September 14, 2003

Marriage Appears to Be Beneficial to Women’s Health, But Only When Marital Satisfaction Is High, New Research Shows

WASHINGTON - Women who are in satisfying marriages have a health advantage over unmarried women or those in unsatisfying marriages, according to a study published in the September issue of Health Psychology, a journal of the American Psychological Association (APA). The study, involving middle-aged women over a 13-year period, finds that women in good marriages were less likely to develop risk factors that lead to cardiovascular diseases compared with other middle-aged women.

Researchers from San Diego State University and the University of Pittsburgh compared cardiovascular risk profiles and trajectories of women who were married or living with a romantic partner and who had high relationship satisfaction with those of women with moderate or low relationship satisfaction and with those women who were single, divorced and widowed. Participants were 493 women (ages 42-50) from the University of Pittsburgh's Healthy Women Study, a longitudinal study that looked at health risk factors during and after menopause. Risk factors were measured during an average of more than five visits over 13-years. Each visit included a blood draw to measure cholesterol and glucose levels, blood pressure evaluation, body-size measurements and assessment of health behaviors (such as diet, smoking and exercise) and psychosocial characteristics (such as depression, anxiety, anger and stress).

Participants who were married or cohabitating completed a seven item marital quality questionnaire that assessed satisfaction with amount of time spent together, communication, sexual activity, agreement on financial matters and similarity of interests, lifestyle and temperament. The questionnaire was completed at the beginning of the study and during the three-year follow-up assessments.

Results indicate that women in marriages characterized by high levels of satisfaction showed a health advantage when compared with participants in marriages characterized by low levels of satisfaction and with unmarried participants (single, widowed or divorced). This included lower levels of biological and lifestyle cardiovascular risk factors - such as blood pressure, cholesterol levels and body mass index - and lower levels of psychosocial cardiovascular risk factors - such as depression, anxiety and anger. Those women in highly satisfying marriages also showed this same health advantage when compared with women in moderately satisfying marriages, but to a lesser extent.

How might being in a good marriage influence health? Previous research indicates several direct and indirect factors may be a work, according to the authors. Marriage itself may offer a health advantage by providing social support and protecting against the risks associated with social isolation. Also, spousal influence and involvement may encourage health-promoting behaviors and deter unhealthy behaviors. Married people, especially women, may also be at a health advantage relative to their unmarried counterparts through the increased availability of socioeconomic resources.

However, research shows poor marital quality may erase these health advantages, say the authors. Marital stress is associated with lifestyle risk factors and nonadherence to medical regimens. Poor marital quality is also linked with more depression, hostility and anger, all risk factors for coronary heart disease. Thus, marital status and quality could influence metabolic risk factors and acute stress responses, which in turn predict cardio-vascular morbidity and mortality, according to the study.

"For the most part, the higher risk groups seemed to maintain an elevated level or risk across the entire study, suggesting that by middle age, the cumulative influence of being single, divorced or widowed or of being in a distressed relationship had already occurred," according to the researchers. Future research with younger couples may identify how and when women in distressed marriages and unmarried women develop higher risk cardiovascular profiles, they add.

Article: "Marital Status and Quality in Middle-Aged Women: Associations With Levels and Trajectories of Cardiovascular Risk Factors," Linda C. Gallo, San Diego State University, Wendy M. Troxel, University of Pittsburgh, Karen A. Matthews, University of Pittsburgh School of Medicine and Lewis H. Kuller, University of Pittsburgh; Health Psychology, Vol. 22, No. 5.

Reporters: Study authors Karen A. Matthews, Ph.D., and Linda C. Gallo, Ph.D., are available for media interviews. Dr. Matthews can be reached at (412) 624-4741 or by Email. Dr. Gallo can be reached at (619) 594-4833 or by Email.

The American Psychological Association (APA), in Washington, DC, is the largest scientific and professional organization representing psychology in the United States and is the world's largest association of psychologists. APA's membership includes more than 150,000 researchers, educators, clinicians, consultants and students. Through its divisions in 53 subfields of psychology and affiliations with 60 state, territorial and Canadian provincial associations, APA works to advance psychology as a science, as a profession and as a means of promoting health, education and human welfare.