ArticleLiterature Review

Health concordance within couples: A systematic review

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Abstract

Research has consistently linked marriage and positive health outcomes. In addition, many researchers have found that couples often have similar or concordant health statuses. However, concordance research has been conducted in many fields for decades without a concise review of the literature, nor has one theory of health concordance been established. A systematic review was performed implementing rigorous identification strategies, and 103 health concordance research articles were identified and reviewed to understand what research has been conducted in mental health, physical health, and health behavior concordance among couples. The research overwhelmingly suggests evidence for concordant mental and physical health, as well as health behaviors among couples. Each area of health concordance research offers room for greater research and deeper understanding for the causes of health concordance.

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... Many studies attribute these factors to individual factors such as medical history, health habits, employment status, neighborhood environments (Liu et al., 2018), and social contacts (Kang et al., 2019;Pinillos-Franco & García-Prieto, 2017). However, some studies have broadened the focus from the individual to analyze the effects of participation in social communities, communication in families (Kang et al., 2019), marital status (Liu & Umberson, 2008), and the effect of serious spousal health events or death (Hagedoorn et al., 2001;Meyler et al., 2007;Valle et al., 2013). One systematic review of 103 articles found a strong association between marriage and health status; it showed that couples often have similar or concordant health statuses and health behaviors (Meyler et al., 2007). ...
... However, some studies have broadened the focus from the individual to analyze the effects of participation in social communities, communication in families (Kang et al., 2019), marital status (Liu & Umberson, 2008), and the effect of serious spousal health events or death (Hagedoorn et al., 2001;Meyler et al., 2007;Valle et al., 2013). One systematic review of 103 articles found a strong association between marriage and health status; it showed that couples often have similar or concordant health statuses and health behaviors (Meyler et al., 2007). Many other studies have shown that when one spouse becomes seriously ill, the psychological or physical health of the other spouse is often affected (Hagedoorn et al., 2001;Valle et al., 2013). ...
... Second, couples monitor each other and try to keep each other healthy. Third, mental health concordance has been reported in families and couples (Meyler et al., 2007). Several studies have shown that health concordance increases with time spent together (Meyler et al., 2007;Ross et al., 1990). ...
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Background We aimed to determine whether poor spousal health affected respondents’ own self-rated health after 1 year among older retired Japanese couples. Methods Data were extracted from the nationwide, population-based survey the “Longitudinal Survey of Middle-aged and Elderly Persons”, which has been conducted annually since 2005 by the Japanese Ministry of Health, Labour and Welfare. We used 2016 survey data as a baseline and 2017 data for 1-year follow-up. Baseline respondents comprised 21,916 individuals; of these, we focused on 4397 respondents who were retired, married, aged 65–70 years, and had good self-rated health. The survey included questions about respondents' own health and lifestyle and their spouses' health status. Multivariate logistic regression analysis was used to explore the association between spousal health at baseline and respondents’ own self-rated health after 1 year. Results We found that poor spousal health is associated with respondents' own self-rated poor health after 1 year. The odds ratio (OR) for worsening health was 1.67 (95% confidence interval (CI): 1.11–2.52) for men and 1.72 (95% CI: 1.25–2.37) for women when their spouse's health was “somewhat bad”. The OR was 2.25 (95% CI: 1.40–3.62) for women when spousal health was “bad/very bad”, compared with “somewhat good”. Conversely, good spousal health was associated with a low risk of declining health for respondents after 1 year. The association for men was apparent when their spouse's health was “good” [OR: 0.69; 95% CI: 0.49–0.98], and the association for women was apparent when their spouse's health was “very good” [OR: 0.46; 95% CI: 0.24–0.90]. Conclusions Poor spousal health is an independent factor that negatively affects own self-rated health after 1 year among retired couples in Japan aged 65–70 years.
... Mutual associations of this kind may be both health bene cial and detrimental. Partners can in uence the take-up of health-related bene ts and improve quality of life, but also affect health behaviors in terms of smoking, drinking, diet, and exercise [12][13][14][15]. Among the elderly, hospitalization or death have been found to increase the mortality and morbidity risks of the spouse [16][17]. ...
... According to marital resource theory, inter-spousal correlation in health may be a function of shared life events and resources, for good or bad. Thus, the presence of a partner is not necessarily protective, and partners may in uence each other negatively in terms of health behavior and health [12] and thus contribute to mutual health bene t receipt. ...
... Inter-spousal correlation in health status follows on assortative mating, common health behaviors, shared environmental risk factors, and direct effects of the health of one spouse on the health of the other. Thus, the presence of a partner is not necessarily protective, and partners may in uence each other negatively [12], which in turn may contribute to mutual health bene t receipt as found here. Our ndings may also be interpreted using economic theories, suggesting that partners' mutual bene t receipt is explained by the fact that individuals strike an optimal balance between the cost of foregone leisure and the bene ts of increased income through paid employment. ...
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Background: The literature on health dependencies among partners typically ignores diversity when it comes to partnership characteristics, which have consequences on many facets of life and may be important for the health of both parties. One salient example is the ethnic or racial composition of the couple. We extend prior work on partnerships and health by investigating how married and cohabiting partners mutually influence each other’s receipt of health-related benefits, and focus on how any such correlations vary by the couple’s ethnic composition. Methods: We study partners’ mutual receipt of sickness allowance and disability pension in ethnically endogamous and exogamous couples in Finland. The population consists of native individuals in similar socioeconomic positions but belonging to two different ethnic groups, Finnish and Swedish speakers, which differ regarding health and cultural practices related to family life. Using data from population registers (36,034 couples in 1987-2011), we estimate discrete-time hazard models for first-time benefit receipt related to partner’s benefit receipt among midlife couples. Results: We find evidence of mutual receipt of health benefits in both endogamous and exogamous couples, the correlation being strongest for disability pension. Partner correlation in disability pension receipt is slightly stronger in endogamous Swedish than in endogamous Finnish couples, while women in exogamous couples are slightly less sensitive to men’s receipt than vice versa. These findings show that the ethnic composition of couples is important for mutual health benefit receipt. Conclusions: Our findings could be explained both by collateral health effects and by rational decisions concerning mutual leisure time, income loss, and informal health care needs. The results clearly cast light on the important issue of mutual health in couples, and that associations of this kind may be heterogeneous across couples that differ in ethnic composition.
... Gendered variations in well-being across partner care arrangements potentially reflect concordance in emotional well-being within couples. Empirical research on mental health concordance overwhelmingly suggests strong within-couple correlations of depressive symptoms and well-being (Meyler et al., 2007). Shared as well as formal care arrangements may reflect worse health and higher care needs of the care-receiving partner than solo-, outsourced, or informal care (Andersen & Newman, 2005). ...
... A study on Mexican American married couples suggests that women are more vulnerable than men to negative emotional reactions to a partner's poor well-being (Peek et al., 2006). Across contexts, however, there is clear evidence of mutual well-being influences for partners of both genders (Meyler et al., 2007). ...
... We then add I's, P's, and couple characteristics as covariates. The nature of our sample (with each observation containing information about both the individual and their partner) allows us to control extensively for the P's health, which partly accounts for well-being concordance within couples (Meyler et al., 2007). For each outcome, we compare results from the unadjusted and fully adjusted models. ...
Article
Objectives: We assess gender moderation in the association between partner care arrangements and individuals' well-being, and the extent to which gender differences vary across European care contexts. Methods: We use 2015 data from the Survey of Health, Ageing and Retirement in Europe for 3,465 couples aged 50+, where at least one partner receives care. We assess gender differences in individuals' life satisfaction and depressive symptoms across five partner care arrangements: solo-; shared formal; shared informal; outsourced formal; and outsourced informal care. We explore heterogeneity in the gendered associations across four care contexts: Northern, Western, Southern and Eastern Europe. Results: Sharing care with formal providers is associated with lower well-being among women than men, with a significant well-being "penalty" among Southern European women with partners in shared formal care. Outsourcing partner care to informal providers is associated with higher well-being than other care arrangements for men across care contexts, but with lower well-being for women in Southern Europe. Discussion: Policies to support caregivers' well-being need to be sensitive to the coordination of formal and informal caregiving support for men and women in their respective care contexts.
... Health behaviors such as physical activity [1], smoking [2], and alcohol use [3] tend to be concordant in romantic couples [4] and there is some evidence that health behavior change is similarly concordant in couples (Jackson et al. [5]; but see Brazeau and Lewis [6]). As a result, interventions have turned to romantic relationships as a context for fostering behavior change [7][8][9]. ...
... med. (2022) XX: [1][2][3][4][5][6][7][8][9][10][11][12][13][14] to select all that were generally true of their eating that day (adapted from [28]). Examples include: "I ate a variety of foods," "I ate foods high in sugar," and "I went long periods without eating during the day." ...
... med. (2022) XX: [1][2][3][4][5][6][7][8][9][10][11][12][13][14] autonomy-limiting social control on 6% of the diary days, only autonomy-supportive social control on 11% of the days, only neutral social control on 13% of the days, both autonomy-supportive social control and autonomy-limiting social control on <1% of the days, both autonomy-supportive social control and neutral social control on 7% of the days, both autonomylimiting and neutral social control on 6% of the days, all strategy types on 3% of days, and no strategy types on 54% of days. ...
Article
Background Prior research has shown that social control strategies can have either positive or negative effects on individuals’ health behaviors. However, no research has examined the degree to which social control attempts enacted by romantic partners are associated with individuals’ relational behaviors or whether perceptions of a partner’s motivation to engage in social control moderate links between the use of social control and either health or relational behaviors. Purpose This study investigated (a) the degree to which two classes of social control strategies that romantic partners can use to improve their partners’ eating behavior (autonomy-supportive and autonomy-limiting strategies) are associated with eating and relational behaviors, and (b) whether perceptions of the partner’s motivation for using social control moderate associations between its use and an individual’s eating and relational behavior. Methods This study had a daily diary design. One hundred and forty-seven individuals in romantic relationships completed surveys for 14 consecutive days. Results On days when individuals reported that their partner used autonomy-supportive social control strategies, individuals reported healthier eating and more constructive relational behaviors. There were no effects of autonomy-limiting strategies on eating or relational behavior. Perceptions of a partner’s motives did not moderate associations between reported social control and any behavioral outcomes. Moreover, there were no effects of either reported social control strategies or partner motive perceptions across time. Conclusion Romantic partners’ perceived use of autonomy-supportive—but not autonomy-limiting—social control has benefits for individuals’ health behaviors without incurring notable costs to their romantic relationship.
... Health benefits may accumulate due to protective effects that enable income pooling and increase economic resources [9], which in turn provide emotional support, social networks, and social control [10,11]. Likewise, while partners may influence the uptake of health-related benefits and improve quality of life, they may also affect health behaviors negatively, in terms of smoking, heavy drinking, poor diet, and inadequate exercise [12][13][14][15]. Among the elderly, hospitalization or death have been found to increase the mortality and morbidity risks of the spouse [16,17]. ...
... In accordance, marital resource theory argues that inter-spousal correlation in health is a function of shared life events and resources, for both good and bad. Thus, the presence of a partner is not necessarily protective, and partners may influence each other negatively in terms of health behavior, and thus contribute to mutual health benefit receipt [12]. ...
... These findings could be explained by mutual health influence between partners, as the state of health for each was often similar and tended to converge over time [33]. Such inter-spousal correlation in health status may follow on assortative mating, common health behaviors, shared environmental risk factors, and direct effects of the health of one spouse on the health of the other [12]. Thus, the presence of a partner is not necessarily protective, and partners may influence each other negatively, which in turn may contribute to mutual health benefit receipt, as found here. ...
Article
Full-text available
The literature on health dependencies among partners typically ignores diversity of partnership characteristics. One salient example is the ethnic composition. We extend prior work on partnerships and health by investigating how married and cohabiting partners mutually influence each other’s receipt of health-related benefits, focusing on how such correlations vary with the couple’s ethnic composition. We study partners’ mutual receipt of sickness allowance and disability pension in ethnically endogamous and exogamous couples in Finland. The population consists of native individuals in similar socioeconomic positions but belonging to two different ethnic groups—Finnish and Swedish speakers—who differ in health and family life. Using data from population registers, we estimate discrete-time hazard models for first-time benefit receipt, as related to partner’s benefit receipt, among midlife couples. We found evidence of mutual receipt of health benefits in both endogamous and exogamous couples, the correlation being strongest for disability pension. Partner correlation in disability pension receipt is slightly stronger in endogamous Swedish than in endogamous Finnish couples, while women in exogamous couples are slightly less sensitive to men’s receipt than vice versa. The results show that mutual health may be heterogeneous across couples that differ in ethnic composition.
... Indeed, with respect to lifestyle, there is intracouple concordance of behavioral factors such as diet, physical activity, and smoking. [1][2][3] As such, it may not be surprising that many studies have shown that older married couples share a propensity for accruing the same cardiovascular risk factors such as hypertension and dyslipidemia. [1][2][3][4][5][6][7] A meta-analysis of such studies revealed that the spouse of a patient with hypertension has 41% higher odds of also having hypertension, as compared with the partner of an unaffected individual. ...
... [1][2][3] As such, it may not be surprising that many studies have shown that older married couples share a propensity for accruing the same cardiovascular risk factors such as hypertension and dyslipidemia. [1][2][3][4][5][6][7] A meta-analysis of such studies revealed that the spouse of a patient with hypertension has 41% higher odds of also having hypertension, as compared with the partner of an unaffected individual. 7 Moreover, given spousal concordance of vascular risk factors, marital partners share similar projected 10-year cardiovascular risk estimates, wherein approximately two-thirds of the vascular risk of an individual can be explained by the projected risk of their partner. ...
... Two main hypotheses for explaining the spousal concordance of cardiovascular risk factors are that the observed associations may reflect (1) the impact of the shared home environment and lifestyle or (2) the tendency to choose a partner with a similar perspective on lifestyle choices and behaviors (assortative mating). 1 However, previous studies have found that it is difficult to determine the relative contributions of these 2 factors. 1 In this context, we hypothesized that an approach to addressing this question would be to evaluate the spousal concordance of cardiovascular risk factors in young, newly married couples, in whom the potential effect of the shared home environment is likely yet to emerge. ...
Article
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Importance Several studies have shown that older married couples share a propensity for accruing the same cardiovascular risk factors such as hypertension and dyslipidemia. However, it remains unclear if these spousal associations reflect their shared home environment and lifestyle or the tendency to choose a partner with a similar perspective on lifestyle choices and behaviors (assortative mating). Evaluating these associations in young, newly married couples may help to differentiate between these 2 possibilities. Objective To evaluate the spousal concordance of cardiovascular risk factors in young, newly married couples. Design, Setting, and Participants This prospective cohort study recruited 831 couples around the time of marriage registration in Liuyang, China, from February 1, 2009, to November 4, 2015. Statistical analysis was performed from April to May 2021. Main Outcomes and Measures Spousal concordance of cardiovascular risk factors. Both partners underwent systematic assessment of cardiovascular risk factors, including evaluation of anthropometrics, blood pressure, and fasting lipids. Results Among the 831 participating couples, mean (SD) age was 24 (3) years in the women and 26 (4) years in the men. There were significant correlations between spouses in systolic blood pressure (r = 0.43; P < .001), diastolic blood pressure (r = 0.36; P < .001), total cholesterol (r = 0.13; P < .001), low-density lipoprotein cholesterol (r = 0.11; P = .003), high-density lipoprotein (HDL) cholesterol (r = 0.22, P < .001), and triglycerides (r = 0.13; P = .001). After adjustment for covariates (age, household income, education level, smoking, and either body mass index or waist circumference), significant correlations persisted between spouses in their systolic blood pressure (r = 0.42; P < .001), diastolic blood pressure (r = 0.34; P < .001), HDL cholesterol (r = 0.17; P < .001), and triglycerides (r = 0.10; P = .04). Conclusions and Relevance This cohort study found spousal concordance of cardiovascular risk factors among young newly married couples. Assortative mating based on these concordant risk factors at the time of marriage may partially explain the shared vascular risk profile of older marital partners and raises the possibility of couple-based care.
... The association of one's own characteristics with functional health is increasingly apparent; however, inadequate data are available on the impact from spouses. Previous literature 18,19 has suggested that the social context in which the individuals live, including especially their spouses, has the potential to shape a person's well-being. Spouses are in an intimate relationship and are often the primary caregiver for each other. ...
... 20 They live in a shared environment, gain almost equal access to resources, have similar health behaviors, demonstrate convergent mood, and are exposed to common stressors. 19,[21][22][23] Therefore, spousal health is not supposed to develop in isolation: characteristics of one are likely to influence the other, and spouses form a reasonable and important dyad for evaluating interdependency. ...
... An increasing body of studies have explored the spousal dynamics and reciprocal associations in health or health behaviors among couples, and in general, these studies point to spousal concordance or similarities across a variety of health-related measures, primarily including blood pressure and other biomarkers, 19,[24][25][26] health behaviors, 27,28 depression and cognitive function, 21,29,30 chronic illnesses, [31][32][33][34][35][36][37] and subjective well-being. 38,39 However, the range of investigated health conditions is still narrow, and relatively little is known about functional limitation. ...
Article
Full-text available
Importance Functional limitation is increasingly common as people age and is often associated with negative consequences. Evidence of the dynamics of functional limitation within couples in China is still inadequate. Objectives To examine whether functional limitation was associated within middle-aged and older couples and to explore sex differences in spousal associations. Design, Setting, and Participants In this nationwide, population-based cohort study performed from January 1, 2011, to December 31, 2018, participants were selected using multistage probability sampling, and 5207 community-dwelling couples (10 414 individuals) 45 years or older were included in the nationally representative China Health and Retirement Longitudinal Study. Data analysis was performed from January 1 to February 28, 2021. Exposures The exposure variable was the presence of functional limitation in spouses. Functional limitation was measured by the activities of daily living (ADLs) and instrumental activities‎ of daily ‎living (IADLs) scales and was defined as having difficulty in independently performing at least 1 ADL or IADL item. Main Outcomes and Measures The main outcome was functional limitation in index participants. Multivariable logistic regression with generalized estimating equations was used to estimate the reciprocal association of functional limitation within couples over time. Results A total of 5207 married, different-sex couples (mean [SD] age, 59.1 [8.8] years for husbands and 57.0 [8.2] years for wives) were included in the study. For husbands, the number (percentage) of participants classified with baseline functional limitation was 1140 (21.9%), the number (percentage) with ADL limitation was 684 (13.1%), and the number (percentage) with IADL limitation was 834 (16.0%). For wives, the number (percentage) of participants classified with baseline functional limitation was 1502 (28.8%), the number (percentage) with ADL limitation was 887 (17.0%), and the number (percentage) with IADL limitation was 1183 (22.7%). Longitudinal results demonstrated an association in spouses developing functional limitation (adjusted odds ratio [OR], 2.55; 95% CI, 2.41-2.69; P < .001), ADL limitation (adjusted OR, 2.26; 95% CI, 2.11-2.41; P < .001), and IADL limitation (adjusted OR, 2.58; 95% CI, 2.43-2.73; P < .001). Subgroup analyses by sex revealed similar patterns of spousal health concordance in terms of all studied outcomes, indicating no sex specificity. Conclusions and Relevance This population-based cohort study suggests that among Chinese middle-aged and older couples there is significant concordance in the development of functional limitation. This study of spousal functional ability from a dyadic perspective may help in the understanding of health risks within a wider familial context and offers novel insights for prioritizing policy focus from individual centered to couple based.
... Concordance among members of couples has been reported in the literature for cognitive functioning (Dufouil, Alpérovitch, & Group, 2000), social engagement (Hoppmann, Gerstorf, & Luszcz, 2008), and mental and physical health outcomes (Kiecolt-Glaser & Wilson, 2017;Meyler, Stimpson, & Peek, 2007;Strawbridge, Wallhagen, & Shema, 2007;Townsend, Miller, & Guo, 2001). However, the interdependence within couples may be asymmetric and may vary by health outcomes. ...
... Finally, a study of older couples in the United States reported that husbands whose wives had dementia were eleven times more likely to also develop dementia, whereas wives had a four times greater risk for dementia if the husband also had dementia (Norton et al., 2010). The ability to predict health outcomes within the couple is due in part to the shared environment and similar risk factors (Meyler et al., 2007). ...
Article
Objectives Increased social engagement in older adults has been linked to positive cognitive outcomes; however, it is unclear if the social engagement of husbands and wives influences their own cognition as well as each other’s cognition. Moreover, it is unknown if any such patterns persist in different country contexts. Methods Data from the 2001 Mexican Health and Aging Study (MHAS) and the 2000 Health and Retirement Study (HRS) were combined, and comparable samples of married couples without cognitive impairment at baseline were drawn. Follow-up cognition data was obtained from the 2012 MHAS and the 2012 HRS. Structural equation models (SEM) were used to test the actor–partner interdependence model with moderating effect of country on the association of social engagement with cognition. Results Significant actor effects were observed for wives in both countries. Actor effects for husbands were observed in the United States only. In Mexico, a significant partner effect was observed where wives’ social engagement benefited their own cognition as well as their husbands’, but not vice versa. Partner effects were not observed in the United States. No moderation effects of country were observed. Discussion Our results suggest asymmetric patterns of actor–partner interdependence in Mexico, which may be reflective of the more traditional social role of women, and codependence within the couple. On the other hand, our results for the United States, where each spouse had significant actor effects but no partner effects, may suggest more independence within the couple.
... infectious disease or unpaid caregiving. These predictions have been found in reviews of empirical evidence (Meyler et al., 2007). For example, amongst studies not focused solely on retirees, Falba and Sindelar (2008) examined changes in smoking, drinking, exercising and other health care prevention amongst individuals and their partners. ...
... One possible influence not explored here or in other retirement and health behaviour concordance studies relates to relationship quality. According to spousal concordance theory (Meyler et al., 2007), one partner may adopt the role of lead decision-maker in choices relating to health behaviour, whilst the other may (or may not) follow. This has influenced the development of new health 10 It is possible that such a finding is partly driven by the fact that more than 65% of those with physical or heavy manual work prior to their retirement are men where the p value of the own retirement effect is smaller than 0.1. ...
Article
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Retirement from paid work is a major transitional point and can have large impacts on lifestyle choices and subsequent health. Using eight waves of data from the English Longitudinal Study of Ageing (ELSA), this paper assesses impacts of both own and partner’s retirement on health and health behaviour by examining heterogeneous effects. We focus on individuals who retired from paid work and estimate fixed effects regression using state pension age (SPA) as an instrumental variable. Our results suggest that whilst own retirement improves health outcomes and increases the probability of engaging in more physical activity, the retirement of a partner does not influence the health or health behaviour of the other partner. The results from sub-sample regressions focusing on differences by sex, education, wealth, and occupation are consistent with these main findings, and find no significant impacts of partner retirement on own health or health behaviour in these sub-groups. Our results for the full sample and the sub-groups are mostly robust to changes in sample restriction and model specification, with only a small number of changes in absolute coefficient size. The results may suggest a role for targeted interventions, particularly amongst those with fewer years of education, lower wealth and some occupational groups.
... www.nature.com/scientificreports/ spousal concordance, defined as consistency in health status between a husband and a wife, has been well known 22 . Several cross-sectional studies on spousal concordance have been conducted in chronic diseases, including hypertension 23,24 , cardiovascular diseases 25,26 , cancers, and type 2 diabetes 27 , which may be explained by the shared environment 22 . ...
... spousal concordance, defined as consistency in health status between a husband and a wife, has been well known 22 . Several cross-sectional studies on spousal concordance have been conducted in chronic diseases, including hypertension 23,24 , cardiovascular diseases 25,26 , cancers, and type 2 diabetes 27 , which may be explained by the shared environment 22 . In Iran, the spousal concordance for type 2 diabetes and hypertension has been previously shown in cross-sectional studies 28,29 . ...
Article
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Considering the dynamic nature of body mass index (BMI) and its importance in determining cardiovascular risks, this study aimed to investigate the life-course trajectory pattern of women’s BMI and its association with cardiovascular risk factors. A total of 1356 couples with 2976 children were recruited and followed up for an average period of 20 years. Latent growth curve modeling was applied to determine women's BMI trajectories; logistic regression was used to investigate the associations between trajectory patterns and cardiovascular risk factors, including hypertension (HTN), dyslipidemia, diabetes mellitus (DM), and obesity. Women were classified into three trajectories, including normal, stage 1 obesity, and stage 2 obesity. Compared to women’s in the normal trajectory group, those in obesity trajectories had higher odds ratios for HTN, DM, and dyslipidemia. Men with obese spouses showed a higher rate of HTN 1.54 (95% CI 1.05–2.25) and DM 1.55; (95% CI 1.00–2.44). The odds of men’s obesity were higher in obese spouses (OR 1.70; 95% CI 1.10–2.62). Offspring of stage 2 obese (OR 2.39; 95% CI 1.67–3.44) and stage 1 obese (OR 4.81; 95% CI 3.16–7.34) mothers were more likely to be obese. Our findings emphasized paying more attention to women with excessive weight to promote familial cardiovascular health in the communities.
... The impact of caregiving on physical health has been reported ambiguously in previous studies [16,17], but tends to be negative [17][18][19] due to three mechanisms. First, there are health spillovers within families and household members, i.e. the illness -such as care need -of one member induces health decreases of the others [20,21]. Second, transition into caregiving is accompanied by occupational, social, and organizational strains [22,23]. ...
... These do both evolve directly with transition into caregiving and have a long-term effect beyond the care period. Although the impact of direct and indirect health spillovers [20,21] could not be disentangled in this study, they might partly explain physical health disadvantages of caregivers. In addition, the occupational and social strains associated with incident caregiving [22,23] seem to play a central role, as these characteristics moderated the health-carerelationship. Socioeconomic, household, and individual characteristics partially mediated the effect caregiving has on physical health, whereas older ages, lower levels of education, low incomes and income decreases, unemployment and leaving full-time occupation -and thus particularly socioeconomic characteristics -were associated with physical health declines. ...
Article
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Background: The number of people in need of care in Germany has been rising since decades, which is related to an increasing need and relevance of informal caregiving. Likewise, the number of people with a migration background has been increasing. This study aims to analyse the impact of informal caregiving on physical health in comparative perspective for Ethnic German Immigrants (EGI) - the largest and oldest immigrant group in Germany - and non-migrant Germans (NMG). Methods: The sample was drawn from the years 2000-2018 of the German Socio-Economic Panel (n = 26,354). NMG (n = 24,634) and EGI (n = 1,720) were categorized into non-caregivers (n = 24,379) and caregivers (n = 1,975), where the latter were distinguished by 1) their caregiving status and history (current, former, and never caregiver) and 2) the number of years in the caregiver role. Generalized Estimating Equations were applied to examine main effects and the interaction effects of caregiving status and migration background for changes in physical health (n = 102,066 observations). Results: Adjusting for socioeconomic, household related, and individual characteristics, NMG and EGI had similar caregiving patterns and physical health. However, the interaction between migration background and caregiving revealed significantly higher declines in physical health for currently caregiving EGI. Sensitivity analyses indicated that particularly socioeconomic resources moderated this effect. Conclusions: Findings suggest that caregiving is associated with declines in physical health, particularly in the long term and for EGI. This implies that care-related disadvantages accumulate over time and that the association of caregiving, health and associated determinants are culturally diverse and shaped by migration background. Both the health disadvantages of caregivers and EGI might be mitigated by a positive social and socioeconomic setting, which highlights the relevance of supporting structures and benefits for these subgroups.
... In one example, communication and conflict resolution styles that were perceived as criticizing or demanding lessened a partner's perceived confidence and extent he or she could address HIV risk as a couple. Similar to findings presented by Hatcher and colleagues [41], communication appeared to have a positive effect on the uptake of HIV prevention behaviors, with positive communication being the pathway through which couples in the intervention felt confident in navigating HIV prevention strategies. Our APIM analyses further suggested that a couple's perceived confidence and communal coping ability was influenced by an individual's perceived sense of relationship quality (actor-driven). ...
... Further, the small sample size limited the number of relationship covariates, and impact of relationship duration was not assessed. Further study is required to understand underlying mechanisms within this population in order to better inform couple-based intervention development [41,52]. ...
Article
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Involving both partners of a couple in HIV prevention can improve maternal and child health outcomes in sub-Saharan Africa. Using data from 96 couples, we explored the actor and partner effects of perceived relationship dynamics on a couple’s confidence and ability to reduce HIV risk together. Perceived relationship quality altered perceived confidence and ability to reduce HIV threat. One’s own ability to confidently act together with their spouse appeared to be stronger for husbands than wives with respect to relationship commitment. A partner’s confidence to communicate with their spouse about HIV risk reduction appeared to be stronger from husbands to wives for relationship satisfaction and trust. Gender differences in perceived relationship quality and effects on communal coping may exist and requires further study for applicability in intervention development in this setting. Efficacious couple-oriented interventions for HIV prevention should incorporate evidence on how partners mutually influence each other’s health beliefs and behaviors.
... Caretaking was an emergent theme which influenced participants' diet, physical activity and stress across multiple significant places. While much is known about marriage and family relationships and their influence on health behaviors, less is known about caretaking relationships and their effect on CVD risk behaviors [47,48]. While caretaking was often described as a negative influence on CVD risk behaviors in our cohort of participants, caretaker contexts were also opportunities to disseminate the lessons learned from the lifestyle intervention. ...
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Background AA living in rural areas of the southeastern U.S. experience a disproportionate burden of cardiovascular disease (CVD) morbidity and mortality. Neighborhood environmental factors contribute to this disparity and may decrease the effectiveness of lifestyle interventions aimed at preventing CVD. Furthermore, the influence of neighborhood factors on AA CVD risk behaviors (i.e. physical activity) may be obscured by the use of researcher-defined neighborhoods and researcher-defined healthy and unhealthy places. The objective of this study was to elucidate the effects of neighborhood environments on AA CVD risk behaviors among AA adults who recently completed a lifestyle intervention. We specifically sought to identify AA adults’ self-perceived places of significance and their perceptions of how these places impact CVD risk behaviors including diet, physical activity and smoking. Methods We conducted semi-structured interviews with AA adults ( N = 26) living in two rural North Carolina counties (Edgecombe and Nash, North Carolina, USA). Participants were recruited from a community-based behavioral CVD risk reduction intervention. All had at least one risk factor for CVD. Participants identified significant places including where they spent the most time, meaningful places, and healthy and unhealthy places on local maps. Using these maps as a reference, participants described the impact of each location on their CVD risk behaviors. Data were transcribed verbatim and coded using NVivo 12. Results The average age of participants was 63 (SD = 10) and 92% were female. Places participants defined as meaningful and places where they spent the most time included churches and relatives’ homes. Healthy places included gyms and parks. Unhealthy places included fast food restaurants and relatives’ homes where unhealthy food was served. Place influenced CVD risk behaviors in multiple ways including through degree of perceived control over the environment, emotional attachment and loneliness, caretaking responsibilities, social pressures and social support. Conclusions As we seek to improve cardiovascular interventions for rural AA in the American South, it will be important to further assess the effect of significant places beyond place of residence. Strategies which leverage or modify behavioral influences within person-defined significant places may improve the reach and effectiveness of behavioral lifestyle interventions.
... X i is a vector of covariates that is supposed to be exogenous, including demographic and socioeconomic variables, and c j , h j and b j ðj ¼ 1, 2, 3Þ are coefficients or coefficient vectors to be estimated; e ji ðj ¼ 1, 2, 3Þ are the corresponding error terms. The error terms are likely to be correlated within the household in our sample because we have couples and spousal correlation in health status is common (Meyler et al., 2007). We use the seemingly unrelated regressions (SUR) method to estimate Equations (1) to (3). ...
Article
Depression comorbid with chronic diseases is common, especially among the older adults. We examine the health of the older adults in China and its relationship with depression, alone or as a comorbidity with chronic diseases. The sample we study includes 10,307 individuals aged 45 or above from the 2011 national wave of the China Health and Retirement Longitudinal Study (CHARLS). Using factor analysis, we obtain three factors out of eight health measurements that capture multiple dimensions of health of an older adult, with which we construct health scores and use as outcome variables. The three factors obtained from the factor analysis can, respectively, be interpreted as ‘physical health’, ‘subjective health’ and ‘cognitive health’. We then apply a system equations approach to compare the disease effects. We find different chronic conditions are significantly associated with ‘physical health’ and ‘subjective health’ but not with ‘cognitive health’. While the key chronic diseases have similar adverse effects on the first two health factors (except for the respiratory diseases), depression impairs subjective and physical health scores to a greater degree than do any chronic diseases. Comorbid depression is significantly associated with a reduction in the physical health score of the older adults, particularly for those with depression and cardiovascular diseases. In light of the increasing burden of chronic diseases and the underfunding-undertreatment situation of depression, health insurance coverage for depression should be improved to provide a more integrated mental health system.
... The notion that partners in close relationships dyadically affect each other's wellbeing is not new [1]. Supporting it, evidence converged to show that one's well-being is affected by not only their own personal characteristics, such as physical and mental health conditions, but also their spousal characteristics in close relationships [2][3][4]. ...
Article
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(1) Background. Extending previous work, the present study examined whether marital satisfaction would magnify the dyadic effect of disabilities on life satisfaction among older married couples. (2) Methods. With responses collected from 11,694 participants (5847 couples; Mage = 63.36 years, median: 62 years) in a large-scale survey study in China in 2015, the actor-partner interdependence model (APIM) analyses were conducted to examine how marital satisfaction moderated the actor and partner effects of disabilities on life satisfaction. In addition, mixed linear model analyses were conducted to examine the gender effect. (3) Results. The results showed that marital satisfaction magnified the negative association between disabilities and life satisfaction with different patterns for each gender. Specifically, husbands’ disabilities significantly negatively predicted their own levels of life satisfaction among those with higher marital satisfaction but not among those with lower marital satisfaction. In contrast, for wives, spousal disabilities significantly predicted lower levels of life satisfaction among those with higher marital satisfaction but not among those with lower marital satisfaction. (4) Conclusions. The evidence for the magnifying effect of marital satisfaction obtained in the present study implicates the importance of taking dyadic dynamics in close relationships into account in health care research.
... Close interpersonal relationships are complex, dynamic systems in which people are constantly engaged in a reciprocal exchange of biobehavioral cues that can influence each other on different levels of functioning, from the physiological and behavioral to the cognitive and emotional (Butler, 2011;Cox & Paley, 1997;Field, 2012;Fogel, 1993;Sbarra & Hazan, 2008). Research has repeatedly shown that partners in close relationships mutually influence or co-regulate each other directly and indirectly, consciously and non-consciously, to impact mental and physical health and functioning for better and for worse (Butler, 2011;Field, 2012;Hofer, 1994;Kiecolt-Glaser & Wilson, 2017;Meyler et al., 2007;Pietromonaco et al., 2013;Robles et al., 2014;Sbarra & Hazan, 2008). ...
Article
The present study investigated associations between prenatal mother–father cortisol linkage and infant executive functions. Data come from an international sample (N = 358) of predominantly white and middle‐ to upper‐class first‐time parents. During late pregnancy, parents collected diurnal salivary cortisol samples and reported on levels of psychological stress. At 24 months, children completed a battery of executive function tasks. Parent cortisol linkage was operationalized as the time‐dependent, within‐dyad association between maternal and paternal diurnal cortisol. Results indicated that prenatal linkage was positively related to infant executive functions, suggesting that stronger mother–father cortisol linkage was associated with higher executive function scores. Additionally, this relation was moderated by paternal average cortisol levels such that executive function scores were lower when fathers had higher average cortisol levels and linkage was weak. This association suggests that elevated paternal cortisol amplifies the negative relation between lower cortisol linkage and lower infant executive function scores. Importantly, these findings were observed while controlling for observational measures of caregiving and self‐report measures of psychosocial functioning and infant social‐emotional behavior. These results suggest that prenatal linkage of mother's and father's stress physiology plays a potentially important part in programming and regulating infant neurocognitive development.
... However, the factors that drive health concordance remain understudied and poorly understood. One explanation for couples' shared health fates is assortative mating, the tendency for people to choose a partner with similar characteristics, including the same health conditions, risk factors, and lifestyles [8]. Nevertheless, health concordance exists even after accounting for individuals' own health risk factors, strengthens over time in some health dimensions, and varies in magnitude across couples [7]. ...
Article
Extensive evidence shows that satisfying marriages boost physical health and longevity. A separate literature reveals strong concordance in couples’ health, but the relationship processes that contribute to health concordance remain poorly understood. The current study examined whether relationship satisfaction and joint health behaviors—the extent to which couples eat, sleep, and exercise together—are associated simultaneously with better health and greater health similarity between partners. Heterogeneous variance multilevel models were applied to data from 234 married couples (Mage = 46, Range = 20–84) reporting on their relationship satisfaction, joint health behaviors, and four health indicators—health satisfaction, depressive symptoms, comorbidities, and medication use. More satisfied couples engaged in more joint health behaviors than less satisfied counterparts. When joint health behaviors and relationship satisfaction were examined as separate fixed effects, both predicted greater health satisfaction and fewer depressive symptoms. More joint health behaviors were also associated with less medication use. When both were modeled together, only relationship satisfaction predicted depressive symptoms. By contrast, in random effects, joint health behaviors predicted greater similarity in health satisfaction, depressive symptoms, and comorbidities. Relationship satisfaction only predicted more similar depressive symptoms. Although more satisfied couples engaged in more joint health behaviors. relationship satisfaction and joint health behaviors uniquely predicted couples’ health quality and concordance, suggesting that distinct mechanisms may drive better health and stronger health resemblance.
... Most research on the health and loneliness relationship has focused on the association between individuals' own health and loneliness with little attention to the effects of spousal health on feelings of loneliness, even though there is strong evidence that caring for a spouse with poor health is a risk factor for one's own health and wellbeing (Meyler et al., 2007). A few studies on the effects of spousal health on loneliness used cross-sectional data (Korporaal et al., 2008), and to our best knowledge, no studies have examined the relationship between spousal health and loneliness in China and whether this relationship varies by gender. ...
Article
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This study examines the effects of own and spousal health on transitions in loneliness over time among married middle-aged and older adults in China, and explores the possible gender differences in these effects using data from the three waves of the China Health and Retirement Longitudinal Study (2011–2015). The sample includes 6,422 men and 6,391 women who were married and aged 45 and older at the baseline survey. Middle-aged and older adults with poorer physical and emotional health statuses are more likely to transition into and less likely to transition out of loneliness in a two-year period. Spouse's emotional health also affects both types of transition in loneliness and spouse's functional limitation affects transition into loneliness through spouse's emotional health. In addition, for married men, their own functional limitation is significantly associated with their transitions into and out of loneliness. For married women, their spouse's functional limitation is significantly associated with their transition into loneliness and this is mainly through its association with spouse's emotional health. Also, for married women, their spouse's emotional health is significantly associated with their transition out of loneliness. Social interventions to reduce feelings of loneliness need to take a couple approach and consider both spouses’ health problems and how they may affect their daily activities and their interactions with each other and with others.
... Couples often have the same dietary patterns, physical activity levels, and share patterns of sedentary behavior which can lead to concordance in weight and BMI, [71][72][73] and, therefore, overweight or obesity may be an issue for both members of the couple. Where necessary, this should be acknowledged and studies or interventions aimed at improving fertility in couples actively seeking pregnancy, developed accordingly. ...
Article
Being overweight or obese can have a negative impact on fertility outcomes. This systematic review updates randomized controlled trial (RCT) findings on the effectiveness of weight loss interventions in reducing weight and improving reproductive outcomes of women and men with overweight or obesity and infertility. Eligible studies, published since the last review, were identified by searching databases from March 20, 2016 until March 31, 2020. RCTs involving any type of lifestyle intervention were considered. Eight RCTs were identified and aggregated with seven RCTs included in our previous review. Meta-analyses revealed that women randomized to a combined diet and exercise intervention were more likely to become pregnant, risk ratio (RR) = 1.87 (95% CI 1.20, 2.93) and achieve a live birth RR = 2.20 (95% CI 1.23, 3.94), compared to women in control groups who received no or minimal intervention. This pattern was not replicated in trials where control groups received immediate access to assisted reproductive technology (ART). No eligible randomized trials involving men were identified. Data were largely obtained from small scale studies. Better designed, adequately powered, robust randomized trials are needed to better understand the effect of weight loss interventions on reproductive outcomes in both women and men.
... The resulting low blood sugar can increase physical sensations of nausea and tension, can impair cognitive and emotional functioning, including increased irritability and anger (i.e., "hangry"), and result in more negative interpersonal interactions including higher rates of arguing (Edwards, 2002;Gonder-Frederick et al., 1997). While even one partner with low blood sugar is cause for concern and heightened interpersonal distress, there is evidence that spouses are highly concordant in their eating behavior in both nutrient intake as well as timing of meals (Davillas & Pudney, 2017;Meyler, Stimpson, & Peek, 2007). As such, the likelihood of conflict increases around times when one or both members in a family has lower blood sugar. ...
Article
Despite sufficient evidence on the role of nutrition in psychosocial health, Marriage and Family Therapists lack the knowledge for sufficient assessment and referrals in treatment. The purpose of this article is to orient MFTs to human metabolism and the effects of various nutrients, or lack thereof, on the psychosocial health in their clients. The roles of several micronutrients and macronutrients will be described as well as the effects of eating patterns and overall metabolic health on mental health. Finally, implications for MFTs as sole practitioners, domains for assessment and psychoeducation, and recommendations for collaborating with nutrition professionals will be discussed.
... Second, whether the spouse provides personal care depends on his or her ability and willingness to provide care. When both spouses are old, they may experience alternating and overlapping health issues over time (Meyler et al., 2007). The accumulation of health issues in old age may make it necessary for both spouses to rely on others for care (Lu & Shelley, 2019;Potter, 2019). ...
Article
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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.
... A spouses' psychological state often impacts that of their patient, and vice versa, resulting in an interdependence of both psychological state and QOL among couples facing cancer [4; 5]. Physical health is additionally observed to be interdependent in couples [6], yet not all studies nd this association in cancer patients [7]. This interdependence rea rms the value of capturing both the patient and spousal caregiver's perspectives, in that the physical or mental health status of the spousal caregiver may indicate greater risk of psychological distress or poorer physical QOL for their partner and vice versa. ...
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Purpose As the economic burden and financial distress (FD) resulting from cancer care are increasingly recognized, FD remains inadequately understood from the perspective of patients and their spousal caregiver, the relational context where most financial and treatment decisions are navigated. Therefore, we assessed FD in both patients with advanced cancer and their spouses to identify symptom and QOL correlates. We additionally examined if illness communication moderated the association between FD and QOL. Methods Patients undergoing treatment for stage III/IV lung cancer or grade III/IV primary brain tumor and their spouses completed measures of their own FD, QOL, symptoms, perception of their spouse’s symptoms, and overall illness communication. Results Patients (62.7%) and spouses (64.7%) endorsed FD; however, spouses rated FD with greater relative severity. For both, FD was associated with greater anxiety, depression, and poorer physical QOL. For patients, FD was additionally associated with poorer mental QOL. Spousal caregivers accurately perceived patient FD, yet patients underreported spouse’s FD by a clinically meaningful difference. A 3-way interaction (FD X role X illness communication) revealed (b = .40, p = .041) that illness communication moderated the association between FD and physical QOL for spouses only. Conclusion In the advanced cancer setting, FD is prevalent in both patients and their caregivers and associated with psychological distress and poor physical QOL. Results suggest that optimal FD interventions should include patients and spouses. As illness communication appears to buffer the negative association of FD with physical QOL, studies targeting illness communication deficits in couples facing advanced disease are warranted.
... Differently from other types of caregiving, cancer caregivers dedicate greater amount of time to caring responsibilities, sustain greater out-of-pocket costs, and are confronted by more rapid changes [27,[43][44][45][46]. A pattern of interaction has been identified between physical and mental health outcomes of patients and their caregivers, both in cross-sectional and longitudinal studies [37,[47][48][49]. Notably, studies have identified that cancer patients and their partners' distress are the strongest predictors of quality of life and have longstanding consequences for both the patient and partner [38,50]. ...
Article
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Purpose: The present work investigated the relationship between patient activation, treatment decision-making, and adherence to the prescribed treatment regimen. Given the role of informal caregivers in patient-reported outcomes, it was additionally assessed whether caregiver involvement acted as a moderator of this relationship. Methods: Survey data collected from 504 cancer survivors were utilized. Structural equation modeling (SEM) controlling for covariates was used to examine the relationship between patient activation measure (PAM), caregiver involvement, and the identified outcomes. Moderator analysis was conducted using multiple group SEM. Results: Patient activation was significantly associated with treatment planning being reflective of survivors’ goals and values (p < 0.001); adherence to treatment (p = 0.011); and satisfaction (p < 0.001). Caregiver’s involvement significantly moderated the association between activation and adherence to treatment. Conclusion: Patient activation was positively associated with all three selected outcomes. However, for cancer survivors reporting low rates of caregiver’s involvement, patient activation was not associated with treatment adherence. Research is needed to test and deliver self-management interventions inclusive of informal caregivers. Implications for Cancer Survivors: Findings supported the need not only to monitor and sustain patient activation across the cancer continuum, but also to assume a dyadic perspective when designing self-management interventions in cancer survivorship.
... We calculate CIVs for the individual's own and spouse's optimal BMI directly from the data and assess the concordance in couple's BMI preferences. Meylera, Stimpson and Peek (2007) performed a systematic review of 103 studies of health-concordance in mental health, physical health, and health behavior among couples. The review suggests evidence for concordant mental and physical health, as well as health behaviors among couples. ...
... Physical activity is not just determined by our physical environment but also by the social context in which it occurs (Jackson et al., 2015;Meyler et al., 2007). Equipping multiple individuals with wearable devices promises insight into how activity levels are linked within social units such as families and couples, and how individuals influence each other on a day-to-day basis. ...
Article
Recent technological and methodological advances have seen a rapid increase in the development and use of wearable technologies, advancing the study and practice of precision health for individuals across real-world contexts and health statuses. This narrative review highlights the recent scientific advances and emerging challenges of wearable technologies. We first review the advantages of monitoring physical activity using wearable technologies over self-reports and examine commercially available devices' reliability and validity. Next, we point to the utility of wearable technologies in naturalistic environments to examine temporal associations between physical activity with other health behaviors, psychological processes, and ambulatory markers of disease that can inform the clinical practice of precision health. We further identify studies that use wearable technologies to facilitate behavior change across different populations, highlighting the need to adapt interventions for different individuals, contexts, and disorders. Balanced against these opportunities, we also highlight several challenges facing the field of precision monitoring. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
... Further, one would expect the couples to share lifestyle and other potential confounding factors. 71,72 The risk of misclassification cannot be ruled out, and it is however reassuring that the sensitivity analysis solely including male covariates in the model (Supplemental Table 6) did not change the estimates significantly. ...
Article
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Purpose: No studies have investigated if drinking water nitrate affects human fecundity. Experimental studies point at detrimental effects on fetal development and on female and male reproduction. This cohort study aimed to explore if female and male preconception and long-term exposure to nitrate in drinking water was associated with fecundability measured as time to pregnancy (TTP) or use of medically assisted reproduction (MAR) treatment. Methods: The study population consisted of pregnant women recruited in their first trimester in 1996-2002 to the Danish National Birth Cohort. Preconception drinking-water nitrate exposure was estimated for the pregnant women (89,109 pregnancies), and long-term drinking water nitrate exposure was estimated from adolescence to conception for the pregnant women (77,474 pregnancies) and their male partners (62,000 pregnancies) by linkage to the national drinking water quality-monitoring database Jupiter. Difference in risk of TTP >12 months or use of MAR treatment between five exposure categories and log-transformed continuous models of preconception and long-term nitrate in drinking water were estimated. Binominal regression models for risk ratios (RR) were adjusted for age, occupation, education, population density, and lifestyle factors. Results: Nitrate in drinking water (median preconception exposure: 1.9 mg/L; median long-term exposure: 3.3 mg/L) was not associated with TTP >12 months or use of MAR treatment, neither in the categorical nor in the continuous models. Conclusion: We found no association between preconception or long-term exposure to drinking water nitrate and fecundability.
... A considerable body of research has documented concordance between romantic partners' health behaviors across behavioral domains (e.g., physical activity, smoking, alcohol consumption, diet; Birditt et al., 2018;Christakis & Fowler, 2008;Meyler et al., 2007;Myers Virtue et al., 2015;Pachucki et al., 2011). However, most studies rely on cross-sectional data, which do not allow investigators to rule out the possibility that concordance is due to similarities between the partners and between their environments that predate their relationship. ...
Article
Relationship partners affect one another’s health outcomes through their health behaviors, yet how this occurs is not well understood. To fill this gap, we present the Dyadic Health Influence Model (DHIM). The DHIM identifies three routes through which a person (the agent) can impact the health beliefs and behavior of their partner (the target). An agent may (a) model health behaviors and shape the shared environment, (b) enact behaviors that promote their relationship, and/or (c) employ strategies to intentionally influence the target’s health behavior. A central premise of the DHIM is that agents act based on their beliefs about their partner’s health and their relationship. In turn, their actions have consequences not only for targets’ health behavior but also for their relationship. We review theoretical and empirical research that provides initial support for the routes and offer testable predictions at the intersection of health behavior change research and relationship science.
... A considerable body of research has documented concordance between romantic partners' health behaviors across behavioral domains (e.g., physical activity, smoking, alcohol consumption, diet; Birditt et al., 2018;Christakis & Fowler, 2008;Meyler et al., 2007;Myers Virtue et al., 2015;Pachucki et al., 2011). However, most studies rely on cross-sectional data, which do not allow investigators to rule out the possibility that concordance is due to similarities between the partners and between their environments that predate their relationship. ...
Article
Relationship partners affect one another’s health outcomes through their health behaviors, yet how this occurs is not well understood. To fill this gap, we present the Dyadic Health Influence Model (DHIM). The DHIM identifies three routes through which a person (the agent) can impact the health beliefs and behavior of their partner (the target). An agent may (a) model health behaviors and shape the shared environment, (b) enact behaviors that promote their relationship, and/or (c) employ strategies to intentionally influence the target’s health behavior. A central premise of the DHIM is that agents act based on their beliefs about their partner’s health and their relationship. In turn, their actions have consequences not only for targets’ health behavior but also for their relationship. We review theoretical and empirical research that provides initial support for the routes and offer testable predictions at the intersection of health behavior change research and relationship science.
... The following survivor variables were used to ensure balance across study group assignment: baseline physical activity, baseline diet quality, age, race, gender, and marital quality. Spousal factors were not included because doing so would likely be redundant given the literature showing a strong concordance between spousal health behavior [31]. Group assignment was conducted separately by disease site. ...
Article
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Spouses offer a primary source of support and may provide critical assistance for behavior change. A diet-exercise intervention previously found efficacious in improving cancer survivors’ lifestyle behaviors was adapted to utilize a couples-based approach. The aims were to test the feasibility of this couples-based (CB) intervention and compare its efficacy to the same program delivered to the survivor-only (SO). Twenty-two survivor-spouse couples completed baseline assessments and were randomized to the CB or SO interventions. The study surpassed feasibility benchmarks; 91% of survivors and 86% of spouses completed a 6-month follow-up. Survivors and spouses attended 94% and 91% of sessions, respectively. The SO survivors showed significant improvements on the 30-s chair stand and arm curl tests, weight, and fruit and vegetable (F and V) consumption. The CB survivors showed significant improvements on the 6-min walk and 2-min step tests, body weight, and fat and F and V consumption. Improvement in the 30-s chair stand and arm curl tests was significantly better for SO survivors. The SO spouses showed no significant changes in outcome measures, but the CB spouses showed significant improvements in moderate-to-strenuous physical activity, weight, and fat and F and V consumption. Weight loss was significantly greater in CB spouses compared to SO spouses. Findings demonstrate feasibility, warranting further investigation of CB approaches to promote lifestyle change among cancer survivors and spouses.
... 12 Spouses generally share a common environment, and many studies have investigated spousal concordances for factors such as lifestyle and physical and psychological health. [17][18][19][20][21][22][23] These factors, which are concordant within couples, are known to be associated with a risk of dementia or cognitive decline 24 and are also negatively associated with spousal cognitive disorders. 13,[25][26][27][28][29] Therefore, these factors may mediate cognitive disorders and changes in cognitive functions that correlate within couples. ...
Article
Full-text available
Importance Although couples could share many risk factors of cognitive disorders in their lifetime, whether shared risk factors mediate the shared risk of cognitive disorders has rarely been investigated. Objective To identify the risk factors of cognitive decline shared within couples and investigate their mediating roles in the shared risk of cognitive disorders and cognitive functions within couples. Design, Setting, and Participants A prospective cohort study was launched in November 1, 2010, and 784 participants were followed up every 2 years until December 31, 2020. This nationwide, multicenter, community-based study included older couples from the Korean Longitudinal Study on Cognitive Aging and Dementia (KLOSCAD) and a cohort of their spouses (KLOSCAD-S). Exposures The cognitive disorder of a spouse was defined as mild cognitive impairment or dementia. Main Outcomes and Measures The mediating roles of factors shared within couples on the association between one spouse’s cognitive disorder and the other’s risk of cognitive disorders was examined with structural equation modeling. Results Included were 784 KLOSCAD participants (307 women [39.2%] and 477 men [60.8%]; mean [SD] age, 74.8 [4.8] years) and their spouses (477 women [60.8%] and 307 men [39.2%]; mean [SD] age, 73.6 [6.2] years). The cognitive disorder of the KLOSCAD participants was associated with almost double the risk of cognitive disorder of their spouses in the KLOSCAD-S cohort (odds ratio, 1.74; 95% CI, 1.12-2.69; P = .01). History of head injury (β = 0.50; 95% CI, 0.09-0.90; P = .02) and age (β = 2.57; 95% CI, 1.37-3.76; P < .001) mediated the association between cognitive disorder in the KLOSCAD participants and their spouses’ risk of cognitive disorder. Physical inactivity mediated the association through major depressive disorder (β = 0.33, 95% CI, 0.09-0.57, P = .006 for physical inactivity; β = 0.28, 95% CI, 0.13-0.44, P < .001 for major depressive disorder). These factors similarly mediated the association between spousal cognitive disorder and cognitive functions such as memory and executive function. Conclusions and Relevance These findings suggest that the risk factors shared within couples may mediate approximately three-quarters of the spousal risk of cognitive disorders. Identification of and intervention in the shared risk factors of dementia within couples may reduce the risk of cognitive disorders in the spouses of people with dementia.
... Therefore, we estimate all models without and with adjusted standard errors for clustering within households and present both sets of results to highlight the role of correlated unobservables associated with marriage. In addition, for those who are married, there is substantial evidence of concordance in their health status, and it is logical to argue that their future economic status is not only influenced by their own health but also the health of their spouse (Bourassa et al., 2015;Kiecolt-Glaser & Wilson, 2017;Lu et al., 2016;Meyler et al., 2007;Torres et al., 2021;Wallace et al., 2017;Wong & Waite, 2015). Accordingly, we explore three ways of incorporating a spousal health shock in the model: including as an additional shock variable the same chronic disease measure for the spouse as for the respondent 13 ; including spousal death between 2001 and 2003 as an additional shock variable; and including spousal death as the only shock. ...
Article
Full-text available
We exploit the longitudinal Mexican Health and Aging Study to estimate the effects of health shocks in the short-run on the subsequent economic well-being of the aging population in Mexico. While there is substantial evidence indicating negative economic effects of such changes in industrialized countries, little is known about health impacts on the future economic position of older adults in low- and middle-income countries. This paper takes an important step towards filling this gap in knowledge. Our results are widely relevant, with a large percentage of the world’s population residing in developing countries such as Mexico that are experiencing rapid aging. We find evidence of negative impacts of health shocks on subsequent economic well-being of older adults in Mexico, but the effect varies according to several dimensions. First, the impact is clearly on income, not wealth. Second, responses are heterogenous across sources of income, with evidence of an impact mainly on labor income. Third, we find clear differences by gender in the impact of a health shock, with a larger negative impact on men. Fourth, we conclude that the population groups most negatively affected are those with the greatest degree of vulnerability prior to the shock, as measured by education and access to health insurance. Even though Mexico has made important gains with anti-poverty programs such as the Programa 70+ pension and a move towards universal health insurance, additional interventions targeted at the most vulnerable subsets of the aging population might be warranted.
... A spouses' psychological state often impacts that of their patient, and vice versa, resulting in an interdependence of both psychological state and QOL among couples facing cancer [26,27]. Physical health is additionally observed to be interdependent in couples [28], yet not all studies find this association in cancer patients [29]. This interdependence reaffirms the value of examining both the patient and spousal caregiver's perspectives of FD, in that the physical or mental health status of the spousal caregiver may indicate a greater risk of psychological distress or poorer physical QOL for their patient and vice versa. ...
Article
Full-text available
Purpose In efforts to understand financial distress (FD) associated with advanced cancer care from the perspective of both patients with incurable disease and their spousal caregivers, we assessed FD in both members of the couple, identified symptom and quality of life (QOL) correlates, and examined the potential role of illness communication. Methods Patients undergoing treatment for stage III/IV lung cancer or a grade III/IV primary brain tumor and their spousal caregivers (n = 76 dyads) completed measures of somatic and affective symptoms including FD, physical and mental QOL, and ease of engaging in illness communication. Patients and caregivers additionally rated their perception of each other’s symptoms, including FD. Results FD was endorsed by both patients (any FD 62.7%; high FD 24%) and spousal caregivers (any FD 64.7%; high FD 32.3%). Self-reported FD was significantly correlated (partial r = .52, p < .001) within couples. FD was associated with greater symptoms of anxiety (r = .29, p = .01; r = .31, p = .01), depression (r = 29, p = 01; r = .39, p = .001), and poorer physical QOL(r = − .25, p = .03; r = − .25, p = .001) for patients and caregivers, respectively. For patients, FD was additionally associated with poorer mental QOL(r = − .44, p < .001). Caregivers accurately perceived patient FD, yet patients tended to underreport their caregiver’s FD by almost an entire point (t = 2.8, p = .007). A 3-way interaction (FD X role X illness communication) revealed (b = .40, p = .041) that illness communication moderated the association between FD and physical QOL for spouses so that spouses who reported less ease of illness communication demonstrated a stronger association between financial distress and physical QOL (b = − 2.08, p < .001) than those reporting greater ease of engaging in illness communication (b = .49, p = .508). Conclusion In the advanced cancer setting, FD is prevalent in both patients and their spousal caregivers and associated with psychological distress and poor physical QOL. Results suggest that optimal FD assessment should include patients and spouses, and spouse’s ease of engaging with illness communication may be a potential target for future intervention studies.
... The mobilizing effects of being part of a couple extend to voting: couples are more likely to vote than singles [10]. Couples' similarities have been attributed to assortative mating, the contributions of shared environments, and partners directly influencing each other's behavior [11]. ...
Article
The purpose of this study was to determine the frequency of concordance and discordance in the COVID-19 vaccination status of intimate couples. Partners are well known to influence each other’s health behaviors, but previous reports of couples’ COVID-19 vaccination status were not found. Among 1305 respondents to an on-line survey who were living with their partners, couples’ COVID-19 vaccination status was 15.63% discordant and 84.37% concordant. Different potentially modifiable reasons for being unvaccinated were emphasized by unvaccinated participants with vaccinated partners and by vaccinated participants with unvaccinated partners. This study provides an estimate of the proportion of couples with discordant COVID-19 vaccine status. The development of tailored, scalable interventions potentially involving the partner might increase the COVID-19 vaccine concordance rate.
... There is a long history of research which has shown the beneficial effects of marriage and partnership on health (Umberson et al., 2010). Those who have a (marital) partner benefit from mutual social support as well as more resources which favour health-enhancing behaviours (Lewis et al., 2006;Liu, 2012;Meyler et al., 2007;Wilson, 2002). Health-related social control theories have put forward that partners influence each other's health behaviour and contribute to keeping their partner healthier (Umberson, 1992). ...
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Macrolevel gender inequality is defined as the unequal distribution of power and resources between men and women shaped by macrolevel social structures and institutions. An emerging line of health research is emphasising its negative consequences on women's health and healthcare access. The present study examines how gender inequality contexts affect women's mammography screening uptake. It adopts a macrosociological and institutionalist approach on preventive healthcare use and compares women who live with a partner with those who do not. This is the first study to test the effect of macrolevel gender inequality on mammography uptake across the 26 Swiss cantons (i.e. regions). The Swiss cantons' autonomy to manage their political and healthcare systems, as provided by the federal system, offers an ideal setting for the comparative analysis of macrolevel factors. Data on 9724 women aged 50–70 from the Swiss Health Interview Survey (waves 2007, 2012 and 2017) is analysed. Multilevel logistic models estimate two canton-level indicators of gender inequality, the gender gaps in time use and full-time employment, and their association with mammography uptake, controlling for women's socioeconomic and demographic characteristics, health status and healthcare use. Cross-level interactions assess how these indicators moderate the mammography uptake of women living with and without a partner. Results show that in cantons with higher gender inequality, women have a lower probability of mammography uptake. Women who live with a partner have a higher mammography uptake than those who do not. However, this advantage is moderated by canton-level gender inequality, namely, women who live with a partner in more gender unequal cantons have a lower mammography uptake than their counterparts who reside in more gender equal cantons. Results support the hypothesis that macrolevel gender inequality moderates women's preventive healthcare uptake, from an institutionalist approach.
... Informal care arises from a communal relationship between an informal caregiver (hereafter referred to as caregiver) and the person in need of care (i.e., the care recipient). Evidence suggests that caregiver and care recipient wellbeing is mutually interconnected, and adaptation to disease or aging often involves both members of the caregiving dyad (Meyler et al., 2007;Kelley et al., 2019;Varner et al., 2019). Using Cook and Kenny's definition, "there is interdependence in a relationship when one person's emotion, cognition, or behavior affects the emotion, cognition, or behavior of a partner" (Cook and Kenny, 2005, p. 101). ...
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Caregiving dyads (i.e., an informal caregiver and a care recipient) work as an interdependent emotional system, whereby it is assumed that what happens to one member of the dyad essentially happens to the other. For example, both members of the dyad are involved in care giving and care receiving experiences and therefore major life events, such as a serious illness affect the dyad and not only the individual. Consequently, informal caregiving may be considered an example of dyadic interdependence, which is "the process by which interacting people influence one another's experience." This systematic review aimed to synthesize studies of dyadic interdependence, specifically in non-spousal caregiving dyads (e.g., adult children-parents, siblings, other relatives, or friends). Electronic databases (PsycINFO, Pubmed, and CINAHL) were systematically searched for dyadic studies reporting on interdependence in the emotional and relational wellbeing of non-spousal caregiving dyads. A total of 239 full-text studies were reviewed, of which 14 quantitative and qualitative studies met the inclusion criteria with a majority of dyads consisting of adult daughters caring for their older mothers. A narrative synthesis suggested mutual influences between non-spousal caregiving dyad members based on: (1) associations between intrapersonal (e.g., psychological functioning) and interpersonal (e.g., relationship processes) variables and emotional and relational wellbeing of the dyad; (2) associations between care context variables (e.g., socio-demographics and care tasks) and emotional and relational wellbeing of the dyad; and (3) patterns of covariation between caregivers' and care recipients' wellbeing. Evidence supporting dyadic interdependence among non-spousal caregiving dyads shed light on the ways dyad members influence each other's wellbeing while providing and receiving care (e.g., via the exchange of support). Future studies investigating mutual influences in dyads, should differentiate subsamples of caregivers based on relationship type, and adopt dyadic and longitudinal designs. Systematic review registration: [https://www.crd.york.ac.uk/prospero/#recordDetails], identifier [CRD42021213147].
... Finally, certain studies discuss the contribution of marriage to health behaviours, which is deemed an essential context to either change, initiate or maintain health behaviours. (Homish & Leonard, 2008;Meyler, Stimpson, & Peek, 2007). ...
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This research report scrutinizes the relationship that is said to exist between marital status and individuals' health status-both physical and psychological aspects of wellness to be included-, as literature on this topic has identified that unmarried individuals usually have worse health conditions than their married equivalents, but this could have been altered due to the increasing changes in partnership. To better understand it, this paper briefly describes the current state of research on the topic, reviewing the existing literature and illustrating some relevant changes in the marital and household tendencies of the last decades, while presenting the causal mechanisms that could be underneath the studied relationship, such as marital quality. Then, the correlation between marital status and health has been statistically studied using an individual-level population dataset, in an attempt to bolster those findings from previous reports and studies. This statistical validation-or not-allows to draw suitable conclusions, whether confirming or discrediting the hypothesis made.
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We investigate the importance of adult children and/or cohabitation with a partner for older hip fracture patients’ probability of independent living, public home care use and hospital readmission. Data from 35,066 Swedish hip fracture patients between 2012 and 2017, aged 65 years, and living at home at the time of the fracture in the Swedish Registry for Hip Fracture Patients and Treatment were linked with national registers. We applied adjusted logistic regression models and Cox proportional hazard models. In total, 959 (4.0%) women and 817 (7.3%) men had no adult children, 13,384 (56.0%) women and 3,623 (32.5%) men had no cohabiting partner and 2,780 (11.6%) women and 1,389 (12.5%) men neither had a cohabiting partner nor adult children. In comparison with women and men who had both a cohabiting partner and adult children, those without a cohabiting partner (i.e. only adult children) and those who neither had a cohabiting partner nor adult children had significantly lower probabilities of returning home (at discharge and after 4 months). They also had a greater probability of both receiving home care and having an increase in the amount of home care they receive. Having a close next of kin and hospital readmission were not associated. In conclusion, absence of a close next of kin, specifically a cohabiting partner, reduces the chance of return to independent living and increases the use of home care after a hip fracture hospitalisation. The findings highlight the importance of family support for older adults living situation after a hip fracture.
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Physical activity is generally regarded as imperative to good health. Given the many health benefits of physical activity and the inclusion of muscle-strengthening physical activity (MSPA) in public health guidelines, an understanding of how romantic partners might foster or inhibit MSPA may be useful in promoting health and relationship quality. This study qualitatively explored how participants (young adults in long-term, dyadic heterosexual relationships) make sense of their partner's engagement in MSPA. The data came from the social media platform Reddit. The thematic analysis suggested five ways in which participants made meaning about MSPA in the context of their romantic relationships. Specifically, participants described experiencing conflict around partner engagement in MSPA, dissatisfaction with the partner's body, concern for partner's health, insecurity in response to physical changes in the partner, and concerns related to the partner balancing responsibilities and commitments. Limitations and implications of the analysis are discussed.
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Purpose: Evidence of shared physical activity (PA) habits within families is inconsistent. The present study aimed at examining intra-family resemblance in PA during different time segments of the week. Method: This cross-sectional study used data from the Danish household-based population study Lolland-Falster Health Study. We assessed time spent in various PA intensities and behaviours using a dual-accelerometer system (Axivity AX3). At least one parent and one child per household provided data for a minimum of three weekdays and one weekend day. We analysed three time segments: early weekdays, late weekdays, and weekends. A linear mixed model regression analysis was used to estimate intraclass correlation coefficients (ICCs) of the total family, parent-child dyads, siblings, and parent-parent dyads for PA outcomes, adjusting for sex, age, parental education, and the interaction between sex and age. Results: We included 774 parents (57.9% female, 42.8±7 years) and 802 children (54.2% girls, 11.1±4.3 years) nested within 523 families. The clustering among the total family was stronger during late weekdays (ICCs 0.11-0.31) and weekends (ICCs 0.14-0.29) than during early weekdays (ICCs 0.02-0.19). We found stronger clustering among siblings (ICCs 0.08-0.47) and between parents (ICCs 0.02-0.52) than between parents and children (ICCs <0.01-0.37). Generally, the clustering was strongest for light PA, and among PA behaviours, walking showed the highest resemblance across all subgroups. Conclusion: Initiatives to promote children's PA that involve parent or sibling co-participation may focus on the time segment and activity types with the highest resemblance. For the family as a whole, promoting walking or limiting sedentary activities may be a potential target for interventions during late weekdays and weekends.Trial registrationClinicaltrials.gov (NCT02482896).
Article
Aims and objectives To examine the joint effects of self and spousal frailty status on functional and mental health in Chinese older adults and determine whether such effects vary by urban versus rural residency. Background Frailty is a clinical syndrome among old adults and would lead to adverse outcomes. However, studies on the interactive patterns of frailty status between spouses and the joint effects of such patterns on health outcomes are scarce. Design Data were from the China Health and Retirement Longitudinal Study (CHARLS). A total of 2,581 married seniors who participated both 2011 and 2015 waves of the CHARLS were categorised into four groups: robust self–robust spouse (RR), robust self–frail spouse (RF), frail self–robust spouse (FR) and frail self–frail spouse (FF). Methods Frailty was measured using the physical frailty phenotype scale. Depressive symptoms were measured using the Center for Epidemiologic Studies Depression Scale (CESD). Functional health was measured by difficulties in activities of daily living (ADL) and instrumental activities of daily living (IADL). The generalised estimating equation was used to estimate the effects of concordant frailty on mental and functional outcomes, stratified by rural/urban residency. This study followed the STROBE checklist. Results The FF group reported higher levels of ADL/IADL difficulties and depressive symptoms at follow-up than the RR group; urban individuals in the RF group reported higher follow-up depression than the RR group; and rural individuals from the FR or RF groups reported more follow-up ADL/IADL difficulties than the RR group. Conclusion Frailty and subsequent health decline are interdependent in older couples, and the rural/urban context is important for understanding this interdependence in the older Chinese population. Relevance to clinical practice Couples-based intervention strategies are needed to tackle situations in which one or both spouses are concurrently facing frailty.
Article
Background Studies have shown the existence of health concordance between patients with type 2 diabetes mellitus (T2DM) and their spouses, and also that spouses could influence the effect of self-management, benefiting patients’ health. However, these studies are heterogeneous and the evidence is inconclusive. Objective To synthesize evidence from published randomized controlled trials: the interventional effects and the quality of study performance, also to identify the research gap and the directions for future studies. Methods We performed the scoping review by following the PRISMA-ScR guidance. We searched and examined the reports from MEDLINE, EMBASE, PsychInfo, CINAHL Plus by the pre-specified criteria. Key characteristics and information of eligible reports were extracted, analysed and synthesized comprehensively, and the results were presented in the form of words and diagrams. Results We identified 5 reports from 4 studies out of 3479 records included. Qualified studies indicated a positive effect of couple-based interventions on couples’ distress. Insufficient evidence on physiological health or health behaviours was identified owing to the small number of included studies and inconsistent assessment outcomes. The methodological quality across these studies was generally low due to inadequate reporting of study process and substantial biases. Conclusions Couple-based interventions for patients with T2DM showed small effects on the couple’s distress while the effects of other outcomes were inconclusive. Future studies should strengthen methodologies by using standard measures of core diabetic outcomes, including detailed assessments of implementation process, and taking a dyadic approach to systematically examine the effects.
Article
Background: Weight gain is common for breast cancer survivors and associated with disease progression, recurrence, and mortality. Traditional behavioral programs fail to address symptoms (i.e., pain, fatigue, distress) experienced by breast cancer survivors that may interfere with weight loss and fail to capitalize on the concordance in weight-related health behaviors of couples. This study aimed to develop and examine the feasibility and acceptability of a behavioral weight and symptom management intervention for breast cancer survivors and their intimate partners. Materials and methods: Interviews were conducted with N=14 couples with overweight/obesity to develop the intervention. Intervention feasibility and acceptability were examined through a single-arm pilot trial (N=12 couples). Patterns of change in intervention targets were examined for survivors and partners. Results: Themes derived from interviews were used to develop the 12-session couple-based intervention, which included components from traditional behavioral weight management interventions, appetite awareness training, and cognitive and behavioral symptom management protocols. Couples also worked together to set goals, create plans for health behavior change, and adjust systemic and relationship barriers to weight loss. Examples were tailored to the experiences and symptom management needs of breast cancer survivors and partners. The intervention demonstrated feasibility (attrition: 8%; session completion: 88%) and acceptability (satisfaction). Survivors and partners experienced reductions in weight and improvements in physical activity, eating behaviors, emotional distress, and self-efficacy. Survivors evidenced improvements in fatigue and pain. Conclusions: A behavioral weight and symptom management intervention for breast cancer survivors and partners is feasible, acceptable, and is potentially efficacious.
Article
I study how family spillovers shape healthcare consumption through two main sources: a learning channel whereby family members share information about their health insurance and the effectiveness of healthcare, and a behavioral channel whereby risk perception and habits are shared and transmitted. I exploit two types of sudden health shocks to identify a causal effect operating through each channel: a spouse’s non-fatal heart attack or stroke and a severe injury to a child. I incorporate these shocks into an event-study framework to quantify the effect of spillovers on healthcare consumption of a non-injured adult family member. I find a significant behavioral spillover effect of an increase of more than 200% in medical expenditure of preventive care over a four-year horizon. Moreover, I find a strong and persistent learning spillover that amounts to an average increase of more than 150% in medical expenditure relative to prior to the health shock, and I demonstrate that this effect promotes health investment. While the first result is in line with previous findings in the literature, the second is novel.
Article
For a given person, many socioeconomic resources are correlated, but resources also accumulate in families, depending on how people sort in relationships based on their individual characteristics. This study proposes that people match on multiple resources in long-term relationships as a strategy for creating families with systematically advantaged portfolios—a strategy we call “consolidation.” Analyzing Health and Retirement Study data and using smoking as a measure of health, we show that couples match on both educational and health statuses at the start of marriage, and this systematic pattern of matching intensifies over time. We find that matching on smoking is not simply a byproduct of educational homogamy, and that matching on smoking/non-smoking status has increased over time. Moreover, couples increasingly sort on education and health jointly, such that highly educated couples are even more likely to be nonsmoking than would be expected by matching on education or smoking status alone. Increasing educational inequalities in quitting smoking between marriage and first birth reinforce this consolidation process. Using Current Population Surveys, we find these patterns are stronger in marriages than in cohabitations. The consolidation of education and health in couples is an important mechanism that amplifies inequality in families and, potentially, across generations.
Article
Background Across a range of studies, health scientists have found that being in a romantic relationship can have positive and negative influences on one’s health. A couple’s health outcomes are often influenced by relationship quality—or how they perceive the positive or negative character of their relationship. These findings have important implications for how scientists and interventionists may leverage romantic relationships facilitating good health among couples. However, in general, couples research has not included Black same-sex male couples in large enough numbers to make previous studies’ findings relevant to them. This represents a gap in the scientific literature and, more importantly, a missed opportunity to understand how romantic relationships influence health for a group that must navigate distinct, multilevel health and social inequities. Objective This study aims to (1) decode and understand the ways in which Black same-sex male couples express their romantic relationships in virtual contexts via symbolic indicators, (2) determine how Black same-sex male couples describe the quality of their romantic relationships, and (3) explore how Black same-sex male couples make meaning of their relationship quality and its impact on their relational and individual health. Methods We will use joint dyadic interviews embedded within a symbolic netnography research design to accomplish our aims. We will use grounded theory to analyze our qualitative data. We will then triangulate our findings to determine how well they answer our research questions. Results This study received ethical approval on October 8, 2020 and we began data collection in November 2020. Results are expected to be available no later than December 31, 2022. Conclusions This study will apply novel symbolic netnographic qualitative methods to further our understanding of Black same-sex male couples’ romantic relationships and how they contribute to their health. The findings will be used to develop programs to improve Black same-sex male couples’ health in community and virtual settings. International Registered Report Identifier (IRRID) DERR1-10.2196/29589
Article
This study examined whether one spouse’s mealtime behaviors were associated with their own and their partner’s depressive symptoms among older, married couples. We examined gender differences in these associations and tested marital satisfaction as a mediator of these associations. 101 couples self-reported mealtime behavior (number of meals, snacks, fast-food meals, and meals eaten alone), depressive symptoms, and marital satisfaction. Results of the actor partner interdependence model revealed a statistically significant actor effect of the number of fast-food meals on depressive symptoms and a significant partner effect of the number of fast-food meals and the number of meals eaten alone on depressive symptoms. There were also gender differences: Husbands’ marital satisfaction mediated the effect of meals eaten alone on depressive symptoms; wife’s marital satisfaction mediated the effect of the husband’s meals eaten alone, and wife’s number of fast-food meals on the wife’s depressive symptoms. Findings have implications for dyadic interventions to improve depressive symptoms.
Article
Objectives: Healthy lifestyle change improves outcomes in coronary heart disease (CHD), but is rarely sustained. To better understand barriers to lifestyle change, we examined couples' talk of engaging with lifestyle advice after one partner receives a diagnosis of CHD. Design: A longitudinal qualitative design, in which a poststructuralist discourse analysis was performed on 35 interviews, conducted with 22 heterosexual British people in a long term relationship. The interviews occurred over three months after one partner was referred to a cardiac rehabilitation programme designed to support lifestyle change. Results: Couples understood their health as a shared practice underpinned by an ideological framework of healthism, creating a form of 'relational healthism'. Practicing relational healthism was not straightforward because the practices of surveillance, control, and discipline related to healthism often contravened relationship norms of support, acceptance and respect for the other's autonomy. Couples struggled to resolve this tension, dynamically adopting, resisting, and occasionally transforming discourses of health and love in ways that worked for and against engagement in lifestyle change. Conclusion: In foregrounding the discursive and relational contexts of behavioural change engagement, we show the considerable complexity for couples, including costs related to engagement with lifestyle advice.
Article
Objective: The growing evidence show that romantic partners' personality traits mutually influence each other's health. The research on relationship between personality and health behaviours should include both partner's perspectives - relations between individuals' traits and their own outcomes (actor effects), and relations between individuals' traits and their partners' outcomes (partner effects). The objective of this study was to examine the actor and partner effects of the Dark Triad (DT) personality traits (psychopathy, Machiavellianism and narcissism) on the health protective behaviours (HPB) in romantic couples. Design: A convenience sample of 188 heterosexual romantic couples participated in a cross-sectional round-robin study. Three predictor measures were Self-Report Psychopathy Scale-III, Narcissistic Personality Inventory and MACH-IV inventory, whereas HPB inventory was used as criterion variable. Results: Data were analysed using the Actor-Partner Interdependence Model (APIM). The results suggest that men's psychopathy, and to a lesser extent men's Machiavellianism exert deleterious effects on their own and their partner's HPB. The majority of these effects replicated across both self-reports and partner-reports. Women's DT traits exerted weaker actor and partner effects on the HPB than men's DT traits. Conclusions: Findings show that men's psychopathy and Machiavellianism have detrimental effects on their own as well as their partner's HPB.
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The course of parental bereavement during the first year following an infant's death was investigated. Also, the differences in mothers' and fathers' reactions, the differences according to the mothers' occupational role, and the similarities in couples' reactions were studied. From a total sample of 59 families, 13 families answered their questionnaires at all three time points (1, 6 and 13 months), 22 families responded at two time points, and 37 families responded at some point following the loss. Measures relating to anxiety, depression, bodily discomfort, general well being and impact of event were used at the three time points. The results showed that grief, as measured by the different inventories, decreased over time. The decrease was most evident from 6 to 13 months, and most prominent in women. A considerable number of the parents were still actively dealing with the loss all through the first year of bereavement. In most couples the mother reported most distress. Mothers were significantly more depressed than fathers at all time points, and mothers also had significantly higher anxiety and lower general health at 1 and 13 months, and intrusive scores of 1 and 6 months. Women at home evidenced more grief at all three time points than women employed outside the home. A high or low score in one spouse was more strongly correlated with a similar score in the other at 1 and 13 months, than at 6 months. The implications for counselling of parents, with special emphasis on the employment situation of the mother, is emphasized.
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This study explored the burdens experienced by 42 adults who lived with a depressed patient and related these burdens to their degree of psychological distress. The comparison group consisted of 23 adults who were living with someone who had been an in- or outpatient but who was not currently in a depressive episode. Respondents who were living with a patient in a depressive episode were quite distressed themselves, and over 40% met a standardized criterion for referral for therapeutic intervention. For these respondents, living with a patient currently in a depressive episode produced numerous burdens in response to the patients' symptoms, particularly patients' lack of interest in social life, fatigue, feelings of hopelessness, and worrying. Multiple regression analyses showed that these burdens accounted almost entirely for respondents' greater psychological distress. It is suggested that clinical depression is often indicative of a more generally distressed interpersonal context. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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A community sample of elderly married couples completed the 60-item General Health Questionnaire and the Leeds General Scales for the Self-Assessment of Depression and Anxiety. Significant concordance was demonstrated between the spouses' scores on these scales. Concordance was higher for depression than for anxiety. There was little to support previous findings that wives are more likely than husbands to be concordant with an ill spouse. The spouse concordance rates for psychiatric morbidity were similar to those found in studies of younger married couples.
Article
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A very similar pattern of homogamy was found in samples of American and Swedish couples for physical, social, and behavioral variables. In the Swedish sample, there were only minor differences in assortment, i.e., in similarity to spouses, between MZ and DZ twins. Although our data are not conclusive on this point, there was an indication that the observed similarity of spouses for most variables is due to initial assortment rather than to convergence of phenotypes after initial contact. Exceptions are that spouses do appear to converge for highly plastic variables such as alcohol consumption and amount of social activity.
Article
This study investigated differences in psychological distress and coping styles between fathers and mothers of pediatric cancer patients, over a 1‐year time period. Also examined were (dis)similarities in couples in distress and coping, and the relationship between (dis)similarities in coping and psychological functioning of both members of a couple. Parents (n=124, 62 couples) were assessed at diagnosis, at 6 and 12 months. Fathers and mothers experienced higher levels of psychiatric symptomatology and psychological distress at diagnosis than men and women of a normgroup. Distress declined significantly with time. Although parents did not report more symptoms than the normgroup 12 months post‐diagnosis, they still were psychologically out of balance. Contrary to findings in the general population, no differences were found between fathers and mothers in psychiatric symptoms or psychological distress on any of the measurements. Only a few gender differences in coping were found. Fathers used more active‐problem focusing at diagnosis and a less palliative reaction pattern at 12 months than did mothers. Mothers used more social‐support seeking on all measurements. A tendency for similarity in the use of the coping styles within couples was found. Discrepancies in coping in couples were positively related to distress in fathers at diagnosis. However, 12 months later, the more discrepant the couples were in their coping preferences the more distress the mothers indicated. © 1998 John Wiley & Sons, Ltd.
Conference Paper
Independent interviews with husbands and wives from 317 community-dwelling older couples showed that depressive symptoms in 1 spouse had a significant impact on depressive symptoms in the other spouse, after controlling for potentially confounding respondent sociodemographic and health status variables. Relationship quality moderated the influence, with spouse depressive symptoms contributing more of the variance to a respondent's symptoms when a couple were close than when they were not and closeness to a spouse buffering the potentially depressive effects of a respondent's own frailty and financial distress. Husband's own variables explained more of the variance in his symptoms when the couple were not close than when they were, and closeness to his wife increased a husband's vulnerability to the impact of the wife's health status.
Article
A meta-analysis of 40 findings from 36 studies (N = 4,952) provided substantial overall support for the proposition that depressive symptoms and mood are contagious. Contagion appeared most pronounced in studies of depressive symptoms (vs. depressive mood). Contagion of depressive mood appears to depend on methodological approach, with strongest to weakest results in the following order: transcript studies, audio/ videotape studies, studies using actual strangers, studies using actual friends/acquaintances, and confederate studies. Contagion of depressed mood/symptoms held across combinations of target x respondent gender. There was very tentative evidence that contagion was specific to depressive versus other symptom/moods. Based in part on our meta-analytic findings, we summarize possible explanations of the phenomenon from cognitive, behavioral, and interpersonal viewpoints and elucidate some clinical implications.
Article
Twenty-two stroke patients and their spouses were studied. All patients were living at home and had had a stroke at least one year previously. Of the 22 patients 14 were men and eight were women. Couples were assessed on the variables of morale, family functioning, health status, and patient functional capacity. For all variables, patient-spouse and husband-wife differences were tested. Couples from a previously studied random community sample were matched to the stroke couples on age and socioeconomic status (SES). Identical morale, family functioning, and health status data collected on these couples were compared to the stroke data. The results included the following: Stroke patients and their spouses were healthy on all variables. Members of the couple did not differ on most variables whether compared as husband-wife or patient-spouse. Wives from the two samples did not differ on any variable. Husbands from the stroke sample differed from the matched husbands on only one health variable—the number of doctor visits made in the past six months.
Article
Some 15% or 1 in 6 American couples in the childbearing years have infertility problems. Numerous studies have demonstrated that both infertile men and women have negative emotional responses, such as stress, anxiety and depression. In Europe, Canada, and the United States the response of infertile husbands was different from that of their wives in self-image, marital adjustment, and sexual relations. The differences in psychological distress, marital satisfaction, and sexual satisfaction between Chinese infertile husbands and wives were evaluated. Fifty-nine infertile couples participated in this study. The subjects completed an Infertility Questionnaire, Marital Satisfaction Questionnaire, and Sexual Satisfaction Questionnaire as measures of gender differences in facing infertility problems. Paired t tests revealed that husbands expressed significantly less distress than that of the wives. The husbands' self-esteem was higher than that of the wives. The husbands' marital and sexual satisfaction was also...
Article
The notion that resemblance between spouses increases with marital duration (convergence) due to common environment or reciprocal influence was tested. Data on body mass, blood pressure, heart rate, lifestyle, personality, quality of life, education, income, identity of spouse, and marital duration were available from several sources for most couples (15,925 to 23,033 pairs with complete data, attrition varying among data sources) residing in a Norwegian county. Correlations between spouses did not vary much with marital duration, implying a stronger effect of mate selection than convergence. There was a moderate convergence for some lifestyle variables and a moderate divergence for variables related to personality.
Article
How does the family affect the health of its adult members? It is in the family that the macro-level social and economic order affects individual physical and emotional well-being. This review presents a general model of understanding family and health that describes patterns of well-being, and then asks, "what explains these patterns?" Explanations are found in causal chains, conditional effects, and "structural amplification." The review summarizes and synthesizes ideas and findings about four factors: marriage and parenthood (which define the family), and the wife's or mother's employment and the family's social status (which connect it to the larger social order). Overall, the married are in better health than the nonmarried, but parents are not better off than nonparents. Women's employment and high family socioeconomic status tend to be associated with good physical and psychological health. Under what circumstances are these basic patterns found, and what explains these patterns—what links structure to individual health? Economic well-being and social support are considered as the basic explanations. Concluding comments point to the need for more studies of the impact of family on the sense of control, which could be an important link to health.
Article
A family study of serum high density lipoprotein (HDL) cholesterol and total serum cholesterol concentration has been undertaken, and the relation to age, sex, cigarette smoking, physical activity and familial occurrence of myocardial infarction (MI) was examined. HDL cholesterol was determined in 251 females and 194 males and total serum cholesterol in 677 females and 657 males, all aged 0-49 years. With respect to HDL cholesterol, significant sex differences were observed both in absolute level and in age-related change. A negative correlation between HDL cholesterol and total serum cholesterol was observed in all age groups except females aged 0-19 years, supporting the hypothesis of HDL as a "clearing'' lipoprotein. HDL cholesterol showed a positive correlation only in pairs of first-degree relatives involving the mother and in sib-sib paris of the same sex. On the other hand, for serum cholesterol a positive correlation was found among all family members, although significantly higher between first-degree relatives than between spouses. No relation was found between cigarette smoking, physical activity of familial occurrence of MI and the HDL cholesterol or total serum cholesterol concentrations. In accordance with the "HDL hypothesis'', the present finding could partly explain the higher incidence of ischaemic heart disease (IHD) in males than in females, and partly also the high risk which is transmitted from women with IHD to their first-degree relatives.
Article
The similarity of behavioral patterns within addict couples before, during, and after a relationship is the focus of this paper. The correlations between partners in real and artificially constructed (pseudo) couples for employment, criminal activities, and other behaviors are examined. The effect of a relationship on behavior is also assessed before, during, and after treatment. Significant correlations during real relationships were found for employment, welfare, and illegal income. Joint couple entry into treatment appears to be more effective for women than men. Similarity within couples disappears when the relationship ends.
Article
A meta-analysis of 40 findings from 36 studies (N= 4,952) provided substantial overall support for the proposition that depressive symptoms and mood are contagious. Contagion appeared most pronounced in studies of depressive symptoms (vs. depressive mood). Contagion of depressive mood appears to depend on methodological approach, with strongest to weakest results in the following order: transcript studies, audio/ videotape studies, studies using actual strangers, studies using actual friends/acquaintances, and confederate studies. Contagion of depressed mood/symptoms held across combinations of target × respondent gender. There was very tentative evidence that contagion was specific to depressive versus other symptom/moods. Based in part on our meta-analytic findings, we summarize possible explanations of the phenomenon from cognitive, behavioral, and interpersonal viewpoints and elucidate some clinical implications.
Article
BACKGROUND Because married couples share at least their home environment, spousal aggregation of cancer might provide clues to unsuspected etiologic factors. The authors sought to measure the concordance of cancer occurrence in married couples and explore factors that might explain greater-than-expected concordance.METHODS The authors identified 25,670 cancer-free married couples in northern California who were followed for up to 31 years for the development of cancer. In Cox proportional hazards analysis, the development of cancer in a spouse was treated as a time-dependent, independent variable, and spouse-with/spouse-without risk ratios were determined, controlling for age and gender. For selected concordant espoused pairs, additional explanatory information was sought in their medical records.RESULTSThere was no excess concordance for all cancers combined; the spouse-with/spouse-without risk ratio was 0.97 (95% confidence interval, 0.90–1.05). Statistically significant husband-wife associations were found only for cancer of the tongue and stomach and for non-Hodgkin lymphoma. Except for cancer of the penis/endometrium and testis/vulva, based on one couple with each combination, gender specific cancers did not aggregate within married couples. Established and suspected risk factors, not necessarily related to the marriage, were found for some individuals who had concordance with their spouses.CONCLUSIONS Little spousal concordance for cancer occurrence was found. The study of spousal aggregation does not appear useful in identifying unsuspected environmental causes of cancer in heterogeneous populations in urban areas of affluent Western countries. A cohort study would have to be much larger than this one to detect weak spousal concordance reliably.. Cancer 1999;86:2413–9. © 1999 American Cancer Society.
Article
To test a caregiving model of depression in spouses, 31 married couples completed interview and questionnaire assessments of depressive symptoms and caregiving activities. Spouses living with a partner with depressive symptoms had more symptoms of depression themselves. However, this association was found to be fully mediated by spouses’ perceived level of caregiving stress and burden. Results suggest that feelings of stress associated with caring for a depressed spouse may lead to depressive symptoms in the caregiving spouse and should be addressed in treatment.
Article
Studies of the influence of social support on successful smoking cessation have been based on the smoker's perceptions only. In this pilot study of 58 couples, pregnant women who had smoked in the 30 days before pregnancy and their partners reported the positive and negative support for cessation they had received (women) or provided (partners). Mean levels of the women's and partners' perceptions of support were compared, and correlations of the two reports were analyzed while controlling for the effect of the couple's smoking status. Women's and partners' reports were similar except partners reported wanting the women to stop smoking more than women perceived. Women's and partners' perceived negative support were moderately correlated (r ≅ .48, p ≅ 001). Partner-reported positive support also was associated with women's perceived negative support (r ≅ .30, p ≅ .03). These relationships remained significant after controlling for partners' and women's smoking status. Generally, partners reported giving more positive and less negative support than women perceived. Results suggest the need for further examination of couples' perceptions of support and the impact on smoking cessation during pregnancy.
Article
The present study was designed to compare the perceptions, mood, marital satisfaction, and behavior of a sample of married couples having a depressed partner with those of nondepressed couples. Eleven couples having a depressed spouse (target) and 11 couples in which neither spouse was depressed engaged in 15-minute videotaped interactions. The videotapes were subsequently scored for positive and negative verbal and nonverbal behavior. Both depressed targets and their spouses rated themselves as experiencing significantly less positive and more negative mood following the interaction than did nondepressed couples. In addition, behavioral analyses indicated that compared with nondepressed couples, depressed targets and their spouses emitted a lower proportion of positive verbal behavior and a greater proportion of negative verbal and nonverbal behavior during the interactions. Finally, to assess predictions derived from Coyne's interpersonal description of depression, verbal/nonverbal affect discrepancy scores were computed for each spouse. Analyses indicated that depressed targets, compared with their spouuses and with nondepressed couples, emitted a greater proportion of behaviors in which the nonverbal communication was more negative than the accompanying verbal message. Contrary to prediction, however, the communications of spouses of depressed partners did not differ on this measure from those of the nondepressed couples. The results of this study are discussed in terms of their theoretical and therapeutic implications for the understanding of the relationship between depression and marital adjustment, and directions for future research in this area are advanced.
Article
HDL, VLDL, and LDL cholesterol as well as total cholesterol were measured in young adult offspring of Framingham Heart Study participants. Parental total cholesterol levels measured in the early 1950s were found to be significant predictors of present total cholesterol in the offspring. While both maternal and paternal cholesterol levels made an independent contribution to the prediction of the offspring's cholesterol, the mother's contribution was significantly greater than the father's for male offspring with a similar but less striking relationship for female offspring. The correlation for LDL cholesterol levels for siblings was higher than for HDL cholesterol or log VLDL choles terol. When adjustments were made for age, body weight, alcohol intake and cigarette smoking, slight reductions in the correlations were noted, but all adjusted correlations remained significantly different from zero. The spouse correlations for lipoproteins, however, did not differ from zero after adujustment. Since the significant association for lipoproteins in spouse pairs disappears on adjustment for correlates but the association for siblings does not, it is likely that the sibling lipoprotein associations result from either genetic or environmental factors shared early in life.
Article
It has been known for some years that familial aggregation of blood pressure levels occurs in adults. The question of how much of this aggregation can be attributed to genetical inheritance, and how much to a shared environment, is not yet resolved. Evidence of the influence of a common environment on blood pressure levels can be gained from examining spouses who are not genetically related. In a family study of blood pressure levels in children, 452 of the parents had had a single continuous marriage. These spouses had a small but significant association with respect to blood pressure, and this association varied with length of marriage. Different interpretations of this result are discussed in relation to those from longitudinal studies.
Article
Values for several coronary risk factors, including systolic and diastolic blood pressure, serum cholesterol, triglycerides, blood glucose, uric acid, hemoglobin, weight, vitral capacity and cigarette smoking have been found to be similar among spouses in the Framingham Study. However, longitudinal analyses show that this spouse concordance does not increase over a twelve-year observation period, suggesting that it has arisen through the marriage of similar people rather than through the sharing of a common marital environment. Apparent conflicts between cross-sectional and longitudinal findings have been resolved by showing that spouses who were concordant at the begining of the study are more likely to survive to later exams, while discordant spouse pairs tend to be dissolved through the death of one of their members.
Article
The authors describe a study of 10 depressed patient couples and 11 surgical control couples. Discussion was generated between parties, and a videotape recording was taken of the interaction. The verbal data were transcribed and analysed into four domains: Expressiveness, Responsiveness, Person control and Tension. The non verbal data were analysed in terms of hand movements and posture. They also compared the patient's behavior with a stranger, and made a follow up recording of patient and spouse 3 to 12 mth later. Significant differences in interaction were found between patient couples compared with control couples and the patient stranger interaction. This was revealed verbally in the domains of Expressiveness, Person Control and Indirect Responsiveness. For the non verbal analysis they found it useful to discriminate between fast speaking and slow speaking speakers. Again, significant differences in hand movements and posture between depressed and control couples reflected the state of interaction between those couples.
Article
Mortality rates are lower for married individuals than they are for unmarried individuals, and marriage seems to be even more beneficial to men than women in this regard. A theoretical model of social integration and social control is developed to explain why this may occur. Drawing from this model, I hypothesize that marriage may be beneficial to health because many spouses monitor and attempt to control their spouse's health behaviors. Furthermore, the provision, receipt, and consequences of these social control efforts may vary for men and women. These hypotheses are considered with analysis of a national panel survey conducted in 1986 (N = 3617) and 1989 (N = 2867). Results show that: (1) marriage is associated with receipt of substantially more efforts to control health for men than women, (2) those who attempt to control the health of others are more likely to be female than male, (3) there is some support for the social control and health behavior hypothesis among the married, and (4) the transition from married to unmarried status is associated with an increase in negative health behavior while the transition from unmarried to married status seems to have little effect on health behavior. A theoretical explanation is developed to explain these marital status differences.
Article
This study examined the relations between spousal variables and the psychological well-being of husbands and wives in older couples to determine if spousal characteristics were more important determinants of well-being for wives than for husbands. One hundred-twenty older married men and women completed standardized self-report measures and a short interview. The variables investigated included education, verbal intelligence, personality, physical health, marital adjustment, psychological well-being, as well as response bias to marital defensiveness. Spousal variables significantly predicted wives' well-being (R2 = 29%) with the three most influential predictor variables being the husbands' perception of the marriage, positive dimension of well-being and physical health. In contrast, spousal variables did not significantly predict husbands' well-being. The study supported the hypothesis of differential responsiveness of men and women to spousal variables and highlighted the importance of marital adjustment for the psychological well-being of older wives.
Article
Is our understanding of how individuals adjust to stressful life events increased when we analyze their adjustment in ways that recognize that these individuals are also married couples? The data used to answer this question came from a unique "natural experiment" occasioned by the forced evacuation of the Israeli settlement of Ophira under the terms of the Camp David Accords. We found that the adjustment of individuals within couples became more similar across the relocation, that is, couples adapted as a "family system." This occurred because the coping skills of one member of the couple "drove" the adjustment of both partners.
Article
Severe cardiomyopathy (SCM) imposes considerable psychosocial stress on families; however, little is known about the effect of SCM from the point of view of the marital couple. In this study, adjustment to SCM of 90 patients and their spouses was compared. Patients reported more vocational, domestic, and sexual problems than spouses. Spouses reported more problems in health care orientation, family relationships, and psychological distress than patients. The findings indicate that severe cardiomyopathy impacts on the psychosocial integrity of both partners. Therefore, one should plan interventions to support spouses as well as patients. Because problems of spouses and patients may differ, both partners should be assessed to appropriately target interventions.
Article
This study used a subsample of 543 married couples from a large group of families in Utah, who were originally studied to assess the genetic and environmental determinants of hypertension. Excluding individuals on medication and controlling for the major risk factors for hypertension, evidence was obtained for cross-spouse blood pressure associations equal in magnitude to self-psychosocial and demographic measures. Observed spouse-spouse similarity for blood pressures remained significant after adjustment for shared psychological factors. It is speculated that different aspects of each spouse's nonmarital environments (e.g. work, social support) have differential impacts on the marital environment and on physiologic indicators of health.
Article
Temporal patterns of distress among two groups of nonterminally ill, surgically treated cancer patients (n = 40) and their spouses (n = 40) during the immediate pre- and postdischarge period were studied. Data about problems encountered and standardized measures of distress (State Anxiety Index, Brief Symptom Index, and Vulnerability Index) were obtained before hospital discharge and at 10, 30, 60, 90, and 180 days postdischarge. The intensity of distress experienced by patients and spouses was remarkably similar, although the temporal pattern of occurrence was significantly different. Prior to discharge, spouse anxiety was significantly higher than that of the patients and above the norm for hospitalized persons. Spouses were least distressed after 10 days at home, but thereafter experienced a rise in vulnerability culminating in observable clinical depression at 90 and 180 days. Peak distress for the patients occurred 10 days after discharge as a function of physical symptoms that were unexpected or more severe than anticipated. Patients with ostomies (n = 20) were slower to return to pre-illness functional levels and had somewhat more psychological distress than nonostomy patients.
Article
The similarity of behavioral patterns within addict couples before, during, and after a relationship is the focus of this paper. The correlations between partners in real and artificially constructed (pseudo) couples for employment, criminal activities, and other behaviors are examined. The effect of a relationship on behavior is also assessed before, during, and after treatment. Significant correlations during real relationships were found for employment, welfare, and illegal income. Joint couple entry into treatment appears to be more effective for women than men. Similarity within couples disappears when the relationship ends.
Article
Age-adjusted mortality rates are higher for the unmarried and nonparents than for the married and parents. The effects of marital and parental status on mortality are usually attributed to the positive effects of social integration or social support. The mechanisms by which social support or integration is linked to health outcomes, however, remain largely unexplored. One mechanism may involve health behaviors; the family relationships of marriage and parenting may provide external regulation and facilitate self-regulation of health behaviors which can affect health. The present study employs a national sample to examine the relationships of marital and parenting status to a variety of health behaviors. Results indicate that marriage and presence of children in the home have a deterrent effect on negative health behaviors. It is suggested, within the theoretical framework of social integration, that family roles promote social control of health behaviors which affect subsequent mortality.
Article
The present article reports on the results of several comparisons between 45 adult males with diagnosed coronary heart disease (cases) and their wives and 50 adult males without coronary heart disease (noncases) and their wives recruited from the Western Collaborative Group Study. The California Psychological Inventory and a life satisfaction inventory were administered to the couples in the two types of families. Results indicate that although both sets of husbands and wives fell within the well-functioning range on the CPI, wives of cases were significantly more dominant and less flexible than wives of noncase husbands. Case husbands were significantly more dominant than noncase husbands. No mean differences existed between case and noncase husbands and wives on a variety of life satisfaction measures. Computation of spouse-pair correlations revealed a pattern of overall dissimilarity across the CPI scales for case couples and overall similarity for the noncase couples. The only scale on which case spouse pairs were significantly similar was one measuring depression. Noncase couples were significantly more similar than case couples on scales measuring sociability, self-acceptance, and socialization. Previous findings from the research literature in the fields of personality, cardiac rehabilitation, and assortative mating are used to generate three competing hypotheses relating the present findings to cross spouse disease associations.