The most incisive guide to issues facing the American family today . . . An invaluable resource for anyone wishing to stay on the cutting edge of research on family trends.

-W. Bradford Wilcox
Associate Professor of Sociology, University of Virginia 

Marriage Means Medicine

Bryce J. Christensen and Robert W. Patterson

Married individuals enjoy such pronounced advantages in health and longevity over unmarried peers that researchers are now intent on figuring why. Two studies—one by researchers in the United States and one by researchers in Canada—suggest that these advantages derive at least in part from the fact that married men and women receive better medical care than their unmarried peers.

The medical advantage that married individuals enjoy over single peers shows up clearly in a study by health researchers at Brigham Young University. By parsing data from the National Cancer Institute for 2,726,147 cases of cancer diagnosed between 2000 and 2007, the researchers identified the social characteristics most often present among men and women who received a cancer diagnosis that included staging, part of a thorough diagnosis spelling out the size of the tumor(s), the number of lymph nodes affected, and the presence or absence of metastasis. Not surprisingly, a diagnosis that includes staging “provides direction on an appropriate course of treatment.”

Marital status, as it turns out, predicts the likelihood of a patient having his cancer staged as part of the diagnosis. “Married individuals,” report the researchers, “were significantly more likely to receive a cancer staging [than were unmarried peers], after adjusting for age, sex, and race.” The researchers note that their findings are “consistent with findings from studies showing that married cancer patients tend to be identified at an earlier stage of disease, experience fewer comorbid conditions, and have better prognosis” than do unmarried peers. The BYU scholars further align their findings with those of an earlier study concluding that “women who were married . . . were more likely to undergo mammography and receive pap testing than single women.” Explaining the pattern, the researchers comment, “Married women enjoy the benefit of a combined income and a stable partner, which increases their likelihood of being able to afford appropriate medical services.”

The medical advantage associated with wedlock likewise appears in the Canadian study. Conducted by researchers at the University of Toronto and McGill University, this study examines the relationship between the social characteristics of those suffering heart attacks and the rapidity with which they seek hospital medical care after first experiencing chest pain. The researchers bring these relationships into focus by analyzing medical records for 7,746 patients with acute myocardial infarction (i.e., heart attack) diagnosed in eighty-two hospitals in Ontario.

Defining six hours from onset of chest pain to arrival at the hospital as their cut-off for timely treatment, the researchers conclude that “being married was associated with lower odds of delayed presentation” at the hospital for treatment (p<0.001). Compared to single peers, married men experiencing chest pain were about one-third as likely to delay their trip to the hospital (odds ratio, 0.35). “Earlier attainment of medical care,” remark the scholars, “may be one reason why married men have a lower risk of cardiovascular mortality than their single counterparts.”

The researchers did not find the same kind of statistically significant reduction of treatment delay when they compared married women experiencing chest pain to single women experiencing the same symptoms. This gender disparity in the effects of marital status does not surprise the Canadian researchers, who reason that because “wives would be more likely than husbands to assume the caregiver role . . . the beneficial effect of marriage would therefore be stronger among men than among women.” Still, when the researchers turned their attention to divorced women, they determined that such women were more than four times as likely as single peers to delay the seeking of medical treatment after experiencing chest pain.

Overall, the researchers marvel at how markedly marital status affects the speed with which those suffering chest pain seek medical care. Indeed, they calculate that “the adjusted time saved” for a typical married person suffering chest pain compared to an unmarried peer suffering the same symptoms was “a remarkable half-hour.” “Among all the factors that had an effect in the primary outcome [statistical] model,” the researchers point out, “only calling an ambulance had a greater influence [than marital status] on the time to presentation.” Wearing a wedding band appears to be as important in dealing with a heart attack as does calling 911. Underscoring the importance of this medical benefit enjoyed by married individuals, the researchers comment, “Because cardiovascular disease is the most frequent cause of death in Canada and the Western world, the benefit at the population level is substantial.”

Whether in Minneapolis or Montreal, whether in the oncology ward or the cardiac unit, marriage means good medicine—and long life!

(Ray M. Merrill et al., “Unstaged Cancer in the United States: A Population-Based Study,” BMC Cancer 11 [September 21, 2011]: 402; Clare L. Atzema et al., “Effect of Marriage on Duration of Chest Pain Associated with Acute Myocardial Infarction Before Seeking Care,” Canadian Medical Association Journal 183.13 [September 20, 2011]: 1482–91.)