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The Marriage Health Connection

US Department of Health and Human Services (HHS)

Married people are generally healthier than unmarried people, as measured by numerous health outcomes.(1)  To investigate the complex relationship between marriage and health, this review scrutinizes recent research, focusing on studies that use rigorous statistical methods to examine whether marriage is a cause of these better health outcomes.

A focus on the most rigorous recent evidence reveals that marriage has positive effects on certain health-related outcomes. These studies find, for example, that marriage improves certain mental health outcomes, reduces the use of some high-cost health services (such as nursing home care), and increases the likelihood of having health insurance coverage. In addition, an emerging literature suggests that growing up with married parents is associated with better health as an adult. Marriage has mixed effects on health behaviors — leading to healthier behaviors in some cases (reduced heavy drinking) and less healthy behaviors in others (weight gain). For other key health outcomes — in particular, measures of specific physical health conditions-the effects of marriage remain largely unaddressed by rigorous research.

The relationship between marriage and health is complex. Marital status can both affect health outcomes and be affected by them. Healthier people may have a better chance of marrying and staying married because they may be viewed as more desirable marriage partners based on their physical attractiveness, earnings potential, mental well-being, degree of self-sufficiency, or likely longevity. Social scientists describe this pattern as the “selection” of healthy people into marriage. If this is the only reason for the correlation between marriage and health, then marriage is not causing better health. Instead, the observed health differences between married and unmarried people are the result of healthier people being more likely to marry.

Alternatively, there may be a true causal link between marriage and better health. Marriage could improve health outcomes in a variety of ways. It may result in two incomes, as well as economies of scale, improving economic well-being.  Having more income could, in turn, improve health outcomes by enhancing access to health care or lowering stress. In addition, a spouse may play an important role in monitoring and encouraging healthy behaviors (such as good eating habits and regular exercise), as well as in discouraging unhealthy ones (such as smoking or heavy drinking). Marriage may also provide an emotionally fulfilling, intimate relationship, satisfying the need for social connection, which could have implications for both physical and mental health.  Most researchers conclude that the association between marriage and health represents a combination of the selection of healthier people into marriage and true health benefits from marriage.

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