Protective Effect Of Marriage Research Articles

An Econometric Assessment of the “Punishment” for Singlehood in Russia: Risks or New Opportunities in Life?

The paper focuses on the effect of having a marriage partner on health and well-being of Russians as compared with their single compatriots. The health status variation between those who are married and those who are single can be explained both by the protective effect of marriage and marriage selection. Using the Cox proportional hazards model on the self-perceived health data from the RLMS 2004-2019 individual questionnaire, while controlling for socioeconomic factors, lifestyle, and living arrangements, we have found that the protective effect of marriage is non‑existent in men, except for a short-term impact of marital transitions. Women are “punished” for their singlehood due to a lack of a partner in their young age, or being in an unregistered union, or the loss of a breadwinner spouse at the age of 50 to 64. In contrast, women over 65 benefit from singlehood.

Marital status and its correlation with age, race, and gender in prognosis of tonsil squamous cell carcinomas.

The objective of this study was to assess the impact of marital status on tonsil squamous cell carcinomas (TSCCs) prognosis and to analyze whether the impact is correlated with gender, age, and race. We examined the clinicopathological variables using Chi-squared tests and evaluated the association between survival and different variables using the methods of Kaplan-Meier. Univariate and multivariate analyses were performed to determine the effects of each variable on survival. A total of 10,720 patients were analyzed. The rate of being married was higher among Asian or Caucasian, and this rate decreased with higher tumor stage. While both married male and female survivors benefit from their marital status, we found a differential in cancer-specific survival based on gender, with males benefitting more than females (p < 0.05). The same results were found in overall survival. Subgroup analysis shows that the protective effect of marriage was consistent in all patients except for N3 groups (all, p < 0.05). While there are survival benefits for married patients with TSCCs, married/partnered males may benefit more than females. Age, race, and gender could affect the correlation between marital status and survival.

Investigating the relationship among seasonality, socioeconomic risk factors and suicides in Greece.

Globally, there has been growing evidence pointing to a relationship among suicides, seasonality and socioeconomic factors. This study aims at investigating the seasonal suicide patterns, the effect of gender on these patterns, the trend of these patterns and whether the suicides are associated with economic and social risk factors. The objects of the current study have been the seasonal suicide patterns in Greece during 1980-2018 (39 years), as well as their interrelation with a variety of socioeconomic risk factors, however for a shorter period (21 years) due to unavailability of aggregated data provided by the Hellenic Statistical Authority (ELSTAT). The Walter-Elwood test was applied in order to investigate seasonality. Poisson regression models were applied to investigate the relationship amongst seasonality, socioeconomic risk factors and monthly suicides. The best variable subset was selected according to the leaps and bounds algorithm. A total of 15,692 suicides were recorded. In the total sample, as well as, in men, a peak was documented in May - June, whereas females mostly peaked in July. Among the risk factors under investigation, an increase in marriage rates appeared to have significantly lowered the number of suicides, while a rise in unemployment rates exhibited a statistically non-significant increase in suicides.. The findings of the study suggest distinct sex-oriented seasonal patterns and a protective effect of marriage.

Birth intentions among US fathers with disabilities

BackgroundMen’s birth intention is an indicator of their sexual health and plays an important role for their child’s health and development; however, birth intendedness in fathers with disabilities has been unknown. ObjectiveThis study examines disparities in birth intendedness among fathers with and without disabilities and explores whether the differences vary by marital status or race/ethnicity. MethodsData from the 2011–2017 National Survey of Family Growth (NSFG) were used to examine pregnancy intendedness for fathers with (n = 380) and without disabilities (n = 1,324) about their last birth in the five years preceding the interview. Multinomial regression models estimated the odds ratios of fathers’ disability status on birth intention controlling for covariates. Interaction effects of disability status by marital status or race/ethnicity were also tested. ResultsFathers with disabilities were 1.89 (95% CI = 1.21, 2.95) times as likely to report their last birth as unwanted versus intended compared to those without disabilities after adjusting for covariates. Although married fathers without disabilities were less likely to report unintended birth than their unmarried counterparts, the protective effect of marriage was not evident among fathers with disabilities. ConclusionsDisabled fathers are at a higher risk of unintended birth compared to nondisabled fathers. These findings highlight the need to increase access to family planning services for disabled men. Further research is needed to better understand the risk factors that contribute to disabled fathers’ unintended birth and how these are linked to their child and family well-being.

Improving in-depth, epidemiological and economic understanding of substance use, harm and its prevention across countries

Welcome to the second issue of Volume 8 of IJADR for 2020. This issue includes papers that focus on the global burden of different substances and their costs as well as studies of substance use and related harm by authors in Scandinavia and North America. The five papers include qualitative and quantitative studies and involve diverse populations from Canada, Sri Lanka, Germany and the United States. In an attempt to identify substance use research priorities for Canada, Sornpaisarn and colleagues (2020) reviewed 2014-2019 publications and analysed secondary data sources to study the relative substance-attributable burden of disease for alcohol, tobacco and other drugs in Canada, finding that tobacco followed by other drugs contributed more to the burden of disease estimates than did alcohol. This pattern was also evident in North America and differs considerably from that observed in the overall global burden of disease estimates, where alcohol ranks higher than other drugs in terms of its contribution to GBD. Secondly, this article reported on wholly attributable relative substance use disorder diagnoses in Canada, finding that relative to alcohol, opioid use disorders required more admissions to hospital. Finally, this article highlights that the greatest societal costs tallied in 2014 were for the costs of alcohol, followed by tobacco and all other drugs combined. Both other drug use and alcohol diagnosis costs increased in the period between 2007 and 2014, with cannabis and opioid costs increasing and tobacco costs declining. Leifman and Trolldal (2020) undertook an interesting study of price and income elasticity in Sri Lanka, finding that the economic drivers of alcohol sales appeared not to be affected by price and income changes to the same extent as sales in high-income countries or in the few studies that have been undertaken in other low- and middle-income countries. Their paper discusses aspects of Sri Lankan drinking culture including limitations on women’s drinking, the greater prevalence of lighter drinking and abstinence, banning of drinking on public holidays and drinking by tourists that may explain why general patterns of alcohol sales are less affected by price and income than expected, but argues that further research is needed to understand drivers of consumption in Sri Lanka. In a study among sexual minority and non-sexual minority men and women in the United States, Karen Trocki and her colleagues (2020) examined the extent to which the protective effects of marriage on substance use that are commonly observed among heterosexual men and women apply to sexual minority groups. They found that marriage confers protective effects against substance use depending on individuals’ sexual minority or non-sexual minority status, their sex, and the substances under study. The researchers call for further research to unpack the factors that may explain the role of marriage as a protective factor against substance use in sexual minority individuals. Egerer and Hellman’s (2020) study considered techniques that may be employed for interpreting researchers’ subjectivity – a well-recognized element – in qualitative research. They introduced three techniques: a form of content analysis, quantification of researchers’ expectations, and analysis of speaker positions among study participants. Using examples of data from focus groups among social workers in Germany, the paper discusses some of the contrasting impressions of qualitative data that can emerge from the use of the different techniques. This paper is likely to be very informative for many readers, and particularly, for those who may not be familiar with methods of analyzing and interpreting qualitative data. Using multi-level data, Julie Croff and her colleagues (2020) examined the extent to which individual-level and school-level parental factors, school environmental factors, alcohol, tobacco and other drug (ATOD) descriptive norms and peer deviance are associated with early adolescents’ lifetime alcohol consumption in a study conducted among seventh grade students in the United States of America. They found that parents’ educational involvement and peer deviance at both the individual and school levels were associated with the adolescents’ alcohol use; however, only individual level ATOD norms were associated with lifetime alcohol use. A key implication of the findings concerns the role of parental involvement at the school level in early adolescents’ alcohol use. The authors concluded that “Parent educational engagement programs need not target all parents, as strong results at the school level may come from a core team of key parent leaders.” (page 93).

Reprint of: Marriage and health: Selection, protection, and assortative mating

Using data from the Panel Study of Income Dynamics (PSID) and the Medical Expenditure Panel Survey (MEPS), we analyze the health gap between married and unmarried individuals of working-age. Controlling for observables, we find a gap that peaks at 10% points at ages 55–59 years. The marriage health gap is similar for men and women. If we allow for unobserved heterogeneity in innate health (permanent and age-dependent), potentially correlated with timing and likelihood of marriage, we find that the effect of marriage on health disappears below age 40 years, while about 5% points difference between married and unmarried individuals remains at older ages (55–59 years). This indicates that the observed gap is mainly driven by selection into marriage at younger ages, but there might be a protective effect of marriage at older ages. Exploring the mechanisms behind this result, we find that better innate health is associated with a higher probability of marriage and a lower probability of divorce, and there is strong assortative mating among couples by innate health. We also find that married individuals are more likely to have a healthier behavior compared to unmarried ones. Finally, we find that health insurance is critical for the beneficial effect of marriage.

Food insecurity, psychological distress and alcohol use: understanding the salience of family roles for gender disparities

ABSTRACTThe goal of this paper was to expand upon research documenting the adverse mental health effects of food insecurity by assessing the explanatory role of gender differences in family roles and arrangements among a nationally-representative sample of U.S. adults. Using data from the combined 2011–2012 and 2013–2014 cycles of The National Health and Nutrition Examination Survey (NHANES), we estimated a series of models using adult food insecurity measures and self-reported gender as main predictors of depressive symptoms and alcohol use. Our results demonstrate that marriage is protective against greater depressive symptomatology among women and men, and higher alcohol consumption among men. However, the protective effects of marriage against high alcohol use are reduced within the context of food insecurity among men. Further, the results indicate that parenthood is protective against greater depressive symptoms and alcohol consumption among women, but not men. The protective effects of having children are, however, diminished among women in food insecure households. These findings add to the growing literature on the mental health consequences of household food insecurity, and extend this work by clarifying ways in which family roles come to bear on gender differences in the association between food insecurity and psychological and behavioural outcomes.

Marriage and health: Selection, protection, and assortative mating

Using data from the Panel Study of Income Dynamics (PSID) and the Medical Expenditure Panel Survey (MEPS), we analyze the health gap between married and unmarried individuals of working-age. Controlling for observables, we find a gap that peaks at 10% points at ages 55–59 years. The marriage health gap is similar for men and women. If we allow for unobserved heterogeneity in innate health (permanent and age-dependent), potentially correlated with timing and likelihood of marriage, we find that the effect of marriage on health disappears below age 40 years, while about 5% points difference between married and unmarried individuals remains at older ages (55–59 years). This indicates that the observed gap is mainly driven by selection into marriage at younger ages, but there might be a protective effect of marriage at older ages. Exploring the mechanisms behind this result, we find that better innate health is associated with a higher probability of marriage and a lower probability of divorce, and there is strong assortative mating among couples by innate health. We also find that married individuals are more likely to have a healthier behavior compared to unmarried ones. Finally, we find that health insurance is critical for the beneficial effect of marriage.

Association between marriage and outcomes in patients with acute ischemic stroke

BackgroundsThe previous studies on the association between marital status and stroke outcomes were rare. Furthermore, the existing studies mostly focused on the protective effect of marriage on survival. We conducted the study to evaluate the association between marital status and adverse stroke outcomes in patients with AIS based on China national stroke registry.MethodsThis was a multicenter, prospective cohort study of patients with AIS. Patients were classified into two groups based on marital status at admission: married and unmarried. The primary outcomes included all-cause mortality, stroke recurrence, combined endpoint, and stroke disability. Stroke disability was defined as modified Rankin Scale of 2–6.ResultsOf 12,118 patients, 1220 were unmarried and 10,898 married. Unmarried patients had higher proportion of 1-year post-stroke events than married patients did. As compared with being unmarried, the adjusted odds ratios with 95% confidence interval of being married for outcomes were as follows: 0.70 (0.58–0.84) for all-cause mortality, 0.78 (0.66–0.91) for stroke recurrence, 0.77 (0.66–0.90) for combined endpoint, and 0.75 (0.65–0.88) for stroke disability. Interactions between marital status and education were significant for all outcomes except for stroke disability.ConclusionsMarital status was associated with all adverse stroke outcomes in patients with acute ischemic stroke, especially in those with middle-school education.

Does Marriage Make Us Healthier? Evidence from Middle-Aged and Older Japanese

This study investigated health premium of marriage among middle-aged and older Japanese. Using a unique longitudinal micro dataset for Japanese aged 45–80 years in 2007, we applied a dynamic panel data model and utilized both subjective and objective health indicators for 4,386 observations from 2008 to 2012. We found significant marriage–health premium among middle-aged Japanese, while the evidence for older Japanese was inconclusive. This is the first study addressing the endogeneity between marriage and health to confirm the protective effect of marriage on health for middle-aged and older people in Japan, which sounds an alarm for Japanese health policies facing the late marriage and rising divorce rates owing to the receding economy and shifting social norms.

Effect of Marriage on Risk for Onset of Alcohol Use Disorder: A Longitudinal and Co-Relative Analysis in a Swedish National Sample.

The authors sought to clarify the relationship between marriage and risk for alcohol use disorder. The association between marital status and risk for first registration for alcohol use disorder in medical, criminal, and pharmacy registries was assessed in a population-based Swedish cohort (N=3,220,628) using longitudinal time-dependent survival and co-relative designs. First marriage was associated with a substantial decline in risk for onset of alcohol use disorder in men (hazard ratio=0.41, 95% CI=0.40-0.42) and women (hazard ratio=0.27, 95% CI=0.26-0.28). This association was slightly stronger when the spouse had no lifetime alcohol use disorder, while marriage to a spouse with lifetime alcohol use disorder increased risk for subsequent alcohol use disorder registration in both men (hazard ratio=1.29, 95% CI=1.16-1.43) and women (hazard ratio=1.18, 95% CI=1.06-1.30). In both sexes, the protective effect of marriage was significantly stronger in those with than those without a family history of alcohol use disorder. In both men and women, the associations between marriage and risk for alcohol use disorder in cousins, half siblings, full siblings, and monozygotic twins discordant for marital status were as strong as that seen in the general population. First marriage to a spouse with no lifetime alcohol use disorder is associated with a large reduction in risk for alcohol use disorder. This association cannot be explained by standard covariates or, as indicated by co-relative analyses, familial genetic or shared environmental confounders. These results are consistent with the hypothesis that the psychological and social aspects of marriage, and in particular health-monitoring spousal interactions, strongly protect against the development of alcohol use disorder. The protective effects of marriage on risk for alcohol use disorder are increased in those at high familial risk for alcoholism.

Is Marriage Protecting Your Health in Recession Times?

This paper aims to contribute to the literature on the protective effects of marriage on individuals’ health by examining whether this advantage is still valid in recession times. A two stage empirical strategy is followed based on individual-level cross-section data for Spain. Using propensity score matching techniques we firstly estimate the causal impact of divorce and legal separation (marital dissolution) on mental health and binge drinking in two different points in time: before and during the economic crisis. Secondly, we examine whether there exists an incremental or detrimental effect on these health outcomes implied by the economic recession using difference-in-difference (DiD) regression methods, upon conditioning on a proxy of innate health status. The results confirm that divorce and separation cause a large and significant deterioration of mental health and a raise in heavy drinking both before the economic recession and after (during) the crisis. Strikingly, we find that this detrimental effect on psychological health is actually lowered because of the recession, although this amelioration on mental health is observed for male individuals. However, heavy drinking does not seem to worsen more with divorce/separation during the economic downturn. These findings, which appear robust to the sensitivity analysis, would then suggest that the marriage institution, contrary to what is generally believed, would not be protecting mental health status, mainly in male individuals, under a period of economic crisis. We speculate that divorce/separation may act as an escape mechanism to confront the usual financial constraints and other stress-related issues which are strengthened during a prolonged period of recession.

Sociodemographic and career history predictors of suicide mortality in the United States Army 2004-2009.

The US Army suicide rate has increased sharply in recent years. Identifying significant predictors of Army suicides in Army and Department of Defense (DoD) administrative records might help focus prevention efforts and guide intervention content. Previous studies of administrative data, although documenting significant predictors, were based on limited samples and models. A career history perspective is used here to develop more textured models. The analysis was carried out as part of the Historical Administrative Data Study (HADS) of the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS). De-identified data were combined across numerous Army and DoD administrative data systems for all Regular Army soldiers on active duty in 2004-2009. Multivariate associations of sociodemographics and Army career variables with suicide were examined in subgroups defined by time in service, rank and deployment history. Several novel results were found that could have intervention implications. The most notable of these were significantly elevated suicide rates (69.6-80.0 suicides per 100000 person-years compared with 18.5 suicides per 100000 person-years in the total Army) among enlisted soldiers deployed either during their first year of service or with less than expected (based on time in service) junior enlisted rank; a substantially greater rise in suicide among women than men during deployment; and a protective effect of marriage against suicide only during deployment. A career history approach produces several actionable insights missed in less textured analyses of administrative data predictors. Expansion of analyses to a richer set of predictors might help refine understanding of intervention implications.

007 Associations between marital status and survival after a first acute myocardial infarction in Scotland, 1988–2004

BackgroundThere is evidence that marriage has a beneficial effect on health; unmarried experience higher mortality and incidence of mental and physical disorders. In particular, being unmarried is associated with elevated...

Differences between married and unmarried men and women in the relationship between perceived physical health and perceived mental health

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The Protective Effect of Marriage on Mortality in a Dynamic Society

We sought to assess whether the protective effect of marriage on overall and cause-specific mortality has changed over time in a dynamic society. Data from the census-based Israel Longitudinal Studies (ILMS) I (1983-1992) and II (1995-2004) were analyzed. Cox proportional hazard modeling adjusting for sociodemographic factors was applied to 152,150 and 209,125 individuals, ages 45-89 years from the ILMS I and II, respectively. During each study period 31,749 (ILMS I) and 37,656 (ILMS II) deaths were reported. Mortality inequalities by marital status remained significant and widened over time for middle-aged and elderly men and women. Changes in cause-specific mortality indicated a widening of cardiovascular disease mortality inequalities by marital status. An increasing trend was also noted for deaths from cancer (+25%) and other causes (+38%, p < 0.05) in middle-aged men, but not women (cancer = 0%; other causes = -3%). The stronger beneficial effect of marriage over time may reflect societal changes that have differentially affected men and women.

Marital life course events and smoking behaviour in Sweden 1980–2000

The protective effect of marriage on smoking has been extensively established in the literature. However, less is known about the dynamics of how smoking behaviour is connected to various marital life course events, and whether there are any gender discrepancies in this respect. In this article the connection between the marital life course and smoking is analysed from a stress-related perspective controlling for other socio-economic characteristics. We use information on 81,000 individuals from the Swedish longitudinal micro-level ULF (Survey of Living Conditions) database 1980–2000, which is randomly drawn from the sample population of all Swedes aged 16–84. Logistic regressions on current smoking status and changes in smoking behaviour of participants in the panel part of the data are estimated. The marital life course is strongly linked to smoking behaviour with being or getting married indicating low smoking risks and marital disruption indicating high risks. The divorced smoke to a higher extent than the widowed and there are signs that getting divorced implies higher risks than becoming widowed, both of taking up/relapsing and, for women, not being able to quit. Further, the results indicate that the connection between smoking cessation and living with a partner is stronger for men, whereas women are more affected by the propensity to start smoking after marital disruption. The protective effect of being married on smoking decreases with the age difference between spouses in households where the wife is older than the husband. Taken together, the results yield a rather complex pattern of smoking behaviour over the marital life course. Further, perceived financial stress is strongly connected to smoking and not being able to quit. Controlling for this effect still leaves a socio-economic status gradient in smoking.

Effects of early and later marriage on women's alcohol use in young adulthood: a prospective analysis.

Previous research shows that marriage leads to reductions in alcohol use, especially for women. Because marriage prior to age 20 (early marriage) is a marker for deviance, the protective effects of marriage may not extend to those who marry in adolescence. We compared the effects of marriage in adolescence versus young adulthood on alcohol consumption, negative alcohol-related consequences and heavy episodic drinking at age 29. We analyzed data from 1,138 women in a longitudinal cohort followed from ages 18 to 29. The original sample was recruited from 30 California and Oregon middle schools and first surveyed at age 13. Women who had not married, had married early or had married between ages 20 and 29 did not differ on alcohol use at age 18. Women who married as young adults were less likely than singles to engage in any alcohol use, heavy episodic drinking or experience negative consequences and reported less alcohol use at age 29. Women who married in adolescence reported fewer negative consequences at age 29 than did singles and (if they had not divorced) were less likely to engage in heavy episodic drinking or experience any negative consequences, reported fewer consequences and consumed less alcohol. The protective effects of marriage in young adulthood were observed whether or not women divorced. Parenthood and college attendance before age 23 did not explain the marriage effect. Results support role theory, which posits that individuals who marry are socialized into conventional adult roles that discourage deviant behavior.

'Kusvika taparadzaniswa nerufu' (Until death do us part)

A cross-sectional study of 7 667 non-virgins between 15 and 54 years of age was carried out to assess the protective effect of marriage against HIV acquisition in a rural population in Zimbabwe, whilst taking into account gender-differentials in risk factors for seroconversion. Persons in stable first marriages and long-term consensual cohabiting unions had higher odds of HIV infection than never-married people but a lower risk than those who had been divorced or widowed, even after adjusting for known confounders and significant risk factors for infection. Partner-related risk factors appear to play a more pivotal role in determining HIV prevalence in females than for males, for whom personal sexual behaviour risk factors are more dominant.

The Relationship Between Marriage and Psychological Well-being

This study examined the relationship between marriage and psychological well-being using a sample from the National Survey of Families and Households panel data. Eight different marital status groups were identified and used to test two competing perspectives explaining the relationship between marriage and individual psychological well-being (protection vs. selection). Findings confirmed the strong effects of marital status on psychological well-being, supporting the protection perspective. The effect of the quality of marital (cohabiting) relationship on psychological well-being was significant, but the strong effect of marital status remained unchanged after controlling for relationship quality. Findings also indicated that the transition to cohabiting did not have the same beneficial effects as marriage for psychological well-being, suggesting that the protective effects of marriage are greater than those of cohabiting relationships. The selection effects of psychological well-being were found to be weak and inconsistent. The findings generally did not vary by gender.