Highly recommended. Suzanne Clisby is a director of postgraduate gender studies and lecturer in social sciences at the University of Hull, UK. Her research focuses on gender, social policy and development, both in UK and international contexts. Julia Holdsworth combines university-based research and teaching in the social sciences with research and community development work both in the UK and abroad.
Published 17 Feb Page count pages. We work from a life course perspective to assess the impact of marital status and marital transitions on subsequent changes in the self-assessed physical health of men and women.
Our results suggest three central conclusions regarding the association of marital status and marital transitions with self-assessed health. First, marital status differences in health appear to reflect the strains of marital dissolution more than they reflect any benefits of marriage. Second, the strains of marital dissolution undermine the self-assessed health of men but not women.
Finally, life course stage is as important as gender in moderating the effects of marital status and marital transitions on health.
Health and Wellness
Married individuals are, on average, healthier than their unmarried counterparts, and men appear to receive more benefits from marriage than women Hemstrom ; Lillard and Waite ; Rogers Recent research, however, raises serious questions about this general conclusion. An alternative explanation is that marital status differences in health result from the substantial but transient strains of marital dissolution. Despite much speculation about the processes responsible for marital status differences in health, most attempts to answer this question have been constrained by the use of cross-sectional data.
We employ nationally representative longitudinal data to examine the impact of transitions into and out of marriage on the self-assessed health status of men and women. We also integrate a life course perspective with research and theory on marriage and health to investigate whether the benefits of being married or the strains of marital dissolution differentially affect the health of young, mid-life, and older men and women. The life course perspective suggests that the timing of role transitions and statuses influences their effects on well-being Elder ; see George Applying a life course framework to research on marriage and health helps to clarify who is most likely to benefit from marriage and to identify those who are most vulnerable to the negative effects of marital dissolution.
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Married individuals report better self-assessed health, have lower rates of long-term illness, are less depressed, and live longer than their unmarried counterparts Hemstrom ; Lillard and Waite ; Ross, Mirowsky, and Goldsteen Theoretical explanations for the link of marital status with health typically take one of two forms. The marital resource model suggests that marital status differences in health result from the greater economic resources, social support, and regulation of health behaviors that the married enjoy Ross et al.
In contrast, the crisis model emphasizes that marital status differences in health exist primarily because the strains of marital dissolution undermine health Booth and Amato ; Williams, Takeuchi, and Adair Two methodological conventions—a heavy reliance on cross-sectional data and a failure to distinguish between marital status at one point in time and marital transitions—make it difficult to sort out the relative contributions of each explanation. For example, the crisis model predicts that after a temporary decline in health following a transition out of marriage, the health of the divorced or widowed should be no different from that of the married.
Although previous research has not examined the relative merits of the crisis and the resource model in accounting for marital status differences in physical health, recent studies of the effects of marital status and marital transitions on mental health offer some insight. This research suggests that the crisis model is more applicable than the marital resource model in accounting for the better mental health of the married compared to the unmarried.
For example, Booth and Amato find that psychological distress increases just prior to divorce, remains elevated for a few years, and eventually returns to levels that are similar to those reported by the continually married. Similarly, longitudinal research on bereavement suggests that there may be few long-term effects of widowhood on mental health McCrae and Costa Cross-sectional research on marital status and psychiatric disorder also provides indirect support for the crisis model.
Williams et al. However, research describing the effect of marital status and marital transitions on mental health cannot be automatically generalized to physical health. Despite substantial comorbidity, the etiologies of mental and physical disorders differ considerably Thoits In the present study, we consider the relative importance of the crisis model and the marital resource model in explaining marital status differences in physical health.
In addition to distinguishing between marital status continuity and marital transitions, we investigate whether the negative health consequences of transitions out of marriage attenuate with time.
Focusing on the physical health consequences of marital transitions also allows for the examination of a neglected issue: the effects of transitions into marriage on health. Little is known about the short-term processes through which entry into marriage and the lifestyle adjustments that it may entail affect health and well-being.
If marital status differences in health reflect resources provided by marriage, transitions into marriage should be associated with improved health, and this advantage should persist or increase with time. Yet research on mental health provides little support for this conclusion. Horwitz and White find no evidence that the transition into first marriage reduces depression among young adults.
Although other studies suggest that transitions into marriage are associated with a decline in depression Simon and Marcussen , it is unclear whether these results are permanent or temporary. As Marks and Lambert point out, failure to consider these temporal changes may overstate the greater well-being of the married compared to the never-married. In sum, although marriage may benefit individuals in ways that ultimately enhance health, recent research on mental health suggests that the average effects of marital status and marital transitions on physical health will provide greater support for the crisis model than the marital resource model.
Thus, we expect that transitions out of marriage will be associated with declines in health while continuity in an unmarried status will not undermine health. Moreover, we expect that declines in health will be sharpest immediately following a transition to divorce or widowhood and will dissipate with time. Although less is known about the health consequences of entering marriage, research on psychological well-being suggests that transitions into first marriage should be associated with improved health immediately following the transition, but these effects may attenuate over time.
Age and other life course markers are associated with a range of psychosocial and structural attributes—all of which may impinge on the process through which marriage and marital transitions affect health.
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The stress process is central to the crisis explanation of marital status differences in health and well-being. Viewing the stress paradigm through a life course lens suggests two key reasons to suspect that the effects of marital transitions on health and well-being may vary by age. First, exposure to multiple stressors increases vulnerability to additional stressful life events or chronic strains Ulbrich, Warheit and Zimmerman Because many older adults experience a pile-up of stressors associated with the death of significant others and declines in economic well-being Mirowsky and Ross ; Ensel et al.
Second, a key premise of stress research is that the extent to which exposure to a role-related stressor i. According to socioemotional selectivity theory, in later years, individuals begin to restrict their social networks to focus more exclusively on their primary relationships, including marriage Carstensen If the marital relationship becomes more salient to individuals at later ages, exits from marriage should more strongly undermine the health of older compared to younger adults.
Life course differences in the effects of transitions into marriage are more difficult to predict. Life course theory suggests that occupying particular roles at non-normative stages of the life course may undermine well-being Elder Clearly, being never-married is common among younger adults, especially given recent increases in the age at first marriage. Older individuals may have more to gain by becoming married because this transition involves an exit from a non-normative status.
A traditional and central focus of research on marriage and health is gender difference, and the physical health advantage of marriage appears to be greater for men than for women Hemstrom ; Lillard and Waite ; Rogers According to the marital resource model, marriage provides more benefits to men in the form of a healthy lifestyle, emotional support, and physical comfort. Thus, we do not know if transitions into or out of marriage have different consequences for the health of women and men. There are a number of reasons to expect that they may.
Well-Being, More Than a Dream: Women Constructing Metaphors of Strength
Despite a convergence of gender roles, women continue to assume more parental and household responsibilities than men Lennon and Rosenfield Thus, it is likely that exiting and entering marriage entails a different balance of rewards and costs for women and men. These life patterns form the context in which marriage and marital transitions are experienced and, therefore, have important implications for the association of marital status with health. In sum, recent research on marriage and mental health, the stress process, and the life course perspective lead us to argue that commonly observed gender and marital status differences in health are better explained with a crisis model than a marital resource model.
We contend that a carefully nuanced analysis of marital status and health that takes into account the time spent in the status, marital transitions, and life course position will support the crisis model and shed light on gender differences in the costs and benefits of marriage for health. We test seven basic hypotheses:. Interviews were conducted with a nationally representative sample of 3, persons ages 24 and older in residing in the contiguous United States.
The sample was obtained using multistage area probability sampling with an oversample of African Americans and older individuals. All analyses presented here are weighted to adjust for the oversample of special populations and the attrition that occurred between waves.
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Analyses reported here are based on a standard cross-sectional time-series, or panel, design. To take full advantage of the available data, we pool the three waves of. This provides two survey waves with information on the respondent at the current survey wave and the previous wave. Since there are two observations for the 2, respondents who participated in all three waves of data collection, standard errors are adjusted for the clustering of observations within individuals.
Estimates of the association of marital transitions with changes in health are obtained using regression with lagged dependent variables. There are two advantages to pooling data. First, this approach increases the age range of respondents who experience marital status transitions of interest and therefore widens the age range across which our results can be generalized. Second, this analytic strategy increases the cell size of respondents experiencing specific marital status transitions, and it reduces the probability that a lack of statistical power will result in a failure to observe a significant effect of marital status or a significant age difference in the association of marital status with health in those instances when these effectsexist i.
Dummy variables represent continuity and change between Time 1 and Time 2 in the following marital statuses: 1 continually married, 2 continually never married, 3 continually divorced, 4 continually widowed, 5 married to divorced, 6 married to widowed, 7 never married to married, and 8 divorced or widowed to remarried. Respondents experiencing more than one marital transition between waves and those whose marital history could not be classified due to missing or inconsistent data are excluded. Because the consequences of divorce and separation for health may differ, respondents who transitioned from married to separated and those who were continually separated between Time 1 and Time 2 are also excluded.
Self-assessed health is widely recognized as a valid indicator of overall health status Ferraro and Farmer Life course stage is measured with a continuous variable that indicates the age of the respondent in years at Time 1. To facilitate interpretation, the age variable is centered at 24 years, the youngest age of respondents in the panel. Analyses not shown indicated that neither an age-squared lower-order coefficient nor any of the interactions with age-squared were significant.
We also consider the effects of the duration in months of the marital status occupied at Time 2.