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The Health Premium of Marriage: Personality or Sex?

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In The Case for Marriage, Linda Waite and Maggie Gallagher (1) promote the advantages of marriage. Married people are healthier, wealthier, and live longer, they conclude. As people spend increasing amounts of their lives single, such conclusions are under attack.

Just a correlation?

One eye-popping finding was that 88 percent of men who remained married between ages 48 and 65 survived compared to 66 percent of other men (2). In other words, just 12 percent died compared to 34 percent of the comparison group. Married women did not have such a large survival advantage. Over the last decade, many studies converge on the conclusion that married persons have lower mortality rates than never married, widowed, or divorced people here and around the world (3).

The correlation between good health outcomes and marriage is still only a correlation. Just because married people are healthier, it does not follow that marriage improved their health. Perhaps healthier people are more attractive as partners and therefore more likely to marry.

A similar argument can be made about the length of marriage. Sociologist Eric Klinenberg (4) argues that couples may stay together because they are happy and healthy rather than being happy and healthy because they stay together. This might be a classic selection effect where initial differences between married people and singles are attributed to marriage itself.

This problem is not easily dismissed because certain personality traits that are correlated with unstable marriage are also associated with health problems. People with short fuses who feel, and express, a great deal of anger and hostility are hard to live with and also have increased vulnerability to heart disease and other illnesses.

Yet, there is far more to it than stable marriage selecting for health-promoting personality traits. There are many ways in which marriage may actually promote health whether these are due to the emotional connection between the partners, or not.

How marriage may boost health

Having a close confidant is one of the key predictors of heart health. Most men have only one close confidant – their wife. Women are more confiding however and typically have several friends to whom they can reveal secrets which may be why marriage is less of a boon to their health (1). Another reason for this difference is that women generally take better care of themselves so that their good health behavior rubs off on their husbands who acquire a more health-conscious diet, get medical checkups, sleep more, and drink less alcohol.

The health benefits from marriage are complex, particularly for men, ranging from good health behavior to the advantages of an intimate social connection to their partner to reduced risks of alcoholism, accidents, and violence (5). One reason that married people are healthier is that tend to enjoy a higher standard of living that is associated with longer life expectancy.

Interestingly, single life elevates men’s testosterone levels. Both competition against other men, and sexual intercourse with new women increase testosterone production (6) that suppresses immune function. On the other hand, marriage tends to calm men down and has the effect of reducing testosterone production.

Married people have sex more often than singles; that is believed to improve health – particularly for men (1, 4). Moreover, men who spend any time in direct care of their children produce more oxytocin, the “cuddling hormone,” that bolsters the immune system (7). Married women typically raise more children than single women, and spend more time in child care thereby deriving greater health benefits.

Conclusion

There may well be a selection effect whereby healthy people spend more of their lives married. Moreover, divorce can be a major stressor with steep health costs (1). Yet Klinenberg’s objection to the Waite and Gallagher thesis about the health benefits of marriage does not hold water. There are just too many compelling biological mechanisms through which marriage makes people healthier. Of course, unmarried cohabitation would have similar benefits except that it is typically more unstable.

By comparison, the single life is (or was) damaging – particularly to men who suffer from the rigors of a risky and unhealthy lifestyle and numerous challenges to the immune system. In the future, as more people are single for longer the quality of single life may improve due to greater social integration (4).

1. Waite, L. J., & Gallagher, M. (2000). The case for marriage. New York: Doubleday.

2. Lillard, L. A., and Waite, L. J. (1995). Till death do us part: Marital disruption and mortality. American Journal of Sociology, 100, 1131-1156.

3. Blomgren, J., Martikainen, P., Grundy, E., & Koskinen, S. (2012). Marital history 1971-1991 and mortality 1991-2004 in England & Wales and Finland. Journal of Epidemiology and Community Health, 66, 30-36.

4. Klinenberg, E. (2012). Going solo: The extraordinary rise and surprising appeal of living alone. New York: Penguin.

5 Courtenay, W. H. (2000). Behavioral factors associated with disease, injury, and death, among men: Evidence and implications for prevention. Journal of Men’s Studies 9, 81-142.

6. Archer, J. (2006). Testosterone and human aggression: an evaluation of the challenge hypothesis. Neuroscence & Biobehavioral Reviews, 30, 319-345.

7. Uvnas-Moberg, K. (1998). Oxytocin may mediate the benefits of positive social interaction and emotions. Psychoneuroendocrinology 23: 819-835.


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