Health, Marriage, and Longer Life for Men
Numerous studies covering 140 years have shown that married persons tend to live longer than their unmarried counterparts. Attempts to explain this advantage have typically focused on the following questions: Does marriage have a direct protective effect, reducing the risk of mortality by providing benefits such as improved health? Or does increased longevity reflect the possibility that healthy people are more likely to get married—and therefore that married people are simply healthier from the start of their married lives?
The focus of these questions suggests that the connection between longevity and the married state can be explained only by "protection" provided through marriage or by "positive selection" into marriage because of good health. However, a third consideration may also offer insights into the relationship between marriage and health. If being married is a way of gaining increased protection against illness and death, then persons in poor health may have a greater incentive to seek these benefits by marrying and staying married. This mechanism may be termed "adverse selection" into marriage and, theoretically, could be as significant a factor as positive selection. Yet, while it is often suggested that selection may account for at least part of the marriage advantage, previous empirical work has concerned itself with positive selection and has not considered the possibility that adverse selection may also play a role.
Recent research at the RAND Center for the Study of Aging attempts to fill this gap. The researchers use a nationally representative dataset to track more than 4000 men over a 22-year period. The study analyzes changes in the men's health status alongside the course of their major marital transitions—their history of marriage, divorce, death of a spouse, and remarriage. Overall, the findings indicate that both the protection and selection scenarios help explain the marriage advantage. On the one hand, good health reduces the risk of mortality and, in certain circumstances, marriage contributes to good health. On the other hand, the health status of individuals does help determine their selection into the married state.
Effects of Marital Status on Health
Analysis of whether marriage directly affects health produces mixed results. Comparisons of currently married and never-married men show that while the former are generally healthier, this difference cannot be attributed simply to the protective effects of marriage. The self-reported health status of men shows that, by itself, becoming married for the first time does not lead to any noticeable benefits. Comparisons of older married and divorced men, however, show that the relative health levels of the latter drop significantly as they age. By the time divorced men reach age 50, they can expect their health to deteriorate much faster than the health of those who are married. For this group of older divorced men, remarriage offers a direct health benefit, bringing their health up to the level of men who have remained married.
The health benefits obtained by men who stay married or remarry stem from a variety of related factors, including care in times of illness, improved nutrition, and a home atmosphere that reduces stress and stress-related illnesses, encourages healthy behaviors, and discourages unhealthy ones such as smoking and excessive drinking. Influences of this type tend to enhance a man's immediate health status and may often improve his chances for a longer life.
Effects of Marital Status on Mortality after Controlling for Health
As men age, their health declines and the risk of mortality increases. Not surprisingly, however, the level of risk is tied to marital status: married men in their 50s, 60s, and 70s have lower mortality rates than those who are unmarried (never married, divorced, or widowed). For divorced men, this higher risk of death is explained primarily by their poorer health. Among never-married men and widowers, however, excess mortality rates are less related to self-reported health status—a finding that raises questions about the factors that lead to earlier death. Previous research has indicated that part of the marriage advantage stems from co-residence with a partner or with other adults. Never-married men may prefer to live alone, thus forgoing the potential life-extending benefits of social integration.
Effects of Health on Marriage Formation and Dissolution
Contrary to conventional wisdom, which assumes that healthier men enter marriage more readily than their less healthy peers, the study shows that healthier men actually tend to marry later and to postpone remarriage. Relatively unhealthy men, by contrast, tend to pursue marriage more actively. They marry earlier, are less likely to divorce and are more likely to remarry following a divorce or the death of a spouse. For these men, marriage can be an effective means of promoting physical health and increasing longevity. Their behavior supports the view that there is an adverse selection into marriage on the basis of health.
At the same time, the study also found evidence for positive selection into marriage on the basis of factors other than health. In their youthful years, some men have attributes (besides their general health status) that not only make them more likely to marry but also make them healthier individuals. Such habits or preferences are established early in the life cycle, leading to a positive overall association between being in good health and being married. This correlation, however, is not a result of the influence of general health on marriageability or of the health benefits of marriage.
Summary and Conclusions
The relationship between marriage and longevity is more complex than had been generally believed. Clearly, the longer life of married men cannot be explained by pointing exclusively to either protection from ill health or selection into marriage on the basis of good health. What the findings confirm for the first time is that the self-reported health status of men does affect marriage decisions—but not in ways that support the notion of positive selection. Since good health discourages marriage, and poorer health encourages marriage, the connection between marriage and better health can be explained by individual habits and preferences that promote both health and marriage.
In addition, the evidence indicates that although marital status has an effect on mortality, the determining factors underlying this effect are not always clear. In the case of older divorced men, being outside of marriage leads to poorer health and also to shorter life. Other unmarried men, however, have higher mortality rates despite the fact that their general health levels are no worse than those of married men. Therefore, while the relatively good health of married men offers a partial explanation for their increased longevity, additional determining factors have yet to be found.
-  Lee A. Lillard and Constantijn W.A. Panis, "Marital Status and Mortality: The Role of Health," Demography, 33(3):313-327, 1996.