Interpersonal Aspects of Midlife Marriage: Health

  If you are married at age 50, you want to have good health, right?  It’s common knowledge that there are studies that say if you are married, you probably are in better health and you will live longer. This assumes that the couple helps take care of and watch out for each other. This simplistic assumption holds true only if you have a satisfactory marriage. What if I told you that being married may cause you to have poor health?  Is your spouse a jerk, an alcoholic, a workaholic or just unresponsive to you?  You can bet this causes you additional stress! This stress causes elevated blood pressure and heart rates even in younger adults. If you are in midlife with continual stress, these physical responses are not good.  In long-term, midlife marriages, being married to someone who is uncaring, unhelpful and makes too many demands on you may cause you to develop physical problems, chronic health problems, and even disability. The chronic strain of an unhealthy marital relationship seems to contribute to poor health in midlife individuals.

     I was reading an article in the Journal of Aging and Health (2005).  This article said that many studies on marital quality and health have been done in the past on younger couples in their 30s and 40s. However, this study examined midlife and older couples and, importantly, it differed from previous studies in that it controlled for depression. Depression is often associated with marital dissatisfaction, poor health and poorer self-perceived health ratings. Controlling for depression gave the researcher a better understanding of the quality of the relationship and physical health of the couples. This was a large study of 729 individuals in their first marriage, ages 50 to 74. The study included five dimensions of marital quality (e.g. marital disagreement, positive and negative spousal behaviors, global quality of the relationship and communication) to discover which aspects of marital quality affected health.  The researcher of this study found that negative spousal behaviors (e.g. too many demands, makes you feel tense, argumentative, critical, cannot be relied on, or just getting on your nerves) were the attributes that most consistently brought about poor health in the other spouse. This was a reliable study and easily generalized to midlife married adults because it was a large study, it controlled for depression, and it also broke down aspects of marital quality into five negative and positive characteristics. 

     The results of this study also agreed with previous studies on the negative effect of social exchanges. These prior findings also report that “negative social exchanges are more strongly and reliably associated with well-being than positive social exchanges” (Bookwala, 2005, p. 99). The author then concludes from this that “negative behaviors from one’s spouse outweighs the role of positive spousal behaviors in physical health” (p. 99).

     In another article in the American Journal of Public Health, (2001), they linked SES (socioeconomic status) with health in midlife married couples. The news from this article is even more alarming. The purpose of the study was to see how often both individuals face health problems at the same time and also to check for a link to SES. This report indicated that SES affects the health of both individuals in a marriage. When one falls into poor health, the other spouse has a larger load to carry with medical costs, employment interruptions, and care giving, etc. This often results in both individuals falling into poor health.  When two “unhealthy persons are married to each other, both lack the support a healthy spouse provides, and both face the additional burden of having a disabled partner” (Wilson, 2001 p. 134). Specifically, this study showed a connection between the health of the husband and the health of the wife. A husband with “excellent” health had a 2.3% chance of having a wife with poor health, versus if the man had “poor” health, 13.2% of the wives had poor health also. In relation to socioeconomic levels, “household income was strongly associated with both individual health status and the joint occurrence of poor health within marriage partnerships” (p. 133).  An example from the study was 12.5% of the households in the lowest quintile had both spouses in poor health, versus “0.7% of household in the top quintile” (p 133).  This study also asked about education levels. The marriages with both individuals not having completed a high school education are at highest risk of both being in poor health. With an inadequate education, it is more difficult for health-related decisions to be made and health care services to be assessed.  When the researcher put both education, SES and health together, “approximately half of all couples in which both spouses were in poor health were in the lowest SES categories both income and education” (p. 133).

     There are a few takeaway points from these two articles on midlife marriage.  First, a marriage is a significant interpersonal relationship that affects you across your life span. It is one of the most intimate connections you have and possibly the greatest source of emotional, physical and financial support you will have. Marital happiness can provide so much to the couple, but there are some aspects of marriage that can be damaging. Negative behaviors on the part of a spouse can lead to poor health in the other spouse. Marital therapy can improve not only the marital quality of the relationship, but it can improve the health of the individual. Also, socioeconomic and educational levels of the couple also have a high chance of affecting the health of both individuals. The quality of marriage, along with education and SES are powerful components to having good health later in life.

Bookwala, J. (2005). The role of marital quality in physical health during the mature years. Journal of Aging and Health. 17(1), 85-104.

            doi: 10.1177/0898264304272794

Wilson, S. E., (2001). Socioeconomic status and the prevalence of health problems among married couples in late midlife. American Journal of Public Health. 91(1). 131-135