Spousal Health Research Articles

Why do spouses provide personal care? A study among care-receiving Dutch community-dwelling older adults.

This study investigates under what conditions older spouses receive personal care from their spouse. Whether spousal care is provided is determined by individual and societal factors related to informal and formal care provision. Individual factors concern the need for care (the care recipient's health status), the spouse's ability to provide care (the spouse's health status) and the quality of the marital bond. Societal factors reflect changing policies on long‐term care (indicated by the year in which care started) and gender role socialisation (gender). From the Longitudinal Aging Study Amsterdam, which completed eight observations between 1996 and 2016, we selected 221 independently living married respondents, aged 59–93, who received personal care for the first time and had at least one previous measurement without care use. The results show that if an older adult received personal care, the likelihood of receiving that care from the spouse decreased over the years: from 80% in 1996 to 50% in 2016. A husband or wife was less likely to receive spousal care when the spouse was unable to provide care or the quality of the relationship was low. No gender differences were found in either the prevalence of spousal care use or in the factors associated with that use. Thus, individual factors and the societal context seem to determine whether one receives personal care from their spouse. The decline in the likelihood of personal care provision from a spouse over the years may indicate a crumbling of family solidarity, an unmeasured and growing inability of the older spouse to provide care or an increasing complexity of care needs that requires the use of formal care. As care‐giving can be a chronic stressor and most spouses provide care without assistance from others, attention from policy makers is needed to sustain the well‐being of older couples.

Associations between spouse and service member prescriptions for high-risk and long-term opioids: A dyadic study

BackgroundEstimates suggest approximately 2.4% of service members, and 15% of service members who have engaged in recent combat, report misusing pain relievers in the past year. This study explores the extent to which military spouses’ obtainment of opioids is associated with their service member partners’ obtainment of opioid prescriptions, in addition to other factors such as service member health, state prescribing patterns, and sociodemographic characteristics. MethodsData were drawn from the Millennium Cohort Family Study, a large, longitudinal survey of married spouses of service members from all service branches, and archival data analyzed from 2018 to 2020. The dependent variables were spouse long-term opioid therapy and spouse opioid prescriptions that pose a high risk of adverse outcomes. ResultsSeven percent of spouse and service member dyads met the criteria for high-risk opioid use, generally because they had purchased a prescription for a ≥90 Morphine Milligram Equivalents daily dose (76.7% for spouses, 72.8% for service members). Strong associations were found between spouse and service member opioid therapies (OR = 5.53 for long-term; OR = 2.20 for high-risk). ConclusionsFindings suggest that reducing the number of long-term and high-risk opioid prescriptions to service members may subsequently reduce the number of similar prescriptions obtained by their spouses. Reducing the number of service members and spouses at risk for adverse events may prove to be effective in stemming the opioid epidemic and improve the overall health and safety of military spouses and thus, the readiness of the U.S. Armed Forces.

Relationship between mindfulness and general health among couples in Mainland China: A crossover perspective

RationalePrevious research has indicated that mindfulness can be beneficial both intrapersonally and interpersonally. Although mindfulness has been shown to improve an individual's health, much less is known about whether these health benefits extend to the individual's spouse. ObjectiveThe present study aims to establish a crossover model to expound ''how'' and ''why'' mindfulness might be associated with both the individual's and the spouse's general health. MethodsIn total, 319 married couples in Mainland China participated in a two-wave survey study with a 3-month interval. The hypotheses were tested by Structural Equation Modeling. ResultsAs expected, mindfulness was positively correlated with personal general health through decreases in perceived social undermining. However, mindfulness had an asymmetrical crossover effect on spouses' general health. Whereas wives' mindfulness had significant benefits for husbands' general health, husbands' mindfulness was not a significant protective factor of wives' general health. The benefits of wives' mindfulness on husbands' general health were mediated by the direct crossover of lower perceived social undermining from wives to husbands. ConclusionsThis study is the first to investigate the relationship between mindfulness and general health at the couple level. Our findings help clarify the benefits of mindfulness on couples' health management from a systemic perspective and provide further support for the crossover theory.

742 Linkages between sleep quality and mental health among couples coping with type 1 diabetes across survey and daily diary methods

Abstract Introduction Sleep serves an important role in maintaining and promoting metabolic and mental health. The interdependent nature of couple relationships makes examining sleep quality from a dyadic perspective critical. This study examined the effect of sleep quality on mental health among couples coping with type 1 diabetes across survey and daily diary methods and investigated whether relationship satisfaction moderated these relations. Methods 199 persons with type 1 diabetes (Mage = 46.82) and their spouses (Mage = 46.41) completed one survey questionnaire reporting their own sleep quality (PSQI), depressive symptoms (CESD), and relationship satisfaction (CSI). They also completed 14-day diaries reporting on their own sleep quality and negative affect. The actor-partner interdependence model and multi-level model were used to examine the effect of sleep quality on mental health across the cross-sectional and daily diary surveys. Multi-level modeling examined effects of within-person and between-person effects of sleep quality on next-day daily negative affect (controlling for prior day affect). Results Cross-sectional survey data revealed an association between poorer global sleep quality and higher depressive symptoms for both partners (actor effects). Spouses’ poorer sleep quality was associated with higher depressive symptoms for persons with T1D (partner effects). Daily diary data demonstrated an association between within-person and between-person effects of own poor sleep quality and higher negative affect for both partners. Poorer daily sleep quality for persons with T1D was associated with higher negative affect for spouses (partner effects). When examining the moderating role of relationship satisfaction, spouses’ poorer overall sleep quality was associated with greater depressive symptoms and overall negative affect respectively for those with lower relationship satisfaction but not for those with higher relationship satisfaction across both methods. Conclusion Findings support the conceptualized link between sleep quality and mental health as both an intraindividual and dyadic process among couples coping with T1D across survey and daily diary methods. Additionally, better relationship satisfaction may buffer the effect of overall poor sleep quality on mental health for spouses. Support (if any) This work was supported by NIH NIDDK program project grant (DP3DK103999). Individual support was provided by T32 MH019986 (ELT).

791 Psychological outcomes among women pursuing Trio-Exome-Sequencing (ES) in the setting of recurrent anomalous fetal phenotypes

To describe psychological outcomes among women with recurrent fetal phenotypes using ES for diagnosis compared to women with one affected pregnancy. Prospective ES study that enrolled patients with any major fetal anomaly and normal microarray after genetic counseling. All participants agree to learn: 1) findings that explain the fetal phenotype; 2) medically actionable secondary findings in a parent (e.g. BRCA), or carrier couple status for significant autosomal recessive disease. Women completed validated scales and free responses before and after ES. Psychological outcomes were compared between women with recurrent fetal phenotypes and those with only one affected pregnancy. Free responses were compared using thematic content analysis. 177 trios were enrolled; of those, 123 have sequencing data. 30 (24.4%) pursued ES for recurrent affected pregnancies; 11received a fetal result (36.7%). Diagnostic yield in overall cohort was lower (31.7%). Maternal demographic characteristics of those with recurrent phenotypes did not differ from the cohort overall. There was no significant difference in pre and post-ES anxiety, depression, or decisional conflict scores between the two groups. However, women with recurrent anomalous phenotypes had significantly higher uncertainty scores (12.4 vs. 9.6 p= 0.03) and overall scored worse on the Multidimensional Impact (MICRA) Questionnaire (36.1 vs. 28.9 p=0.03) (Table 1). As such, those with recurrent phenotypes reported testing for the following reasons: 1) to inform future reproductive decisions and diagnosis; 2) personal and spousal health. A common narrative within this group was having “no personal expectations." By contrast, those with a first affected pregnancy had more hope for: (1) diagnosis of the pregnancy, (2) advancing science and “helping others,” and (3) personal reassurance or “closure” (Figure 1). Women pursuing ES in the setting of recurrent anomalous phenotypes may pursue sequencing for different reasons than women with a single affected pregnancy and may be more impacted by test-related uncertainty.View Large Image Figure ViewerDownload Hi-res image Download (PPT)

The Role of Paid Family Leave in Labor Supply Responses to a Spouse's Disability or Health Shock

The Role of Paid Family Leave in Labor Supply Responses to a Spouse's Disability or Health Shock

Experiences of becoming widowed in old age – a cross-countries study with qualitative interviews from Denmark and quantitative measures of association in a Swedish sample

ABSTRACT Purpose: Becoming widowed is a stressful health-threatening event causing major life changes. We explored how widowed people experience becoming widowed and examined if these experiences are quantitatively associated with widowhood. Methods: A multi-methods study using an exploratory sequential mixed-methods approach including a qualitative descriptive study with widowed people from Denmark and a Swedish cohort study. Qualitative interviews (n = 9) were analysed using qualitative content analysis, describing experiences as explained by the widowed people. The quantitative association of the experiences was examined by identifying proxies for the qualitative experiences of widowhood in the cohort study and examining the occurrence in widowed people compared to married people (n = 1,095). Results: Six categories of experiences emerged: the circumstances around spousal death, mental health and well-being, physical health, social relations, activities and practicalities. The quantitative examination showed a significant association with widowhood regarding mental and physical health problems. Conclusion: The circumstances around spousal death and the time before spousal death, in general, were important to how participants felt being widowed. Being ill negatively affected mental health and well-being, partly because of the inability to participate in activities and social relations. This is important, as health problems are more common among widowed people than married people.

Effects of formal home care on spousal health outcomes

This study estimates the impacts of formal home care provided by paid professionals on spousal health outcomes. We use data from the Survey of Health, Ageing, and Retirement in Europe, a panel of older adults living in several European countries, and match new formal home care users to non-users to account for the endogeneity of the decision to seek formal home care. After considering underlying mechanisms, our results suggest that at least in the short run, the use of formal home care does not impact spousal physical or mental health. We also find that formal home care use increases spousal informal caregiving —along the extensive margin—, although in our sample and short time horizon, spousal informal caregiving does not seem to impact health.

Patients and spouses coping with inflammatory arthritis: Impact of communication and spousal perceived social support and burden.

To guide Therapeutic Patient Education (TPE) programs to improve patients' and spouses' perceived health, we aimed to analyze the effect of the spouse health state and patient-spouse relationship on functional impairment, mental health and self-efficacy of patients with RA or SpA. In this observational cross-sectional study, inclusion criteria were age≥18years and diagnosis of RA or SpA. The outcome criteria were functional impairment and mental health measured by the Medical Outcomes Study Short-Form 12-item version (SF-12-MCS); mental health measured by the General Health Questionnaire (GHQ-12); and self-efficacy by the General Self-Efficacy Scale (GSE Scale). Caregiver-patient relationship was assessed by the Personal Assessment of Intimacy in Relationships (PAIR) questionnaire and the Dyadic Adjustment Scale (DAS); social support by the Social Support Questionnaire-6 and spousal burden by the Zarit questionnaire. A total of 88 patient-spouse couples were included. Patients were mostly female (n=68, 77%), with mean age 59 (SD 12.6) years; 69% had RA. On bivariate analyses, only spousal burden was associated with patients' functional impairment. Patients' mental health was associated with satisfaction with social support and the dyad relationship. Self-efficacy of patients was associated with spousal burden, satisfaction with social support, spousal anxiety/depression and the dyad relationship. On multivariate analysis, improved mental health and perceived self-efficacy of patients were associated with spousal satisfaction with social support (Beta=0.8, P=0.1 with GHQ-12) good communication in the couple (Beta=0.5, P=0.04 with SF-12-MCS and Beta=0.4, P=0.04 with GSE Scale) and low spousal-assessed burden (Beta=-0.2, P=0.003 with GSE Scale). This study has identified potential focus for intervention. It has highlighted the importance of recognizing the role of couple communication (experiencing an open and fluent exchange of ideas) in the patient's mental health and self-efficacy but also perceived satisfaction with social support of both members of the couple on the patient's mental health.

Loneliness, Marital Quality, and Vascular Health Among Older U.S. Couples: A Longitudinal Dyadic Study

Loneliness is a contributor to later life declines in health, including vascular health. Importantly, loneliness is not restricted to those who lack close social ties: More than one-third of married U.S. older adults experience loneliness, and having a lonely spouse increases the likelihood of experiencing loneliness oneself. Thus, over time loneliness in either spouse may lead to worse health for both spouses. Using longitudinal dyadic data from the Health and Retirement Study (2008-2014), we estimated multilevel lagged dependent variable models to examine implications of both partners’ loneliness at baseline for each spouse’s HbA1c four years later. Findings revealed that effects of both partners’ loneliness were contingent upon marital quality: Own and partner’s loneliness led to increases in HbA1c when perceived marital support was low, but this was attenuated at higher levels of marital support. These results extend prior research concerning loneliness and vascular health, and loneliness as a relational experience.

Older Adults’ Receptivity to Spousal Health Support: A Qualitative Analysis

Romantic partners play a powerful role in promoting each other’s well-being, particularly later in life. Although there is a robust literature documenting how spouses tend to respond to each other’s health issues (e.g., support, control), there has been a surprising dearth of studies examining how receptive spouses are to these overtures. To reveal how older couples react to each other’s health support attempts, we used a qualitative approach to analyze transcripts of 64 older, married, heterosexual couples observed discussing each other’s health issues. Thematic analysis revealed older couples responded to spouses’ health support strategies in four different ways: 1) listening (individuals actively listened); 2) accepting (individuals welcomed spousal efforts); 3) deflecting (individuals redirected conversation away from health); and 4) rejecting (individuals dismissed and refused spousal intervention). Given the rise in late-life caregiving, identifying the very different responses that are evoked when partners intervene in each other’s health warrants further investigation. Part of a symposium sponsored by Dyadic Research on Health and Illness Across the Adult Lifespan Interest Group.

The effects of job displacement on spousal health

This paper studies how job displacement influences the health of the worker’s spouse. Results show that the husband’s displacement leads to an increase in the probability of the wife reporting her physical health as fair/poor. These wives are also more likely to experience high blood pressure, heart disease, and/or emotional issues. Wives who are in poor health at baseline, are in low financial standing prior to the husbands’ job loss, are not working two years before the husbands’ job loss, and have children at home at the time of the husbands’ displacement tend to drive these results. Husbands of displaced wives experience little change in self-reported health, the probability of high blood pressure, heart disease, or emotional issues.

Fertility and pregnancy in Iranian thalassemia patients: An update on transfusion complications

Despite the significant advances in thalassemia pathobiology and efficacy of chelation regimens, complications of transfusion therapy have attenuated the reproductive health of thalassemia patients. Depending on clinical profiles, we aimed to assess the fertility status and stresses among thalassemia patients who desired to have children. A total of 213 couples in reproductive ages were enrolled in this study in Tehran. Patients' demographic, clinical, fertility and spouse's health status were documented. We evaluated the pituitary-gonadal axis, serum ferritin, liver enzymes, and alloimmunization before planning a pregnancy and reported them as a function of spontaneous conception and transfusion dependency. Data showed that 131 patients (62%) had 228 spontaneous pregnancies leading to 198 (86.6%) successful pregnancies. A significant difference was observed in spontaneous pregnancy with respect to fertility complications and transfusion dependency. In addition, the clinical conditions of spouses in patients with any spontaneous pregnancy were more thalassemia carriers (P < .05). Moreover, serum ferritin levels had a significant negative correlation with the levels of Testosterone, Estradiol, luteinizing hormone, and follicle-stimulating hormone. Furthermore, a significant positive correlation was reported with the level of liver enzymes. Finally, alanine transaminase and aspartate transaminase had a significant negative correlation with pituitary hormones. We suggest that organised instruction in addition to good iron chelation, especially during the puberty period, would reduce the oxidative damage and related complications in thalassemia patients. Moreover, infertility seems to be attributed to iron deposition in various endocrine organs, pituitary, reproductive system and the liver, contributing to hormonal metabolism.

Associations of warzone veteran mental health with partner mental health and family functioning: Family Foundations Study

Warzone participation is associated with increased risk of stress-related psychopathology, including posttraumatic stress disorder (PTSD) and depression. Prior research suggests that the mental health of spouses of warzone veterans (WZVs) is linked to that of their partners. Additionally, PTSD among WZVs has been associated with marital dysfunction. Less is known about the effects of depression among WZVs on partner mental health and family relationships. We sought in this study to examine associations between WZV PTSD and depression and partner mental health and relationship outcomes. Using a nationally dispersed sample of Iraq and Afghanistan veterans and their married and unmarried intimate partners, 245 dyads completed structured psychiatric interviews and psychometric surveys assessing family functioning and relationship aggression. Adjusted regression analyses indicated that depression among WZVs was associated with partner depression and anxiety disorders. WZV PTSD and depression were also associated with partner-reported relationship dysfunction, dissatisfaction, and communication issues, and higher rates of intimate partner aggression victimization and perpetration. Mental health consequences of war extend beyond WZVs to the mental health of their intimate partners and their relationships with intimate partners.

Feasibility and acceptability of a video library tool to support community health worker counseling in rural Afghan districts: a cross-sectional assessment

BackgroundRural Afghan populations have low skilled birth attendance rates and high maternal and infant mortality. Insecurity and armed conflict, geographic barriers, and cultural norms often hinder women’s access to facility-based reproductive, maternal, newborn, and child health (RMNCH) services. Community health workers (CHWs) are critical agents for behavioral change in this and similarly fragile settings, where RMNCH information exposure is limited by low literacy and mass media access. We assessed the feasibility and acceptability of a computer tablet-based health video library (HVL) to enhance CHW counseling on RMNCH topics in three rural Afghan districts.MethodsThe HVL was introduced by trained CHWs in 10 pilot communities within one rural district in each of Balkh, Herat, and Kandahar provinces. We used a mixed-methods study design to assess exposure to and perception of the HVL 6 months post-introduction. We surveyed married women (n = 473) and men (n = 468) with at least one child under 5 years and conducted in-depth interviews with CHWs and community leaders (shuras and Family Health Action groups) within pilot communities (n = 80). Program improvement needs were summarized using quantitative and qualitative data.ResultsHigher proportions of women in Balkh (60.3%) and Herat (67.3%) reported viewing at least one HVL video compared to women in Kandahar (15%), while male HVL exposure was low (8–17%) across all districts. Most HVL-exposed clients (85–93% of women and 74–92% of men) reported post-video counseling by CHWs. Nearly all (94–96% of women and 85–92% of men) were very interested in watching videos on other health topics in the future. Participants recommended increasing the number of videos and range of topics, using tablets with larger screens, and translating videos into additional local languages to improve the HVL program.ConclusionThe HVL was a highly acceptable tool for relaying health information, but coverage of female audiences in Kandahar and male audiences broadly was low. The HVL should better engage men and other key influencers to engineer local solutions that directly facilitate male HVL exposure, indirectly improve women’s HVL access, and support collaborative spousal health decision-making. A larger efficacy trial is warranted to measure the HVL’s effect on knowledge and health-related behavioral outcomes.

Performance of Everyday Occupations and Perceived Health of Spouses of Men With Spinal Cord Injury at Discharge and 6 Months Later.

An exploratory longitudinal study. (a) Compare the occupational performance, and life satisfaction of spouses of men with SCI with those of spouses of healthy men, (b) compare the occupational performance, perceived health, and life satisfaction of spouses of men with SCI at discharge from inpatient rehabilitation and 6 months postdischarge; and (c) assess whether the functioning levels of men with SCI and the perceived mental health of the spouse, correlate with her occupational performance. Spouses of men with spinal cord injury (SCI) report having symptoms of depression and anxiety. However, their ability to choose everyday occupations and perform them satisfactorily (occupational performance) was less studied. Fifteen women spouses of men with SCI and 15 women spouses of healthy men participated. Study measures included four self-report questionnaires and the Occupational Performance History Interview that was analyzed quantitatively and measured occupational performance by three components: occupational identity, competence, and settings. Occupational performance and life satisfaction of caregivers were lower than those of spouses of healthy men and did not significantly change over 6 months. However, they had higher scores on physical, mental, and general health 6 months postdischarge than at discharge. Mental health of the spouse correlated with her occupational identity. It is recommended that rehabilitation intervention focus not only on patients with SCI, but also on their healthy spouses to promote their occupational performance, health, and well-being. 3.

High-risk and Long-term Opioid Prescribing to Military Spouses in the Millennium Cohort Family Study.

The use and misuse of opioids by active service members has been examined in several studies, but little is known about their spouses' opioid use. This study estimates the number of military spouses who received high-risk or long-term opioid prescriptions between 2010 and 2014, and addresses how the Military Health System can help prevent risky prescribing in order to improve military force readiness. This study used data from the Millennium Cohort Family Study, a nationwide survey of 9,872 spouses of service members with 2 to 5years of military service, augmented with information from the military's Pharmacy Data Transaction Service about prescriptions for controlled drugs dispensed to these service members' spouses. Our objectives were to estimate the prevalence of opioid prescribing indicative of long-term use (≥60day supply or at least one extended-release opioid prescription in any 3-month period) and, separately, high-risk use (daily dosage of ≥90 morphine mg equivalent or total dosage of ≥8,190 morphine mg equivalent, or prescriptions from more than three pharmacies, or concurrent prescriptions). For each of these dependent variables, we conducted bivariate analyses and multiple logistic regression models using information about spouses' physical health, sociodemographic characteristics, substance use behaviors, perceived social support, and stresses associated with military stress, among others. Informed consent, including consent to link survey responses to medical and personnel records, was obtained from all participants. The Naval Health Research Center's Institutional Review Board and the Office of Management and Budget approved the study. Spouses were predominantly female (86%), had not served in the military themselves (79%), and were spouses of enlisted (91%) active duty (86%) service members. Almost half (47.6%) of spouses obtained at least one opioid prescription during the 2-year observation window, and 8.5% had received opioid prescriptions that posed risk to their health. About 7% met the criteria for receipt of high-risk opioid prescriptions, 3% obtained opioids from three or more pharmacies during a 3-month period, and 4% of spouses who received any opioids received both long-term and high-risk prescriptions. Adverse childhood experiences, physical pain, and lack of social support were associated with increased odds of obtaining high-risk opioid prescriptions. Approximately 48% of military spouses had used Military Health System insurance to fill at least one opioid prescription during the 2-year observation period. The Department of Defense has taken measures to minimize high-risk opioid prescribing, including passing prescribing guidelines in 2017, establishing the controlled drug management analysis reporting tool, establishing a pain management education and training program, and more. These efforts should continue to expand as reducing the numbers of service members and spouses at risk for adverse events may be effective in reducing opioid misuse and improve the overall health and safety of military spouses and thus, the readiness of the U.S. Armed Forces.

The cross-spousal effect of education on health

This paper studies the cross-spousal effect of education on health. We address the endogeneity of education that arises from one's own unobserved endowment using the within-twin fixed-effect method. We explore unique information on spousal health at both wedding and survey times to investigate the role of spousal unobserved endowment. We find that wives' education reduces husbands' consumption on cigarettes and alcohol, increases exercise frequency, lowers the probability of being overweight, and decreases the number of chronic diseases. By contrast, the effect of husbands' education on wives' health is weak.

Unpaid Public Work is Not Cost Free: Military Spouses Performing Emotional Labor

Historically, unpaid work was expected of women in many walks of life, privately, in the domestic sphere, and in the public sphere supporting their husband’s career. As women have gained rights of individual recognition and pursued their own careers, the formal expectations of military spouses have diminished. This study explored the meaning and impact of unpaid public work on the health and wellbeing of spouses of senior military Service people. Data are presented from: 12 interviews with spouses from six countries; a group discussion interviewed women; and a workshop with spouses who had not previously participated in the research. A modified grounded approach found that the unpaid public work undertaken involves emotional labor in both private/domestic and public spheres. The impact of unpaid public work is characterized by paradoxes: facilitating care for others while delaying care for oneself; loneliness alongside loss of privacy and control; and valuing the unpaid public work while the general public and military institution may not. This research illuminates the need for support for those continuing to engage in unpaid public work in the future as well as the work that may need to be undertaken by other agencies where spouses no longer provide unpaid work.

Association of military life experiences and health indicators among military spouses

BackgroundThe health and well-being of military spouses directly contribute to a robust military force by enabling the spouse to better support the active duty member’s career. In order to understand the overall health and well-being of military spouses, we assessed health indicators among military spouses using the Healthy People 2020 framework and examined associations of these health indicators with military experiences and psychosocial factors.MethodsUsing data from the Millennium Cohort Family Study, a U.S. Department of Defense-sponsored survey of 9872 spouses of service members with 2–5 years of military service, we examined attainment of Healthy People 2020 goals for spouses and service members, including healthy weight, exercise, sleep, and alcohol and tobacco use. Multivariable logistic regression models assessed associations of spouse health indicators with stressful military life experiences and social support, adjusting for demographics and military descriptors. The spousal survey was administered nationwide in 2011.ResultsThe majority of military spouses met each health goal assessed. However, less than half met the healthy weight and the strength training goals. Reporting greater perceived family support from the military was associated with better behavioral health outcomes, while having no one to turn to for support was associated with poorer outcomes. Using the Healthy People 2020 objectives as a framework for identifying key health behaviors and benchmarks, this study identified factors, including military-specific experiences, that may contribute to physical health behaviors and outcomes among military spouses. With respect to demographic characteristics, the findings are consistent with other literature that women are more likely to refrain from risky substance use and that greater education is associated with better overall health outcomes.ConclusionsFindings suggest that enhanced social and military support and tailored programming for military spouses may improve health outcomes and contribute to the well-being of military couples. Such programming could also bolster force readiness and retention.