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Romantic relationships, particularly marriage, have beneficial, and at times, detrimental effects on health. Current research on the topic has focused on the physiological, psychological, and social factors that account for how and why romantic relationships are related to health. Research in this area also has focused on the role that relationships status, gender, sexual orientation, age, and physical health conditions play in whether romantic relationships are related to better (or worse) health. Findings from this line of work have the potential to impact intervention efforts that involve both members of a relationship to enhance physical, psychological, and relational well-being.
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August K.J., Kelly C.S., and Markey C.N., Marriage, Romantic Relationships, and Health. In: Howard S. Friedman
(Editor in Chief), Encyclopedia of Mental Health, 2nd edition, Vol 3, Waltham, MA: Academic Press, 2016, pp. 46-52.
Copyright © 2016 Elsevier Inc. unless otherwise stated. All rights reserved.
Marriage, Romantic Relationships, and Health
KJ August, CS Kelly, and CN Markey, Rutgers University, Camden, NJ, USA
r2016 Elsevier Inc. All rights reserved.
Behavioral health Refers to behaviors, or actions, that have
consequences for health such as alcohol and tobacco use.
Cohabitation Romantic partners who reside together in a
committed, often monogamous, relationship, without
being legally married.
Companionship Enjoyable interaction and camaraderie
among social network members, such as spouses. This
includes engaging in shared recreation and other activities
for enjoyment.
Dating A relationship between two individuals, in which
they engage in mutual activities together to assess interest in
pursuing a more committed relationship. This type of
relationship may or may not be monogamous between two
Divorce The legal dissolution of a marriage; considered a
nal end to a marital relationship.
Marriage A legal, social, and often religious institution
that binds two romantic partners until death do they part
or until separation or divorce is sought.
Same-sex relationship A romantic relationship comprised
of two individuals of the same sex (gender); i.e., two men
who are romantically involved or two women who are
romantically involved.
Separation The event in which spouses choose to live
apart, either temporarily (trial separation) or as a step in
the process to divorce. Legal separationrefers to a formal,
court-sanctioned division of marital property.
Social control Attempts to inuence and regulate the
health behavior of another individual.
Social support Provision of care and aid in times of
need. Different types of social support have been
distinguished (e.g., emotional, instrumental, and
Widowhood The relationship status in which ones
spouse has died. A widow refers to a woman whose
spouse has died; a widower refers to a man whose spouse
has died.
Romantic relationships are typically construed as positive
contributors to individualslives. A meaningful relationship
with a signicant other may bring companionship, friendship,
love, security, and happiness to an individuals life. It also may
bring health benets. Being in a romantic relationship usually
indicates greater social integration, which has been found to
be associated with better health outcomes and longevity
(Berkman and Syme, 1979). In fact, some research suggests
that an absence of signicant social relationships, such as ro-
mantic partners, may be as detrimental to health as is smok-
ing, high blood pressure, and obesity (House et al., 1988).
Having a partner also provides access to a larger social network
of family, friends, and other individuals in the community,
who offer benets in their own right (Musick and Bumpass,
2012). Romantic relationships, however, have unique and
robust effects on health compared to other social network ties.
The contributions of romantic relationships, particularly
marriage, to individualshealth have been reported in terms of
both physical health and psychological well-being. In this
article we focus primarily on physical health (see DePaulo;
deJong and Reis entries for other information about relation-
ships and psychological well-being).
How and Why Are Romantic Relationships and Health
In general, there is a high degree of concordance between ro-
mantic partnershealth and health behaviors, such that the
health of a husband or wife is strongly associated with his or
her spouses health (Falba and Sindelar, 2008;Meyler et al.,
2007). Additionally, relationship functioning has been found
to be associated with cardiovascular, endocrine, and immune
functioning (Rankin-Esquer et al., 2000;Robles and Kiecolt-
Glaser, 2003). Married individuals also have been shown to
have better health experiences than nonmarried individuals in
a number of areas, including pain and pain-related disability,
periodontal disease, rheumatoid arthritis, heart health,
neurological disorders, ulcers, and self-reports of overall health
status (Carels et al., 1998;Coughlin, 1990;Kiecolt-Glaser and
Newton, 2001;Levenstein et al., 1995;Marcenes and Sheiham,
1996;Medalie et al., 1992;Rankin-Esquer et al., 2000;Tucker
et al., 1996;Flor et al., 1989;Zautra et al., 1998). Finally, it has
been well established that people who are married live longer
than those who are not married (Rogers, 1995;Lillard and
Waite, 1995;Lillard and Panis, 1996;Umberson et al., 2010;
Friedman and Martin, 2011).
The positive benets of romantic relationships are thought
to be attributable to both selection and protection effects (Fu
and Goldman, 1994;Kiecolt-Glaser and Newton, 2001). In
other words, healthier individuals are more likely to nd and
maintain relationships, and individuals who are in relation-
ships experience the protective effects they may offer. Ac-
cording to the protection theory, an individuals physical and
psychological experiences are affected by their relationships.
For example, married individuals have been found to be more
likely to exercise and eat breakfast and less likely to smoke or
drink heavily than unmarried individuals (Joung et al., 1995).
Although this theory posits a causal link between romantic
relationships and health, there is no true way to determine
Encyclopedia of Mental Health, Volume 3 doi:10.1016/B978-0-12-397045-9.00074-446
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whether romantic relationships cause better health outcomes.
However, by examining these associations using advanced
methodologies that involve following couples across time and
documenting their relationship functioning and health at
various intervals, researchers can become more condent in
the temporal order of such posited effects.
A number of reasons have been offered as to why
romantic relationships contribute to better or worse health. In
addition to feelings of attachment and intimacy, individuals
often feel an increased sense of meaning and purpose in
life that may accompany a romantic relationship (Antonovsky,
1979). These positive emotions, in turn, are related to
many benecial health effects, including lower disease inci-
dence, less health-related symptoms, and increased longevity
(Pressman and Cohen, 2005). More practical explanations
involve the health advantages of having two incomes such as
better access to health care and less stress (Lerman, 2002),
which, in turn, are associated with lower rates of morbidity
and mortality.
Additional pathways whereby romantic relationships are
related to health involve the specic interactions that partners
engage in with each other. The receipt of social support, as well
its perceived availability, often is cited as a common pathway
by which romantic relationships are associated with health
(Robles and Kiecolt-Glaser, 2003;Seeman and Syme, 1987;
see Uchino, Bowen, and Kent entry). Many different types of
social support (emotional, informational, and instrumental)
have been shown to have unique effects on health (Cohen,
2004). A health-specic type of support that has been found to
be especially important in fostering healthy behaviors among
spouses is health-related social support, or efforts to encourage
individualspositive health beliefs and health behaviors
(August and Sorkin, 2010;Gallant, 2003;Joung et al., 1995;
Markey et al., 2005;Umberson, 1992).
Not only is receiving social support associated with positive
benets, but some evidence suggests that providing support
may have benets as well. Support provision has been found
to be associated with less psychological distress (Cialdini et al.,
1973;Midlarsky, 1991), better health (Schwartz and Sendor,
2000), and greater longevity (Brown et al., 2003). Support
provision is not always positive, however, as illustrated by the
caregiving literature (see Zarit entry). Caregivers who provide
support or care to an ill relative often experience deleterious
psychological, physical, and other effects due to the chronic
stress it elicits (Vitaliano et al., 2003). These adverse effects of
caregiving have been shown to be particularly strong for
spousal caregivers (Marks, 1998). This line of research illus-
trates the importance of taking both romantic partnersper-
spectives and experiences into account.
Other than social support, partners in romantic relation-
ships also serve as each otherssource of companionship,
which includes enjoyable interactions and camaraderie, such
as shared recreational activities, that partners engage in toge-
ther. In contrast to support, which helps alleviate stress,
companionship is considered a restorative activity that indi-
viduals engage in for enjoyment purposes, and as such, it has
been shown to reduce stress and bolster positive emotions
(Rook, 1987,1995). As noted above, positive emotions are
associated with a number of salubrious effects on health
(Pressman and Cohen, 2005).
Finally, romantic partners often are involved in monitoring
and inuencing each others health behaviors by engaging in
health-related social control. Social control refers to indi-
vidualsattempts to monitor and inuence anothers health
behaviors. In fact, research suggests that spouses are the most
common network members that engage in social control
toward one another (August and Sorkin, 2010;Umberson,
1992). This can occur both indirectly and directly. The indirect
route occurs by individualsinternalization of role obligations,
such as when a partner seeks medical care to protect their
health for the benet of their partner (Markey et al., 2007). The
direct route entails providing specic verbal instructions or
using other strategies to exert inuence on their partners to
engage in healthy behaviors (Lewis and Rook, 1999;Franks
et al., 2006;Umberson, 1992) (It is of course possible that
romantic partners sometimes engage in inuence attempts that
undermine, rather than promote, sound health behavior, but
such attempts tend to be less common among spouses, in
particular; Henry et al., 2013.). Although potentially well-
intentioned, exerting social control on a partners health be-
havior may come at a cost. Evidence suggests that while social
control may be effective at behavior change, it also may elicit
psychological distress by implying that the individual is un-
able to successfully engage in these healthy behaviors on his or
her own (Hughes and Gove, 1981;Lewis and Rook, 1999).
As illustrated by the research on the potential dual-effects
of social control, romantic relationships are complex and
multifaceted and being in a relationship is not inevitably
positive. For example, spousal support efforts can go awry, in
that they can be excessive or incongruent with the recipients
needs (Coyne et al., 1988). These ineffective types of support
can decrease feelings of self-efcacy, autonomy, and overall
well-being. Spouses also can act in ways toward each other that
are critical, insensitive, or demanding, which are likely to
arouse emotional distress. These emotions, in turn, are asso-
ciated with engagement in poor heath behaviors (Rook et al.,
2010), and also may elicit harmful physiological responses
that, if chronic, can cause wear-and-tear on the body over time
(McEwen and Seeman, 2003). In fact, these negative social
interactions have been found to have a more potent effect on
health and well-being than positive social interactions (Okun
and Keith, 1998;Rook, 1998). This suggests that the quality of
peoples relationships may be much more consequential for
their well-being than is the mere presence or absence of a
signicant other (Gottman and Notarius, 2002). Indeed, re-
search has found that being in an unhappy stable relationship
may have a deleterious impact on health (Robles and Kiecolt-
Glaser, 2003;Williams, 2003). This may be particularly
true if the relationship is stressful and presents a strain on
psychological and physical well-being (Burmin and Margolin,
1992;Gottman and Notarius, 2002). Consistent with this
notion, single people have somewhat better health outcomes
than those in low-quality relationships (Glenn and Weaver,
1981;Cummins et al., 1996), and unhappy relationships are
associated with a decreased chance of individuals making
positive health behavior changes, decreased well-being, in-
creased prevalence of mental disorders, greater health prob-
lems, and increased mortality rates (Hintikka et al., 1999;
Robles and Kiecolt-Glaser, 2003;Schafer et al., 2000;Tucker,
2002;Walen and Lachman, 2000). Some research even
Marriage, Romantic Relationships, and Health 47
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suggests that individuals who are in an unhappy or un-
satisfying marriage actually suffer progressive decline in their
health over time (Umberson et al., 2006). Researchers, there-
fore, have cautioned that nding a romantic partner or getting
married is not an antidote to ill health or the key to happiness
(Friedman, 2003;Tucker et al., 1996).
The Role of Relationship Status, Gender, Sexual
Orientation, Age, and Physical Health Conditions
Relationship Status
A large body of evidence exists to suggest that married indi-
viduals are generally healthier, have better health outcomes,
and live longer than unmarried individuals (Wood et al.,
2007). This is due, in part, to married individualsengagement
in more healthy (and less risky) behaviors compared to un-
married individuals. Yet, other evidence suggests that the
married are more likely to be overweight and exercise less than
the unmarried (Umberson et al., 2010). Research that com-
pares individuals who are married to those that are unmarried
typically treats individuals in the unmarriedcategory as a
homogeneous group however, without considering unique
effects on divorced, separated, widowed, and never married
individuals. There is evidence, for example, that never married
individuals fare just as well as their married counterparts; it
may be the dissolution of marriage through divorce/separation
and widowhood that is responsible for the deleterious effects
of not being married (see DePaulo entry).
Much research on dating has focused on adolescents and
young adults, with considerable focus on intimate partner
violence in dating relationships (Stets and Pirog-Good, 1987;
Wekerle and Wolfe, 1999), as well as how these relationships
encourage or deter risky health behaviors such as substance
use and sexual behavior (Umberson et al., 2010). More re-
search needs to focus on a broader range of health outcomes,
as well as how dating relationships are related to health among
middle-aged and older adults.
Another type of nonmarital romantic relationship, coha-
bitation, has become more common in recent years (Casper
and Cohen, 2000;Kreider, 2010). Cohabitation before mar-
riage is generally viewed as a socially acceptable transitional
stage that often (but not always) leads to marriage, and it is
becoming increasingly more common as an alternative to
marriage. The exact nature of cohabitations effects on health is
unclear. When compared to non-cohabitating individuals,
cohabitating individuals have been found to have an increased
risk of obesity, but also a great likelihood of engaging in less
risky behaviors such as substance use (Umberson et al., 2010).
The evidence is also inconclusive when comparing cohabitat-
ing individuals to their married counterparts, with some
studies nding that cohabitating individuals may have worse
health outcomes (Horwitz and White, 1998), and other
studies nding no signicant differences in health between
those who cohabitate and those who are married (Wu et al.,
2003;Musick and Bumpass, 2006). These latter ndings sug-
gest that the protective effects of marriage may extend to
cohabitating couples. The conicting results in the literature
on the health effects of cohabitation may be due to a number
of factors, but one important consideration is age. There
is evidence that young adults and older adults view cohabi-
tation differently. Young adults tend to see cohabitation
as another step in the relationship process, usually the step
preceding marriage. Older adults view cohabitation, in
contrast, as a marriage alternative (King and Scott, 2005;
Brown et al., 2012). Research on cohabitation in older adults
is currently limited to a few studies, but the differences in
the function of cohabitation at different ages may explain
some of the inconsistent ndings seen in the literature.
Given the changing cultural and normative expectations for
romantic relationships, there is a need for more research to
examine the health effects of these emerging trends to under-
stand whether cohabitation confers the same benets as
Research examining mens and womens relationship and
health experiences is conicting (Carr and Springer, 2010).
Some research suggests that men and women experience
similar mortality risks when they are in relationships (versus
not being in relationships; Manzoli et al., 2007). However, in
one classic study, signicant gender differences in the pro-
tective effect of marriage were reported such that nonmarried
men had a 250% greater mortality rate than married men, and
nonmarried women had only a 50% greater mortality rate
than married women (Ross et al., 1990). Other research sug-
gests that marital dissolution has a more deleterious inuence
on mens health than womens(Bloom et al., 1978;Tucker
et al., 1996). Thus, some researchers would argue that men
may confer more health benets from romantic relationships
than women do, but the extent to which men and women are
uniquely affected by their romantic relationships in specic
health domains has yet to be fully explored. For example, it is
possible that women positively impact their male partners
through health-promoting efforts such as encouraging them to
go to the doctor when they are sick, while men may positively
impact their female partners through other health-promoting
efforts such as encouraging them to participate in physical
activity (Markey et al., 2007). Further, in comparing married
men to married women, it seems that married women may
experience better mental health (e.g., less depression), whereas
married men may experience better behavioral health (e.g.,
less frequent alcohol use; Simon, 2002). The research is in-
conclusive as to whether these gender differences extend to
same-sex couples, and other nonmarital relationships,
Sexual Orientation
In the past few years, civil rights issues among gay and lesbian
couples have taken center stage in the political sphere (see
Moradi entry). In the United States, gay and lesbian couples
have struggled (and in most cases are still struggling) to
maintain rights afforded to their heterosexual peers, such as
legally acknowledged marriage and the ability to adopt chil-
dren. At the heart of the debate about these civil rights issues
lies the assumption that gay and lesbian relationships are
differentthan heterosexual relationships (Biblarz and Savci,
2010). However, contrary to this belief, research examining
48 Marriage, Romantic Relationships, and Health
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same-sex romantic couples generally has found that these ro-
mantic relationships are extremely similar to heterosexual re-
lationships across a wide range of variables (Markey and
Markey, 2011). For example, same-sex romantic couples and
heterosexual couples report similar levels of affective ex-
pression, intimacy, conict, relationship commitment, and
overall satisfaction (Blumstein and Schwartz, 1983;Kurdek,
1998,2001,2004). It follows then that men and women in
same-sex relationships should experience similar health
benets from their relationships than do their heterosexual
peers. Preliminary research supports this notion (Lewis et al.,
2006;Markey and Markey, 2012;Wienke and Hill, 2008).
Further, it has been suggested that a reduction in stigma
that accompanies legally sanctioned civil unions and marriage
equality may offer health benets to men and women in
same-sex relationships (King and Bartlett, 2006). Other re-
search has found, however, that lesbian, gay, bisexual,
or transgender (LGBT) individuals are at a greater health risk
overall, including higher substance use rates (Hughes
and Eliason, 2002), sexually transmitted infections (Marrazzo
et al., 2005;Stolte and Coutinho, 2002), obesity (Boehmer
et al., 2007), and suicide (Remafedi et al., 1998;Meyer, 2003).
These risks are believed to be socially inuenced due to
the stigma associated with being a LGBT person, and thus, are
not inevitable. More research needs to be conducted, however,
to fully understand the impact of LGBT relationships on
Relationships have a cumulative effect on health across the
lifespan. Even before the formation of romantic relationships,
however, parents have a signicant inuence on health that
lasts into adulthood (Haas, 2008). The role that romantic
partners play in each others health differs across age groups,
often corresponding to the life events and health issues that
are salient during a specic period.
The research on how romantic relationships impact health
during adolescence is largely focused on how the dating rela-
tionship can help or hinder health, through its inuence on
health behaviors (e.g., smoking, alcohol and drug use, and
sexual behavior; Umberson et al.,2010) and intimate partner
violence (Silverman et al.,2001;Stets and Pirog-Good, 1987;
Wekerle and Wolfe, 1999). During young adulthood, dating
remains common, but individuals also start to cohabitate, as
well as experience other signicant life events such as rst
marriages, child-bearing, and starting a career. Thus, romantic
partners during this time often serve as buffers to the stress
associated with these new experiences (e.g., Shrout et al., 2006)
and may help regulate important health behaviors during these
transitions (Horwitz et al.,1996). Also during this time, mar-
riage helps to curb substance use, as studies have found that
heavy alcohol and marijuana use declines upon entry into rst
marriage in young adulthood (Bachman et al.,1997;Curran
et al.,1998;Duncan et al.,2006). However, romantic partners
can be a source of stress in their own right, given the high rates
of breakups and marital dissolution through separation or di-
vorce during young adulthood (Copen et al.,2012).
In middle and late adulthood, spouses continue to be at
the center of the social network (Antonucci and Akiyama,
1987) and thus remain a consistent and important contributor
to their partnershealth. At this time, the effects of marriage
on health can most notably be seen, as couples often face
the management of chronic disease and disability, in addition
to other signicant stressful life experiences, including retire-
ment and bereavement. The transition into widowhood is a
signicant stressor and can have many adverse effects on
health, such as weight loss and increased mortality risk
(Umberson et al., 2009). The adverse health effects associated
with widowhood may depend on social regulation of health
behaviors from non-spousal sources, however (Williams,
Physical Health Conditions
The association between romantic relationships and health
may take on a different meaning in the context of a chronic
physical health condition. However, because chronic health
conditions tend to be the result of accumulated insults to the
body over the lifespan (McEwen and Seeman, 2003), it is
difcult to make denitive conclusions about whether rela-
tionship functioning contributes to the development of
chronic conditions; instead, research has focused on how re-
lationships contribute to the management and progression of
these conditions (see Revenson entry).Spouses are the social
network members most often involved in their partners
chronic illness management (Ell, 1996;Revenson, 1994), and
they are likely to share the overarching goal of promoting
adherence to the prescribed treatment regimen, which often
includes initiation and maintenance of a number of health
behaviors (Franks et al., 2006). Given low adherence rates,
spousesinvolvement is typically ongoing, and this long-term
commitment may be a chronic stressor (Revenson et al., 2005).
In this sense, health conditions are considered sharedstres-
sors that both members of a romantic couple often manage, or
cope with, together; in other words, they affect not only the
patient, but also his or her spouse. Whether these joint, or
collaborative, coping efforts pose benecial or harmful mental
and physical health for both members of the couple depends
on a number of developmental and contextual factors, in-
cluding type and stage of condition, culture, gender, and
marital quality (Berg and Upchurch, 2007).
Implications for Individuals, Practice, and Policy
An understanding of how and why romantic relationships are
related to health and well-being has implications not only for
individuals, but also for medical practice, intervention efforts,
and policy decisions. This is particularly important as demo-
graphic shifts leave a growing portion of the population facing
the burden of chronic disease. Given the integral role that
romantic partners play in each others health, it is essential to
extend intervention efforts to involve partners in ways research
indicates to be effective.
Research on the implications of health-related social sup-
port and control suggest, for example, that support is related to
better health behaviors and psychological well-being for both
members of the couple, and that gentler, persuasive control
strategies to inuence a partners health behaviors are more
effective than heavy-handed, critical strategies (August et al.,
Marriage, Romantic Relationships, and Health 49
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2011, 2013;Lewis and Rook, 1999). This illustrates the im-
portance of designing interventions to benet both members
of the couple and the relationship without sacricing the
health or well-being of one partner over the other. Indeed,
some evidence suggests that compared to usual medical care,
psychosocial interventions for couples managing chronic dis-
eases other than dementia are related to less depression and
lower mortality rates among patients, and less depression and
burden among their spouses, particularly when the inter-
ventions are relationship-focused (Martire et al., 2004). These
positive mental health effects may, in turn, have implications
for both patients and their spousesphysical health.
In addition to the research on the health benets of op-
posite-sex relationships, some evidence suggests that same-sex
relationships have similar effects on health (Markey and Mar-
key, 2011). Most work to date, however, has focused on HIV
and other negative health behaviors and outcomes, and less is
known about more positive indicators of health among LGBT
couples. With recent legislative changes allowing same-sex
marriage in some states, an increasing number of individuals in
the LGBT community may be transitioning into marriages. This
provides an opportunity to understand more about whether
same-sex marriage offers protective effects on health in the
same way as it does for opposite-sex marriages, and potentially
will provide further support for both state and federal legis-
latures to expand this benet to all members of society.
There is a great deal of research to suggest that romantic re-
lationships, particularly marriage, have benecial, and at
times, detrimental, effects on health. Yet, relationship norms
in the United States and other industrialized nations are
changing. Although many individuals marry, others never
marry, cohabitate, or divorce (Liu and Umberson, 2008). Very
little is understood about the extent to which alternatives to
marriage confer those same benets or detriments as marriage
itself. An additional challenge in the study of romantic rela-
tionships and health is disentangling the effects of selection
versus protection in an attempt to understand the causal na-
ture of this relationship. These continued efforts to further
understand how and why romantic relationships are related to
health have implications for the design of interventions that
can promote positive relationship functioning to optimize the
physical and mental health of both members of a romantic
See also: Behavioral Medicine. Caregiving. Chronic Illness and
Mental Health. Couple Therapy. Divorce and Parental Separation.
Intimate Partner Violence. Lesbian, Gay, Bisexual, and Transgender
Issues. Love and Intimacy. Singles and Mental Health. Social
Support and Mental Health
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52 Marriage, Romantic Relationships, and Health
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... This paper focuses on body weight perceptions because some research indicates that perceptions are more predictive of health attitudes and behaviors than one's objective body weight [e.g., eating habits are affected by perceived weight; (2)]. Perceptions of one's partner's weight are also important as partners may be ideal sources of support in the introduction and maintenance of relevant, positive health habits (3). There is no research to date examining partners' perceptions of each other's weight statuses, however. ...
... In addition to the positive benefits being in a romantic relationship may confer to one's health (3), being involved in a romantic relationship might also lead to changes to health habits that result in weight gain. Indeed, evidence suggests that body size is influenced not only by individuals' genes, but also by a number of social factors, one of which is marital status (4). ...
... This finding is consistent with the "mating market model, " where longer relationships, which may represent greater commitment and security, are associated with weight gain. Although relationship support and security confer some health benefits, they may also contribute to a lack of concern about maintaining eating and physical activity patterns that are conducive to health in the long-term (3,40). ...
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Romantic relationship experiences have been found to be relevant to body image and weight in adulthood. In this study, we investigated predictors of heterosexual, lesbian, and gay romantic partners' (N = 500, Mage = 29.3) perceptions of their own and their partners' weight at the beginning of their relationship and 4.8 years later, on average. Perceived changes in participants' own weight status was associated with greater body dissastisfaction and longer relationship length. Perceived changes in partners' weight status was associated with their partners' BMI, as well as relationship quality. We also found that gender was important in understanding some of these associations. Implications of weight perceptions for individuals' and their partners' health and well-being and the critical role of relationship quality are discussed in the context of the health regulation model.
... Provided that heterosexual relationships constitute the most common route to family formation, it has been suggested that the herbivorization of young adults contributes to Japan's low birth rates [6,13]. Furthermore, individuals in romantic relationships tend to experience better health outcomes and life satisfaction compared to their single counterparts, although these associations depend on the quality of the relationship [14][15][16]. If a large number of individuals live without intimate relationships, this may also have implications for public health. ...
... Intimate relationships constitute an important component of human fertility and life satisfaction and are associated with better health outcomes [6,[13][14][15][16]. As such, a purportedly decreasing interest in sex and romantic relationships has brought young Japanese adults under national scrutiny and fostered unease in light of the country's rapidly ageing population, low Table 1 ...
Full-text available
Background It has been suggested that an increasing proportion of young adults in Japan have lost interest in romantic relationships, a phenomenon termed “herbivorization”. We assessed trends in heterosexual relationship status and self-reported interest in heterosexual romantic relationships in nationally representative data. Methods We used data from seven rounds of the National Fertility Survey (1987–2015) and included adults aged 18–39 years (18–34 years in the 1987 survey; sample size 11,683–17,675). Current heterosexual relationship status (married; unmarried but in a relationship; single) was estimated by sex, age group and survey year, with singles further categorized into those reporting interest vs. no interest in heterosexual romantic relationships. Information about same-sex relationships were not available. Results Between 1992 and 2015, the age-standardized proportion of 18-39-year-old Japanese adults who were single had increased steadily, from 27.4 to 40.7% among women and from 40.3 to 50.8% among men. This increase was largely driven by decreases in the proportion of married women aged 25–39 years and men aged 30–39 years, while those in a relationship had increased only slightly for women and remained stable for men. By 2015, the proportion of single women was 30.2% in those aged 30–34 years and 24.4% in those aged 35–39 years. The corresponding numbers for men were 39.3% and 32.4%. Around half of the singles (21.4% of all women and 25.1% of all men aged 18–39 years) reported that they had no interest in heterosexual romantic relationships. Single women and men who reported no interest in romantic relationships had lower income and educational levels and were less likely to have regular employment compared to those who reported such an interest. Conclusions In this analysis of heterosexual relationships in nationally representative data from Japan, singlehood among young adults had steadily increased over the last three decades. In 2015 around one in four women and one in three men in their thirties were unmarried and not in a heterosexual relationship. Half of the singles reported no interest in romantic relationships and these women and men had lower income and educational levels and were less likely to have regular employment.
... For instance, individuals in committed relationships are less likely to experience mental health problems and to be overweight in comparison with single individuals [1]. It is also well established that marriage promotes longevity of life [4]. Yet, research indicates that simply being in a committed relationship does not necessarily have bene cial effects in and of itself. ...
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Background It is imperative for health care professionals to have access to valid and reliable tools to evaluate the quality of romantic relationships, as it has been repeatedly shown to be related to psychological and physical health outcomes. The Couples Satisfaction Index (CSI) was developed to address the shortcomings of the most widely cited measures of satisfaction by increasing precision and power of measurement. However, the use of this questionnaire is limited due to a lack of translated versions. The purpose of the current study was therefore to translate the CSI to Canadian French (CanFrench-CSI) and to evaluate its reliability in a sample of male Canadians. Methods The CSI questionnaire was adapted and translated into Canadian French using a forward-backward approach. Its reliability was then evaluated by means of Cronbach’s alpha internal consistency coefficients, corrected item-total correlation coefficients, and a test-retest intraclass correlation coefficient at a two-week interval. Results Data from 53 men in committed relationships were analyzed. The French adaptation of the CSI demonstrated satisfactory internal consistency and test-retest reliability. Conclusions Overall, the results provided evidence supporting the translation consistency and reliability of the CanFrench-CSI, and thus, paved the way for further research on romantic relationships and health outcomes among French-speaking individuals.
... Gratitude shared either from one person to another or mutually between persons helps form relationships between them, strengthens their social bonds, and promotes feelings of being socially integrated (Algoe, Fredrickson, & Gable, 2013;Algoe, Haidt, & Gable, 2008). It is also related to social support, a strong predictor of better health (August, Kelly, & Markey, 2016;Sun et al. 2014;). When one has received something positive from another person, they may feel grateful for the benefits. ...
This dissertation examines how the relationship between eudaimonic well-being and health is contingent upon socio-cultural and personal factors. Although eudaimonic well-being has been thought to have salubrious health effects, this dissertation provides evidence in three separate papers that there may be conditions under which additional factors are necessary for eudaimonic well-being to be beneficial, as well as conditions under which it may backfire. Chapter 1 provides an introduction to eudaimonic well-being, a brief overview of the literature on cultural influences on psychological processes and their relation to health, and a brief explanation of how adverse life experiences negatively affect the nervous system and health. Chapter 2 assesses the association between purpose in life and health across cultures, addressing the possibility that a sense of purpose in life may not necessarily directly be beneficial for health in a collectivist culture. It finds that, among Americans, purpose in life consistently predicted better biological health. However, purpose only predicted better health among Japanese who are sufficiently high in gratitude. This is perhaps due to how some purposes may be perceived in collectivist culture, requiring a social virtue such as gratitude to mitigate any potential costs. The third chapter compares victims of sexual assault with their peers who have never experienced an assault with respect to well-being and health. It finds that the victims of sexual assault are lower in eudaimonic well-being than their peers and rate themselves as having having poorer health, although their biological health does not differ. Additionally, it finds that the relationship between assault history and self-rated health is mediated by eudaimonic well-being, as well as neuroticism. Chapter 4 focuses on victims of childhood sexual abuse, assessing the relationship between the severity of their abuse and their health, and whether this relationship is moderated by their eudaimonic well-being. It finds that, among those who experienced the most severe abuse, a high sense of well-being is associated with poorer health outcomes, perhaps due to a conflict between current beliefs and past experience. While eudaimonic well-being is generally thought to be beneficial for health, this effect is present only when one’s well-being is congruent with one’s culture and prior personal experiences. In the final chapter, I review the present findings and suggest the need for further research both on other conditions under which eudaimonic well-being is not directly linked with better health, as well as further investigation into why well-being appears to backfire under certain conditions.
... En este estudio, la salud es entendida como el funcionamiento adecuado a nivel físico, psicosocial y emocional (Sánchez Aragón, García Meraz y Martínez Trujillo, 2017), es decir, abarca tanto la esfera fisiológica como la afectiva y aquellas e-ISSN 2382-3984 / Vol. 15, n°. 26 / julio-diciembre 2019 / Bogotá D.C., Colombia Universidad Cooperativa de Colombia condiciones que provienen del ambiente social que rodea a la persona (Alcántara, 2008), incluyendo sus relaciones de pareja, las cuales, dependiendo de su calidad, impactarán en su salud física y mental (August, Kelly & Markey, 2016). En este sentido, se argumenta que la convivencia en pareja se asocia a un mejor perfil de salud con respecto a la población que no la tiene (Gumà, Arpino y Solé-Auró, 2018). ...
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Introducción: Las relaciones de pareja llegan a convertirse en el vínculo más importante para el ser humano ya que en ellas se fomentan y enriquecen ciertos atributos individuales que se evidencian en la interacción romántica. Ejemplo de ello son los constructos de: optimismo, resiliencia y humor positivo -entre otras- que traen consigo contribuciones en el ánimo, la satisfacción con la vida, el bienestar y la salud de las personas. Objetivo: (1) Identificar el nivel de magnitud en optimismo, resiliencia, sentido del humor y salud, (2) examinar las posibles diferencias según el sexo en dichas variables y (3) conocer el grado de asociación entre el optimismo, la resiliencia y el sentido del humor con la salud de hombres y mujeres con pareja. Metodología: se realizó un estudio correlacional y comparativo con una muestra no probabilística por conveniencia de 240 personas (50% mujeres y 50% hombres) adultos, con edades comprendidas entre los 18 y 75 años, cuya escolaridad mínima fue de preparatoria y tiempo mínimo de relación de seis meses. Resultados: se destacan la relación positiva que existe entre el optimismo, la resiliencia y el sentido del humor con la salud, especialmente con el factor de vitalidad; y relación negativa con algunos factores que indican problemas con la salud. En cuanto a las diferencias por sexo, se encontró que los hombres presentan mayor confianza en sí mismos, fortaleza, apoyo social, creatividad/ingenio, orientación humorística hacia lo social, prudencia, humor negro y vitalidad en comparación con las mujeres que solamente puntuaron alto en esperanza y pasividad humorística.
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Introduction: Marriage, divorce and fertility are declining in Japan. There is concern that the COVID-19 pandemic may have accelerated the decrease in marriages and births while increasing the number of divorces. Changes in partnership behaviours and fertility have significant implications for mental health, well-being and population demographics. Methods: Japanese vital statistical data were collected for December 2011-May 2021. We used the Farrington algorithm on the daily numbers of marriages, divorces and births (per month) in order to determine whether any given month between January 2017 and May 2021 had a significant excess or deficit. Analyses were conducted at the national and regional levels. Results: During the pandemic, significant deficits in the national number of marriages were noted in January 2020, April 2020, May 2020, July 2020, September 2020 and April 2021. Regional marriage patterns reflected national trends. Divorces were noted to be in deficit during April 2020, May 2020 and May 2021 at the country level. Regional analyses mirrored national divorce trends with the exception of Shikoku, which showed no deficits during the pandemic. Significant deficits in the number of total births were noted in December 2020, January 2021 and February 2021. Regionally, birth deficits were concentrated in Chubu, Kansai and Kanto. After the start of the pandemic, no significant excesses in marriages, divorces or births were noted at the national or regional level. Conclusions: Marriages and divorces declined during the pandemic in Japan, especially during state of emergency declarations. There were decreased births between December 2020 and February 2021, approximately 8-10 months after the first state of emergency, suggesting that couples altered their pregnancy intention in response to the pandemic. Metropolitan regions were more affected by the pandemic than their less metropolitan counterparts.
Objectives This study aimed to identify clusters of participants with Type 2 diabetes mellitus (T2DM) at risk for developing psychological and somatic distress symptoms. Moreover, we investigated whether the different clusters were associated with glycemic control, sleep, and physical activity levels. Design and main outcome measures. In a cross-sectional design, participants with T2DM (n = 269) completed questionnaires on psychological and somatic distress, sleep disorders and physical activity. Results Cluster analyses yielded three groups: a) "high self-confident and low demoralised"; b) "low support and low involvement"; c) "high consequences, high demoralisation and nagging". The groups were distinguished by the social, cognitive, and vital exhaustion variables and significant differences in diabetes-related psychological distress and physical activity. The measure of glycemic control did not differ between clusters. The "high self-confident and low demoralised" group displayed the lowest scores on psychological distress compared to the other clusters. Conclusions Results suggest that social cognitive dimensions and affective states play a key role in defining clusters in participants with T2DM. Thus, we need to consider the psychological profiles of participants with T2DM when designing interventions to improve self-management strategies.
In this chapter, diabetes will be understood as a complex and common disease in Mexico, which greatly affects the person and those around him, especially the couple. Likewise, the importance of the couple is evident, since it contributes to offset the negative effects of the disease, through the social support it provides, increasing self-care, adaptation to changes, effective coping, motivation to commit to adaptive behaviors, and as long-term consequences, an improvement in the health and well-being of the patient. Therefore, in this research, 248 people with diabetes who were in a romantic relationship were studied, in order to explore how satisfaction with social support and the ability to receive it affects their health and subjective well-being.
As a concept, romantic intimacy may be examined through Schaefer and Olson's (1981) measure, the Personal Assessment of Intimacy in Relationships (PAIR), which identified five dimensions of intimacy: emotional, intellectual, recreational, sexual, and social intimacy. Moore, McCabe, and Stockdale's (1998) attempt to replicate this five-factor model was not successful, and they instead proposed a three-factor model of intimacy: engagement, communication, and shared friendships. The objective of the present study was to examine the psychometric properties of the PAIR with individuals involved in same-sex couple relationships using these two models. Three hundred fifty participants completed the PAIR, the Experiences in Close Relationships, and the brief 4-item version of the Dyadic Adjustment Scale. Confirmatory factor analyses were not able to replicate both the original five-factor structure and the proposed three-factor structure of the PAIR. Rather, results supported the factor structure, reliability, and concurrent validity of our revised version of Moore et al.'s (1998) three-factor model of intimacy, which retained the three dimensions after various modifications (i.e., addition of covariance terms, deletion of an item, and transference of items) were made. Links were found between these three dimensions of intimacy and insecure romantic attachment, as well as relationship happiness.
Members of 63 lesbian and 72 gay couples reported how frequently their partners engaged in diet-related social support and control (persuasion and pressure) and how they responded behaviorally and emotionally to such attempts. Although lesbian women received more frequent diet-related social support than gay men, there were no gender differences in the receipt of diet-related social control. Results of multilevel models that controlled for body mass index revealed that all participants responded to all types of involvement with guilt and to support and persuasion with appreciation. Responses to pressure differed for lesbian women and gay men and acted as a function of relationship quality. Findings from this study may increase awareness of the importance of same-sex partners' involvement in eating behaviors.
The relationship between social and community ties and mortality was assessed using the 1965 Human Population Laboratory survey of a random sample of 6928 adults in Alameda County, California and a subsequent nine-year mortaNty follow-up. The findings show that people who lacked social and community ties were more likely to die in the follow-up period than those with more extensive contacts. The age-Adjusted relative risks for those most isoiated when compared to those with the most social contacts were 2.3 for men and 2.8 for women. The association between social ties and mortality was found to be independent of self-reported physical health status at the time of the 1965 survey, year of death, socioeconomic status, and health practices such as smoking, alcoholic beverage consumption, obesity, physical actIvity, and utilization of preventive health services as well as a cumulative Index of health practices.
Objective. The effects of interpersonal stress on disease activity were examined for married women with rheumatoid arthritis (RA) who differ in the quality of their relationships with their spouses. Methods. Measures of interpersonal events were collected weekly for 12 weeks and related to disease activity through a comparison of clinician ratings and immune markers taken at baseline and during a highly stressful week for 20 RA patients. Individual differences in marital relationship variables and illness characteristics were used to predict group differences in how stress affected disease activity. Results. Significant elevations in total T cell activation (DR + CD3 cells), soluble interleukin-2 receptor (sIL-2R), and clinician's global ratings of disease activity were found during a week of significant interpersonal stress. However, women with better spousal relationships did not show increases in disease activity following an episode of interpersonal stress. In addition, patients taking low-dose prednisone showed greater reactivity to stress than patients not currently using glucocorticoid treatment. Conclusion. The results are consistent with the hypothesis that disease activity in RA increases following increases in interpersonal stress and that women with stronger marital relationships were less vulnerable to those stressors.
This study investigated the association between health and the quality of personal relationships in a sample of 308 staff and students at a university. Individuals in relationships were generally in better health than those who were single and relationship quality was inversely related to health problems. However, these findings only applied to relationships of at least medium quality. Single people had somewhat better health outcomes than those in low quality relationships. These findings were strongest for mental health, with there being little association between physical health and quality of relationships. The results are consistent with relationship quality being a critical factor mediating personal wellbeing.
Despite the growing importance of and interest in cohabitation as a living arrangement, little is known about the relationship between cohabitation and mental health. This research tests how the mental health of cohabitors compares with that of unmarried and of married persons. It uses a cohort of unmarried young adults who were sampled when they were 18, 21, or 24 years old and resampled 7 years later when they were 25, 28, or 31 years old. We compare the mental health of cohabitors with the unmarried and married after controlling for premarital levels of mental health and conventionality. The results of multivariate analyses indicate no differences between cohabitors and others in levels of depression. Cohabiting men, however, report significantly more alcohol problems than both married and single men, and cohabiting women report more alcohol problems than married women. In general, the results indicate that cohabitation is unrelated to depression but is associated with alcohol problems for men.
Data from partners of 236 married, 66 gay cohabiting, and 51 lesbian cohabiting couples were used to assess if members of married couples differed from those of either gay couples or lesbian couples on five dimensions of relationship quality (intimacy, autonomy, equality, constructive problem solving, and barriers to leaving), two relationship outcomes (the trajectory of change in relationship satisfaction and relationship dissolution over 5 years), and the link between each dimension of relationship quality and each relationship outcome. Relative to married partners, gay partners reported more autonomy, fewer barriers to leaving, and more frequent relationship dissolution. Relative to married partners, lesbian partners reported more intimacy, more autonomy, more equality, fewer barriers to leaving, and more frequent relationship dissolution. Overall, the strength with which the dimensions of relationship quality were linked to each relationship outcome for married partners was equivalent to that for both gay and lesbian partners.
Data from six U.S. national surveys are used to compare the estimated contributions to global happiness of marital happiness and satisfaction with each of seven aspects of life, ranging from work to friendships. Separate estimates are provided for white men, white women, black men, and black women. Except for black men, the estimated contribution of marital happiness is far greater than the estimated contribution of any of the kinds of satisfaction, including satisfaction with work. These findings, considered in conjunction with other evidence, indicate that Americans depend very heavily on their marriages for their psychological well-being. Some implications of the findings are discussed.