Wedding ring = better health?

What next – prescriptions for a trip to the altar? Dr. Randall Bock, a Boston-area physician, wonders if it’s appropriate to advise patients to get married for the sake of their health.

After all, doctors urge patients to stop smoking, lose weight, get vaccinated, have a colonoscopy and so on, Dr. Bock points out. Why not tell them to get married – especially since multiple studies have found that marriage is generally associated with better health?

Here’s an excerpt from his post, via Kevin MD:

Not only do people live longer married, but they live wealthier and happier, and this conclusion remains even after you factor out preselection towards marriage people. You could argue that maybe those destined for poorer life expectancies never marry in the first place but probably the opposite is true, people who need care and caring tend to marry at a higher frequency.

Dr. Bock then shares a story about one of his patients, a 22-year-old unmarried woman with a 1-year-old child. The child’s father has asked her to marry him but she wants to go back to school and isn’t ready yet for marriage. Dr. Bock suggests that she “consider the beneficial social and general health aspects of solidifying her ongoing relationship with the child’s father.”

The patient listens politely. Dr. Bock thinks the conversation was productive. But two days later she calls to let him know she will not be coming back as his patient, ever.

According to the science, Dr. Bock actually has a point. Whether marriage affects health and longevity has been well studied. One of the earliest of these studies was undertaken in the 1850s by British epidemiologist William Farr, who analyzed French birth, death and marriage records and concluded that those who were married generally lived longer and were in better health than those who were unmarried or widowed. Subsequent studies over a century and a half have confirmed Farr’s observations, associating matrimony with a lower risk of pneumonia, cancer, dementia and even likelihood to undergo surgery.

Although it would be easy to conclude that everyone should get married so they can be healthier, the picture is more complicated than this. Later and more detailed studies have found that the type of relationship matters; marriages that are stressful or abusive are worse for people’s health than a happy, supportive marriage. Other studies have noted that people who have married and then divorced are less healthy than people who remained unmarried. The marriage benefit also seems to be strongest for men but less so for women.

The philosophical questions raised by this are intriguing. A recommendation from the physician can have power, especially when it comes in the context of a solid, ongoing relationship between doctor and patient. Patients often will discuss things with their doctor that they might not bring up with someone else. If the goal is to help the patient be healthy, why not suggest lifestyle and social choices that are backed up by evidence?

On the other hand, physicians need to beware imposing their own values on their patients. And anyway, where would you draw the line? Church-going and moderate alcohol consumption also have been linked to better health. Does this mean physicians should start urging their patients to go to church every Sunday and knock back a beer or two each night? Does the promise of better health trump every other consideration or preference the patient might have?

For what it’s worth, virtually everyone who responded to Dr. Bock’s post thought he crossed the line. “Completely and utterly inappropriate,” one person wrote. “You do not know the child’s father, and the patient was not there for social advice.”

A female reader took Dr. Bock to task for imposing his views about marriage on a patient whom he barely knew. “I would no more take personal marital or religious advice from a physician than I would from a mailman – except my mailman probably knows me and my family far better!” she wrote.

What do readers think? Should doctors be talking to their patients about the health benefits of marriage? Or is this a topic that should remain off limits unless the patient specifically asks for advice?

Photo: Wikimedia Commons

15 thoughts on “Wedding ring = better health?

  1. I DO NOT AGREE WITH IT AT ALL. I HAVE BEEN DIVORCED FOR 14 YEARS AND LOVE BEING SINGLE AND NOT WORRING ABOUT ANYONE BUT MY SELF AND DAUGHTER. I AM VERY HAPPY LIVING SINGLE AND I DO HAVE A STEADY BOYFRIEND BUT WOULD NEVER WANT TO MARRY. I PERFER THE TIME TO MY SELF WHEN I WANT IT. I CAN SPEND TIME WITH HIM AND UP AND LEAVE WHEN I WANT… MARRIED YOU ARE STUCK. I LIKE THE INDEPENDENCE AND HAVE RAISED MY DAUGHTER THAT WAY. I SEE WEAR IT WOULD HELPFUL FOR MEN BUT NOT WOMAN. MEN NEED SOMEONE TO TAKE CARE OF THEM… THEY ARE WEAK. WOMAN DO NOT THEY ALREADY TAKE CARE OF THEM SELVES,CHILDREN FRIENDS, FAMILY WHY PUT ANOTHER BURDEN ON A WOMANS BACK TO WORRY ABOUT?
    I DO NOT AGREE WHATS SO EVER. AND IM VERY HEALTHY, HAPPY AND CONTENT ON HOW MY LIFE IS LIVED AS A SINGLE MOTHER.

  2. Put the info on a flier and those patients who choose to read the statistics and considerate it can. This way you can feel you are being complete as a doc by providing the statistics without it being so personal as an actual discussion would seem.

  3. i think krista is disgruntled a bit. you can’t just lump all men in a group by saying we are weak and need somebody to take care of them. i take care of myself, and my girlfriend. i help my sister,parents and anybody else that is in my life that i care about that needs help. the facts may indicate such trends about married life in general but it is not an all encompassing FACT. it all depends on the people and situation.

  4. KRISTA, being the primary custodial parent, with the mother living in another state, I raised my two girls, mostly by my self, from the ages of 4 and 6 to adulthood. My older one is going to school to become an Architect and the younger one to become a Civil Engineer. The younger one was approached by the university to be a math tutor for the other engineering students needing help. It is a paid position. So I’m thinking I must have done something right.
    Men weak? I don’t think so. I raised my kids with my values. The oldest is happily married.
    I resent your statement that “MEN NEED SOMEONE TO TAKE CARE OF THEM… THEY ARE WEAK.” I can see where you like to be alone because you don’t have much choice in the matter.
    I am in a long time healthy, committed relationship with a woman who also knows what it takes to make a relationship work. From your post, you do not know what it takes.
    So, who is actually is weak?

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  6. I cannot say for 100% that this doctor stepped completely out of line in his suggestion to get married. He probably shouldn’t have given his patient his opinion on the matter. However, if his patient didn’t want his opinion why did she tell him that her boyfriend proposed and that she isn’t ready for marriage? The doctor probably wouldn’t have said anything about getting married if she hadn’t offered this information about her social life.

  7. The controversy of this issue could have been reduced significantly if the doctor had limited his suggestions to the health benefits of having a significant other. This in of itself is worthy of mention as a means to reduce mortality while avoiding any religious implications associated with marriage.

    • I was wondering the same thing. If you look at the big picture, the health benefit seems to lie overall in having meaningful social connections – meaningful being defined according to what each individual values most. Marriage is one subset of this but it’s certainly not the only connection that matters. What about pets? Having a dog or cat has been shown to be beneficial to health as well.

      It would be interesting to know whether the doctor would have brought up the subject of marriage if there hadn’t been a child involved in the situation. Would he still have advised her to “solidify” the relationship with her boyfriend, even if they didn’t have a child?

  8. Interesting enough there is more controversy over Krista’s response than the actual article itself. Generally speaking I can see where men can be needy. Have you noticed that even though it is 2011, men still expect a women to do majority of the cleaning, cooking, and child rearing. It was nice to hear about Fgore’s success as a parent and happiness. However, from what I have seen women are still in the kitchen, and men are still dependent on a women to be all to all.
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  9. Feeling happy and complete doesn’t have to be through marriage. There are many people unhappy in marriages that cause health problems due to the drama and stress. A fantastic book by Louise Hay, called “You Can Heal Your Life” it teaches us to love our selves and forgive. I love this book. She was able to be healed of cancer through special detox and forgiveness process.

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  11. Hello Anne

    I am the “female reader” you mentioned who wrote the comment to Dr. Bock about taking advice from my mailman.

    I also challenged Dr. Bock’s assumption that marriage is generally associated with better health. This is only partly true – for men, but not for women.

    In fact, a man’s physical health does apparently benefit simply from the state of being married, whether or not he rates it as a good marriage.

    But a woman’s overall health can be significantly threatened by trouble at home, according to researchers at the University of Utah. Women in fact respond to unhappy marriages by being three times more likely to develop serious cardiac risk factors that can lead to heart disease.

    Women who report marital strain also have higher incidence of depression, high blood pressure, high LDL (bad) cholesterol, obesity and other signs of metabolic syndrome.

    What about single, divorced, or other women who are “between husbands”? After accounting for a variety of factors, the Utah researchers found that there were NO STATISTICALLY SIGNIFICANT HEALTH DIFFERENCES between happily married women and unmarried women. More on this at “Poor Marriage = Poor Heart Health For Women” at HEART SISTERS – http://myheartsisters.org/2009/06/29/poor-marriage/

    I still maintain that the good doctor was WAY out of line here. His appointment with the 22-year old woman was their first ever “meet the doctor” visit. He knew nothing about her or her life or the prospective husband in this case. And she never came back to see him after this visit – which tells you what she thought of his “advice”, too.

    Cheers,
    C.

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