Changes In Marital Status Research Articles

Changes in Dental Care Use Following Marital Status Change in the Health and Retirement Study.

Previous studies have indicated that married people are generally healthier than unmarried people, with lower mortality rates. Most work in this area has employed cross-sectional data, and few studies have examined change in marital status from married to unmarried as a potential social ecological determinant of dental health behavior. Here we used longitudinal data to examine change in dental behavior over time following marital status change, and to explore whether self-reported gender may play a modifying role in any behavioral change. Employing panel data from the Healthy Retirement Study (1996-2018) to follow all individuals who entered the study in married/partnered status, and using both two-way fixed effects and group-time average difference-in-difference models, we analyzed the association between any change in marital status and dental care use, compared to individuals who remained married. All analyses were stratified by gender. Both types of difference-in-difference analyses indicated that both widowhood and divorce were associated with a decrease in dental care use in both genders. Divorced men saw the greatest decrease in dental care use. We found gender had a moderating effect on strength of association in all analyses. This research suggests that any change in marital status from married to unmarried has a detrimental effect on dental health behavior for both genders. Future research might investigate other potential barriers to dental care access these populations might face, in order to develop effective interventions.

The Longitudinal Evidence on Social Ties and Fruit and Vegetable Intake among Aging Adults: A Systematic Review.

Social ties are associated with the mortality and morbidity of aging populations; however, the role of social ties in healthy eating practices or gender differences in this link is less understood. The objective of this study was to examine the longitudinal evidence for the impact of changes in social ties on fruit and vegetable (FV) intakes among aging adults, with attention to gender differences. Medline, Embase, Scopus, CINAHL, and ProQuest databases were searched until December 2022. Longitudinal studies evaluating changes in living arrangement, marital status, social network, or social participation and changes in FV intake among middle- and older-age adults were included. Data from the included studies were extracted using a standardized template and analyzed using a narrative approach. A total of 4956 titles were eligible after deduplication, and 75 full texts were screened. Seven studies met the inclusion criteria, and all examined marital transitions only. Five marital transitions were assessed: staying married, becoming widowed, becoming divorced, remaining unmarried, and becoming married. Both the quantity and variety of fruit and/or vegetables eaten were studied. Three of the included studies had only male or only female populations. The studies found that marital dissolution (divorce or widowhood), and remaining unmarried, were associated with reduced FV intakes in older women or men, compared with staying married. The associations were stronger in men than in women. Two studies showed that becoming married was associated with increased vegetable intakes, but 3 reported null results. The included studies were of medium quality. There is a paucity of longitudinal research on whether changes in social ties are associated with changes in FV intakes among aging adults. This review showed that specific marital transitions may influence healthy eating habits, especially in older men. No evidence exists on whether changes in other social ties might alter healthy eating. PROSPERO registration No. CRD42022365795.

A systematic review of social connections as determinants of obesity: Longitudinal evidence limited to marital transitions.

Social relationships impact health and may affect proximal determinants such as obesity. Our review examined empirical evidence of the impact of changes in social relationships on risk of obesity in aging adults, with attention to gender. We systematically searched Medline, EMBASE, Scopus, CINAHL, and ProQuest Dissertations and reference lists of relevant reviews and papers published up to November 2022. Longitudinal studies examining changes in marital status, living arrangement, social participation, and social networks and anthropometric changes or incident obesity were deemed eligible. Relevant data were extracted and synthesized narratively. We identified 41,910 eligible titles, resulting in 252 full texts and 7 included studies. All studies were conducted in the United States and assessed marital transitions only; 3 studies included both women and men. Overall, compared with people who remain non-married, entering marriage leads to a significant increase in body mass index (BMI) for both genders. Conversely, transitioning out of marriage through widowhood or divorce leads to a decrease in weight (kg/lbs), waist circumference, and BMI for both genders. All seven studies were deemed to be of medium quality. Our review revealed a paucity of prospective evidence on social connections as determinants of obesity among aging adults. There is limited evidence that marital transitions are associated with changes in anthropometric measurements in aging individuals, but no evidence on the effects of changes in living arrangements, social participation, and social networks on anthropometric measurements. More research attention to the social determinants of obesity is warranted.

The impact of marital status change on earnings in Russia

The impact of marital status change on earnings in Russia

Are Contraceptive Method Preferences Stable? Measuring Change in the Preferred Method among Kenyan Women.

Contraceptive preferences are important for reproductive outcomes, such as contraceptive continuation and pregnancy. Current approaches to measuring reproductive preferences in population surveys are limited to exploring only fertility preferences and implicitly assume that contracepting people are using a method they want. We know that people change their fertility preferences over the life course as a response to life events, but there is no information about changes in contraceptive preferences, given the limited evidence about the measurement and distribution of contraceptive preferences. In this study, we examined the extent of change in women's contraceptive preferences over one year and identified characteristics associated with this change in Kenya using three rounds of nationally representative longitudinal data. Over one year, 18 percent of contraceptive users and 46 percent of contraceptive nonusers reported changes in their preferred contraceptive. Experiencing a pregnancy or birth and changes in marital status were associated with changes in contraceptive preferences for users and nonusers. We found that contraceptive preferences are dynamic, suggesting that family planning programs should ensure people's access to various methods to respond to women's changing circumstances and preferences.

The impact of a breast cancer diagnosis on marital outcomes and factors associated with divorce and separation.

To analyze marital outcomes, divorce or separation, and its association with demographic, socioeconomic, and clinicopathological factors among breast cancer (BC) survivors after 2-years of diagnosis. We performed a retrospective analysis of marital status at baseline and at years 1 and 2 of follow-up of women aged ≥ 18 years diagnosed with invasive BC participating in the AMAZONA III (GBECAM0115) study. The BC diagnosis occurred between January 2016 and March 2018 at 23 institutions in Brazil. Of the 2974 women enrolled in AMAZONA III, 599 were married or living under common law at baseline. Divorce or separation occurred in 35 (5.8%) patients at 2 years of follow-up. In the multivariate analysis, public health insurance coverage was associated with a higher risk of marital status change (8.25% vs. 2.79%, RR 3.09, 95% CI 1.39 - 7.03, p = 0.007). Women who underwent mastectomy, adenomastectomy or skin-sparing mastectomy were associated with a higher risk of divorce or separation (8.1% vs. 4.49%, RR 1.97, 95 CI 1.04 - 3.72, p = 0.0366) than those who underwent breast-conserving surgery. Women covered by the public health system and those who underwent mastectomy, adenomastectomy or skin-sparing mastectomy were associated with a higher risk of divorce or separation. This evidence further supports the idea that long-term marital stability is associated with a complex interplay between socioeconomic conditions and stressors, such as BC diagnosis and treatment. ClinicalTrials Registration: NCT02663973.

Survey of long term survivors of oral cancer: Looking beyond cancer biology.

6087 Background: While surgery is the main stay of treatment for early stage oral cancers, advanced stages require adjuvant treatments in the form of radiotherapy or concurrent radiotherapy. Yet, the effectiveness of these interventions is not solely determined by clinical measures but also by personal factors such as individual motivation, support from loved ones, and financial security. These aspects might explain the survival rate variations among patients who, despite having similar prognostic categories and stages of disease, show differing outcomes. The role of social determinants in influencing patient survival, apart from the acknowledged impact of disease biology, is not well understood. Methods: All treatment-naive oral cavity cancer patients who underwent definitive treatment during 2014 to 2018 at our institute and are alive for more than five years were selected for this study. A custom investigator-administered questionnaire was developed and it had 32 questions under six domains- personal, habit history, financial, social, functional, and emotional. The study was approved by the institutional ethics committee. Of the 1787 potential participants, we found that 219 had expired, only 442 patients agreed to answer the questionnaire, while 45 refused to participate. The rest of the patients were not reachable telephonically. Results: This survey had 442 patients, of which 90% were males, with a mean age of 52.1 years. The most common site of the presentation was buccal mucosa (60%), and 59% presented in the locally advanced stage. Post-operatively, 71% received adjuvant therapy. All patients were motivated to undergo the radical treatments and had their family support. However, post-treatment, about 10% of individuals experienced a change in marital status. Financial constraints did affect 20% of patients during and after treatment, and more than 70% had their out-of-pocket expenditure above 50% of the total cost. While 80% did not have trouble attending social functions, 46% reported trouble eating socially. However, this was more common for patients who received adjuvant treatment (p < 0.001). About 21% reported shoulder dysfunction and body discomfort. However, no statistically significant associations could be drawn for any of the domains of the questionnaire when compared to patients between the early and late stages. Shoulder discomfort was experienced more by patients who were treated for tongue cancer (p-value 0.010). Conclusions: The results of this study shed light on the challenges faced by long-term survivors of oral cancer following radical treatment regimens. More than half of patients reported that out-of-pocket expenses constituted more than half of their total treatment costs. A notable minority of people suffer from shoulder dysfunction, suggesting there is a clear opportunity for advancements in reconstruction and rehabilitation.

Assessment of the socioeconomic impact of COVID-19 in Rwanda: Findings from a country-wide community survey, preliminary analysis to inform further global research

RationaleThe COVID-19 pandemic along with its devastating impact on human lives has disrupted the socioeconomic situation worldwide. Rwanda has adopted lockdowns and other measures to prevent the spread of the COVID-19 pandemic. Recent studies documented the macro-level socio-economic pandemic impact but the impact on a household’s daily life has been scarcely documented especially in low-and-middle-income countries. ObjectiveThis work describes the interplay between multiple factors to assess the socio-economic impact of COVID-19 on the Rwandan population at the micro-level (household). MethodsData from a country-wide community survey conducted in Rwanda between December 2021 and March 2022 were used. A total of 26,412 response forms were received from around 4400 participants surveyed in 6 recurrent bi-weekly phases where participants were randomly selected. The Multivariable Logistic regression model was fitted to data with a backward stepwise elimination algorithm to assess the socioeconomic impact of COVID-19 on households’ income. Factors considered in this study are gender, age group, residence, level of education, occupation, change in employment status, socioeconomic status, and marital status. ResultsThe multivariable logistic regression model provided the factors associated with the decline in income due to COVID-19. The results show that people living without a partner are more likely to experience income decline due to COVID-19 than people living with their partner. It is seen that the higher the number of children in a household, the higher the risk of experiencing a decrease in income. Taking into consideration the education level and comparing people with post-secondary and university level vis-a-vis people who did not attend school, the latter are 27 times more likely to experience a decrease in their income, those who attended primary school are 5 times more likely to experience a decrease in income, and those who attended secondary school are almost 2 times more likely to experience a decrease in income. ConclusionsThe findings from this research will be used by policymakers and other stakeholders to design and implement preventive and responsive measures for future pandemics that should be multifactorial and tailored to transversal parameters like gender and residence.

Mengatasi Permasalahan Administrasi Pernikahan dan Kependudukan Melalui Inovasi Pelayanan Publik Jalan Berdua di Kota Pasuruan

The marriage registration process is one of the important stages in validating a marriage legally. This process often requires complex efforts, takes time and costs significant money, especially for couples who come from areas far from population administration offices or religious courts. To overcome this challenge, the Pasuruan City Government has introduced an innovative Double Road service. This service allows couples to register their marriage as well as change their marital status on their Family Card and Electronic KTP documents. This second road innovation has the impact of improving population administration services regarding changes in marital status on Family Cards and Electronic KTPs. This research aims to describe the problems that arise in the Innovation program and the efforts made to overcome the problems that arise in the Dual Road Innovation program in Pasuruan City. This research uses a qualitative descriptive approach with primary and secondary data sources. Primary data was obtained through interviews, observation and documentation related to Jalan Berdua innovation. Secondary data is in the form of documents related to research. Data collection techniques involve observation, open interviews, and documentation. This research will provide an overview of the problems faced in implementing the Double Road Innovation in Pasuruan City and the efforts that have been made to overcome them. The results of this research are: Overall, the Jalan Berdua program in Pasuruan City is a successful example of how innovation in population administration services can improve efficiency, accessibility, community satisfaction, inter-agency cooperation, and effective use of data.

중⋅고령 만성질환자의 우울궤적 유형과 예측요인

This study was conducted to identify different trajectories of depressive symptoms among older adults transitioning to patients with chronic diseases and to test the associated predictors. Four waves of Korean Longitudinal Study of Ageing were used for analyses, and demographic, clinical, and social factors were included as predictors. Among 433 middle-aged and older adults transitioning between 1st and 2nd waves, three distinct depressive symptom trajectories were identified through growth mixture modeling: low and decreasing(17.2%), increasing then persistently moderate(61%), and increasing then persistently high(21.8%) depressive symptoms over time. Results of logistic regression showed that changes in marital status, cognitive function, perceived limitation of activities, frequency of social contact and satisfaction with family relationships distinguished the trajectories. Notably, cognitive function and family relationships emerged as crucial factors across all trajectory classes. Thus, it is highly recommended to exert great effort to reduce depression levels of chronic patients by enhancing their cognitive function levels and family relationship satisfaction.

Where Microsurgical Tubal Reanastomosis Stands in the In vitro Fertilization Era.

Among various options of contraception, bilateral tubal ligation (BTL) remains the most frequently used method for women worldwide even at present. However, up to 30% of those who undergo BTL eventually change their minds and wish to conceive again for a variety of reasons, such as a change in marital status or simply wanting more children. In this case, we can either approach it surgically with tubal re-anastomosis (TA) or by in vitro fertilization (IVF)-embryo transfer. Despite the many advantages of TA which lead the American Society of Reproductive Medicine Committee Opinion to recommend it as the primary choice of treatment in posttubal ligation infertility in 2012, IVF is widely being chosen as the first-line treatment nowadays. This study will review the efficacy of TA in various aspects, including pregnancy rate, cost-effectiveness, feasibility, and accessibility, based on review of the literature and our experience. Through this study, we intend to provide a basis for gynecologists to consider TA as the first option in women who wish to conceive again after BTL in this day and age of IVF.

Social isolation and depression as risk factors for weight loss of 5kg or more among older Korean adults.

Given a well-known overlapping prevalence of social isolation with loneliness and depression among older adults, this study aimed to contextually investigate the relationship of these constructs with weight loss of more than 5kg in a year, with a special focus on the intersection of living alone and marital dissolution as key dimensions of isolation. The data were obtained from the Korean Longitudinal Study of Aging (KLoSA) from 2006, 2008, 2010, 2012, 2014, 2016, and 2018, with an adult sample of those aged 65 and older (n = 5,481). The study evaluated several critical dimensions of social isolation: living alone, transition to living alone, infrequent social contact with children or friends, and infrequent social participation. These dimensions were examined individually and as a composite scale, along with loneliness and depressive symptoms, to determine their association with weight loss of 5kg or greater among older men and women. Generalized Estimating Equation (GEE) regression models enabled investigation of whether socially isolated men and women tended to lose 5kg or more in weight, given other confounding factors. Surprisingly, the results showed no evidence of such a trend. However, significant associations were found between weight loss and changes in living alone and marital status. For older men, transitioning to living alone without a change in marital status was linked to significant weight loss. For older women, transitioning to living alone following widowhood or divorce was the risk factor. These relationships remained significant even after adjusting for depression and a wide range of covariates. Additional analysis testing a cumulative effect revealed that only depression was a risk factor for being underweight at the last observation. Therefore, to prevent a clinically risky extent of weight loss, health policies for older Koreans should focus on those who transition to living alone, especially due to spousal bereavement or divorce (among women) and separation from living with children (among men).

Agriculture land use transformation: A threat to sustainable food production systems, rural food security, and farmer well-being?

The acquisition of agricultural land is a crucial aspect of survival for numerous rural communities, serving as a fundamental tool for combating poverty and food insecurity and promoting equitable sustainable economic progress. The expropriation of land offers a promising prospect for remedying past inequities and promoting both economic progress and food sufficiency. Limited research has examined the association between land expropriation and food security, livelihood shocks, and the well-being of rural households worldwide. Therefore, this research explores the implications of land expropriation on food security, livelihood shocks, and well-being of land lost rural communities. The data were collected from 384 farmers selected through stratified sampling techniques using face-to-face surveys in rural China. The data were analyzed using descriptive and logit regression models. The descriptive findings showed that land expropriation has detrimental effects on the livelihood, food security, and well-being of the farmers. Furthermore, these impacts are more harmful among land-expropriated households with a lower educational level, a large family size, and women farmers in less developed rural communities. The econometric results evinced that gender, age, education level, marital status, family size, and negative changes in income all significantly affect the impact of land expropriation on the food security of farmers. Similarly, the findings revealed that farmers with lower education levels were more likely to be affected by land loss as compared to farmers with medium and high education levels. Farmers with complete land loss were 1.70 times more likely to suffer livelihood shocks than those with partial land loss. The results also evinced that the well-being of all farmers was not affected equally, and some farmers' well-being was affected more than others due to various socioeconomic backgrounds. Therefore, this study suggests the implementation of public policies that provide support to farmers who have been marginalized due to land acquisition.

Cigarette Smoking, Mental Health, Depression, Maryland Behavioral Risk Factor Surveillance System Survey, 2020.

Smoking cessation is linked to improved mental health that encompasses the overall well-being and psychological functioning of an individual. Examine relationships between smoking, mental health, and social connectedness among adults in Maryland, US in 2020. This cross-sectional study used data from the Maryland 2020 Behavioral Risk Factor Surveillance System Survey of adults during the onset of COVID-19. Primary outcomes measured include demographics, depression, and number of not good mental health days among individuals with current and former smoking statuses compared to those who have never smoked. Compared to those who never smoked, individuals who currently smoked had an increased relative risk of reporting 14 or more days of not good mental health (RRR = 1.63, 95% CI: 1.35-1.97, P < .001) and a history of depression (RRR = 1.99, 95% CI: 1.69-2.35, P < .001). Individuals with former smoking status also showed elevated risk, with RRR = 1.24 (95% CI: 1.06-1.45, P = .006) for 14 or more days of not good mental health and RRR = 1.46 (95% CI: 1.28-1.66, P < .001) for a history of depression. Widowed, separated, or divorced; unemployed or unable to work; without a high school diploma; or recent physical exam were inclined to have a current or former smoking status. We identify critical subpopulations vulnerable to life-long smoking behaviors amid the COVID-19 pandemic including adults under 35years old, and those suffering from depression, a lack of social connectedness due to unemployment, changes in marital status, and outdated physical exams. The US Surgeon General's 2023 Advisory on the epidemic of loneliness and the 2021 Youth Mental Health Report emphasize the mental health crises among the young in which these findings serve as a compelling call to action for innovating targeted public health interventions.

Incidence and Correlates of Severe Depression and Stigmatization among HIVPositive Patients Seeking Care at Soroti Regional Referral Hospital

Depressive disorders are notably more prevalent among people living with HIV/AIDS (PLWHA), occurring at rates three times higher than in the general population. In Uganda, the reported prevalence of depressive disorders among PLWHA ranges between 20% and 40%, with stigma affecting about 34% of this demographic. This study aimed to estimate the prevalence and identify factors associated with major depression and stigma among HIV-positive patients attending the ART clinic at Soroti Regional Referral Hospital (SRRH). Conducted as a descriptive cross-sectional hospital-based study, the research utilized a simple random sampling technique to select 138 participants aged 18 years and older, already diagnosed with HIV and attending the SRRH ART clinic. Critically ill or admitted individuals were excluded from the study. The majority of respondents were female (60.9%), aged between 31 and 45 years (45.7%), and had attained primary school education (54%). The study found a 16.7% prevalence of current major depressive episodes among PLWHA, with 56.5% experiencing recurrent major depressive episodes. Regarding stigma, the prevalence of minimal, mild, and moderate stigma was 65.2%, 29%, and 5.8%, respectively. Factors such as male gender, being divorced or widowed, and being unemployed or engaged in peasant work were statistically associated with any form of major depressive episode. Additionally, recent initiation of ART was linked to stigma among this population. The findings underscored the frequent occurrence of major depression and stigma among PLWHA, which were influenced by factors such as changes in marital status, recent ART initiation, and limited employment opportunities. The study recommended institutionalized and personalized counseling, the formation of social or peer support groups, community education initiatives regarding major depression and stigma among PLWHA, and regular patient follow-ups to mitigate the incidence and prevalence of major depression and stigma in this vulnerable segment of the population. Keywords: prevalence, depression, stigma, HIV

Factors Leading to a Decrease in Grip Strength Among the Oldest Old: A Large, Representative, Longitudinal Survey

ObjectivesGrip strength is an indicator for physical performance and highly correlated with general health among older adults. To date, there is limited knowledge regarding the factors contributing to grip strength exclusively among the oldest old based on data from large representative samples and also including institutionalized individuals. Consequently, the purpose of our current study was to address this gap in knowledge. DesignA large representative, longitudinal study. Setting and ParticipantsSurvey on quality of life and subjective well-being of the very old in North Rhine-Westphalia (NRW80+), including individuals ≥80 years (residing in institutionalized settings and living in private households) in North Rhine-Westphalia (n = 1824, mean age was 86.7 years, 80 to 104 years). MethodsIn accordance with other large cohort studies, isometric grip strength was measured using a dynamometer (Smedley Dynamometer, 100 kg). ResultsLinear fixed effects regressions showed that decreases in grip strength were significantly associated with increases in age (β = −0.70, P < .001), decreases in social network size (β = 0.08, P < .05), and worsening self-rated health (β = 0.80, P < .01). In contrast, decreases in grip strength were not significantly associated with changes in marital status, changes in living situation, changes in the number of chronic conditions, changes in depressive symptoms, and changes in health literacy. Conclusions and ImplicationsIt has been shown that age, social network size, and self-rated health were associated with grip strength among the oldest old longitudinally. Our current study may assist in identifying individuals at risk for low grip strength. For example, efforts to maintain social contacts may be beneficial to maintain grip strength. This is relevant because low grip strength contributes to unfavorable outcomes such as poor quality of life, functional impairment, cognitive decline, and reduced longevity.

Marital status over 28 years of parents of individuals with autism and other developmental disabilities.

Longitudinal, prospective analyses of marital status in parents of individuals with autism are needed to better understand the types and timing of supports needed to mitigate the impact of divorce on the family. We describe the timing of divorce and the factors that contribute to divorce in a longitudinal sample of families of individuals with autism and other developmental disabilities. Participants included parents of 219 children initially referred for autism and other developmental delays followed to age 30 years. Approximately 36% of individuals in our sample experienced a parental divorce by age 30. Higher rates of divorce were associated with lower maternal education and families of color and moderately associated with younger maternal age at child's birth, autism symptom severity, and ASD diagnosis. Divorces were most common in children's early years (under age 5) and also in the teenage years and beyond (over age 15). After age 15, higher risk was associated with the child's higher cognitive ability and daily living skills, and being a multiplex family. Results suggest that divorce risk in families of children with autism remains high through childhood into early adulthood. Understanding factors related to changes in marital status may help support families across time. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Enjeux éthiques de la chirurgie de réassignation sexuelle

Gender reassignment raises complex ethical issues. It questions gender identity and the right to self-determination. Some highlight the right to access the medical care necessary to live according to one's perceived gender. Others worry about the potential rush into major medical decisions, especially among minors. The need for a medical diagnosis of gender dysphoria can be seen as pathologizing. The requirement for surgery for marital status change, while not mandatory in many places, remains controversial. The balance between informed consent and access to treatment, as well as stigma and discrimination, contribute to the complexity of ethical issues. Finally, the issues surrounding the competence of health professionals, the quality of care and the integration of individual needs make these decisions particularly sensitive from an ethical point of view.

When Marriage Ends: Differences in Affluence and Poverty Among Older Adults in Israel

Studies show that the economic benefits of marriage carry over into old age and that widowhood and divorce have detrimental economic consequences, especially for women. This study asks how affluence and poverty are affected by the timing of widowhood and divorce and tests whether they operate in symmetry. The study draws on Israel’s annual Social Survey from multiple years (2013–2017), conducted by Israel’s Central Bureau of Statistics. The sample is limited to older individuals, aged 55+ (n = 4824 men, 5643 women). The findings show that married people are less likely to be poor than unmarried people, but they are not always more likely to be affluent. Widowed men and women, and divorced men are more likely to achieve affluence than continuously married couples. The explanation may be that, in the Israeli context, the widowed tend to inherit benefits accumulated by their late spouse, whereas the divorced tend to divide resources when the marriage dissolves. Women incur higher and longer-term penalties for their change in marital status than do men, so that previously married women tend to have higher rates of poverty and lower rates of affluence than previously married men. The findings show that affluence and poverty do not operate in symmetry and that affluence does not simply mirror poverty, especially among men. For example, early widowed and late divorced men have higher odds of both poverty and affluence than married men. These findings demonstrate that poverty and affluence operate differently and examining both leads to new insights.

Marital transitions and frailty among middle-aged and older adults in China: The roles of social support

BackgroundThis study explored the association of marital transitions and frailty among Chinese middle-aged and older people and whether this association differs by social support. MethodsWe used a sample of 12,388 adults aged ≥45 years who participated in the China Health and Retirement Longitudinal Study (CHARLS) between 2015 and 2018. Between-wave changes in marital status (“married at both times”, “unmarried to married”, “married to unmarried”, “unmarried at both times”) were used to explore the changes in frailty measured by the frailty index (FI), which was constructed from 55 health variables. Social support was evaluated based on social engagement and intergenerational support. The associations among marital transitions, social support and frailty were analyzed using generalized estimating equations (GEEs). ResultsThe mean FI of 12,388 participants was 0.23 (SD = 0.13). Participants who were married to unmarried (β = 0.014, B = 0.005, P = 0.012) and unmarried at both times (β = 0.022, B = 0.003, P < 0.001) had significant a positive impact on FI compared with participants who were married at both times. Social engagement, financial support by children and providing care to grandchildren had an interactive effect with marital transitions in influencing FI. ConclusionsBeing unmarried may increase frailty among Chinese middle-aged and older adults. Financial support by children may mitigate the adverse effects of being unmarried on frailty.