Living in Sin, In Sickness and In Health? An Investigation of Cohabitation, Marriage, and Health

Abstract

The physical and psychological health benefits of marriage have been well-documented in the family and medical sociology literature. Given the recent increases in the prevalence of cohabitation, this research asks whether marriage still confers the same health benefits, and whether cohabitation might do the same. Using two waves of a nationally representative sample, the effects of union type on eleven health outcomes were examined, both cross-sectionally and longitudinally; processual factors such as social support, health behaviors, and socioeconomic status were also examined. Union type was not a consistent predictor of health outcomes: spouses appear somewhat better off than singles, but major differences between cohabitation and marriage were not found. Further, the health benefits of marriage are primarily afforded to men, and the benefits of both union types are more pronounced for younger persons. Social support was a consistent and positive predictor of physical and psychological health, although men may receive greater benefits than women. Health behavior measures were not effective predictors of health outcomes, but this may be due to measurement issues. Socioeconomic status measures were also consistent predictors of physical and psychological health, although an individual’s employment was more often significant than total household income. Additional analyses were conducted to test the “selection hypothesis†– that healthier people are more likely to enter unions. Results are supportive of selective effects for marriage, but not nearly as much so for cohabitation, implying that perhaps different mate selection processes are at work for the two union types. Theoretical, research, and policy implications are discussed.