Dr. Nimako writes: The link between marriage and health

We have traditionally seen marriage as a union that provides companionship, security and a sanctioned avenue for procreation for the couple involved. But there seems to be more to it; marriage has implications on our health scientists have been trying to proof the linkages for decades.

In 2005, researchers from Warwik University analyzed close to 100 studies from across the world, and spanning over 30 years, that tried to assess the health benefits, or otherwise, of marriage. Their findings make for interesting reading, as summarized below.

Benefits for physical health

In an interesting study in 2003, it was found that people who have stronger social ties, like marriage, are better able to withstand cold viruses, probably due to the strengthening of the immune system.

Marriage also seems to have a cardio-protective effect; good marriages have been found to keep the blood pressure normal. Research has also found that married individuals survived heart attacks more often than their single compatriots.

Researchers in the University of Pennsylvania also found that separated or divorced individuals who underwent heart surgery were 40% more likely to die or suffer a new disability in the ensuing two years post-surgery than those individuals with a partner at home.

An important study into the effects of marriage on the incidence of Alzheimer’s disease was published in 1999, using data from France. The authors of the study found significantly higher risk of Alzheimer’s among the never married and much lower incidence among those who had stayed married.

For both sexes, increases in marriage quality bring about large perceived benefits in health. Most interestingly, the mechanism by which this is caused is identified as marriage quality reducing distress, which in turn reduces risky behaviours, which brings health benefits. Marriage also increases emotional support and may change lifestyles because of some kind of guardian effect, where healthy activities are increased and risky behaviours reduced.

Marital harmony was also found to be associated with much better sleep and fewer visits to the doctor.

Benefits for psychology

Comparing the different marital states with regards to mental wellbeing, it was found that the married turn out to be happier than cohabiters, who are themselves happier than single individuals. Among the married, however, it was demonstrated that marriage quality was the best predictor of mental wellbeing, with those reporting happy marriages being the happiest and vice versa.

Some of the studies also showed that there is a lower incidence of depression among married women and lower incidence of alcohol abuse among married men compared to their unmarried contemporaries.

Benefits for Longevity

People who are divorced or separated or widowed are at a particularly high risk of dying prematurely. Those never married face somewhat lower risks of death in any given period, but the married have easily the lowest risk of all the groups.

Compared to married men, it has been found that widowed men have a 44% higher risk of mortality, and divorced men a 60% higher risk, while widowed women have 36% and single women 50% greater risks. These are enormous effects from relationships.

A study out of Britain found that the large benefits of marriage were enough to offset the risk of smoking for men, and enough to offset approximately half the smoking risk for women.

The protective effect is especially strong against ‘social’ causes of death (classified here as accidents, suicide, cirrhosis (irreversible liver damage) or homicide).

The challenges

Though research has identified these positive associations with marriage, a causal relationship is difficult to establish; are the benefits of marriage just co-incidental? E.g. is happiness in a marriage caused by the marriage or are the two individuals naturally happy people? Philosopher David Hume pointed out, just because something moves first does not mean that it causes what goes second, no matter how reliable the correlation.  Hume’s example was the crowing of the cock followed by the invariable rising of the sun.

Also, human beings are not, of course, randomly assigned to marriage. They choose it. Because of that, there are likely always to be difficulties about how to interpret the deep links between marriage and wellbeing.

On the flip side, it must be recognized that it is not always rosy for the married. One recent study showed that for women especially, there is a notable increase in body mass index associated with living with a partner, with attendant health effects.

Another downside to marriage from the studies is autonomy. The review of the literature shows that though the continually single are less happy and more depressed, they exhibit higher autonomy and personal growth than their married counterparts.

Then there is the devil called divorce. Though no one goes into a marriage with the aim to dissolve it later, it is a real possibility, considering that about 50% of marriages end in divorce, or separation at the least. The literature shows that most of the health benefits derived from being married are eroded when the partners separate.

Even before divorce, there is the phenomenon of a bad marriage. As you would have noted by now, almost all the benefits of marriage have a caveat: the marriage has to be a harmonious, happy one. Benefits like lowering of blood pressure, better sleep and reduction in incidence of depression are absent in a bad marriage and in a good number of such marriages the reverse prevails.

In Conclusion

The institution called marriage, if executed as it ought to be – in harmony and happiness – produces desirable health outcomes, and the reverse also holds.

As the Good Book says, he [or she] who finds a wife [or husband], finds a good thing; once it remains a “good thing” you are safe, otherwise you may be digging an early grave.

When it comes to marriage, choose happiness, and all other things will be added to you.

By: By: K.T. Nimako (MB ChB)

Dr. Kojo Nimako is a private medical practitioner with an interest in public health, and Citi FM’s Chief Medical Correspondent. He is also the editor of healthbloggh.com and the Executive Director of Helping Hand Medical Outreach, an NGO focused on health education.

Follow on Twitter: @KTNimako

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