 1986 to 2004. In this
survey, participants rated their own health on a five-point scale (excellent,
very good, good, fair, poor). Zheng and Thomas then used follow-up data to identify
the nearly 24,100 people who died between 1986 and 2006.
The self-rated health measure used in this study has been
found to be one of the best predictors of whether a person will die in both the
short and long term – even better than doctor diagnosis in some cases, Zheng
The researchers used a statistical model to determine how
self-rated health, marriage status and other factors related to mortality risk
over a three-year period.
What the study
Overall, the researchers confirmed the volumes of previous
research that has found that, overall, being unmarried – including never
married, separated, divorced and widowed – significantly increases the risk of
death within three years. For example, a never-married person who lists his
health as “excellent” is two times more likely to die within three years than a
similar married person in excellent health.
But their new finding is that as self-rated health declines
(from excellent down to poor), the mortality advantage for married people
For example, for never-married people, each unit decline in
health (e.g., from fair to poor) decreases the risk of death compared to
married people by 12 percent. When people rate their health as “poor,” there is
essentially no difference in mortality risks between married and unmarried
“These results suggest that marriage may be important for
the prevention of disease, but not as helpful once people become seriously
ill,” Zheng said.
“That’s why we see a protective effect of marriage when
people are in excellent health, but not when they are in poor health.”
The researchers confirmed that marriage offers diminishing
protection against mortality at poorer levels of health by using another, more
objective measure of health. They compared married and unmarried people’s responses
to questions about how well they could handle routine care activities such as
eating and bathing, as well as activities that promote independent living, such
as driving and cooking.
These results also showed that married and unmarried people
have similar mortality rates when they have worse health as measured by
limitations on their ability to perform these types of activities.
But the diminishing protection of marriage as health
declines is only part of the explanation about why marriage may not guard
health as much as assumed. The other explanation uncovered by the study is that
married people overestimate how healthy they are.
“The married don’t seem to report their health as being poor
until they’ve already developed much more severe health problems,” Zheng said.
“They have a different threshold for what they consider to
be bad health compared to unmarried people.”
That means that once a married person rates his health as
“poor,” he may be sicker than a similar single person who also lists his health
The reason may have to do with the social support married
people receive from their spouses.
“Even when married people do get sick, the impact on their
life may be less because of the support they receive from their husband or
wife. They don’t rate their health as low as do unmarried people, because their
spouse helps them cope,” Zheng said.
These results shouldn’t be used to cast doubt on the
validity of self-rated health measures, Zheng said. In general, self-rated
health is still very useful and accurate in predicting mortality. However, the
results here show researchers should use such measures cautiously when
comparing people of different marital statuses.
People should also be clear about what marriage can and
cannot do when it comes to health.
“Marriage is helpful in persuading people to adopt a healthy lifestyle
that can lead to a longer life,” Zheng said. “But it is not as useful in
helping people recover from a serious illness.”
The research was supported in part by the Eunice Kennedy
Shriver National Institute of Health and Child Development.