Highlights
- •This study is the first to use longitudinal data to assess the association between marital relationship and multimorbidity globally.
- •Multimorbidity prevalence is higher in the currently non-married population than in the married group.
- •Both marital status and length of marriage are associated with multimorbidity prevalence.
- •Marital relationships may provide prognostic information about the future multimorbidity risk.
Abstract
Background
Marital relationship plays an important role in health and wellbeing. However, how
marriage is associated with multimorbidity (the co-occurrence of two or more chronic
conditions) has not been comprehensively investigated. We aimed to assess the association
between marriage and multimorbidity in middle-aged adults.
Methods
We used nationally representative data on 23641 adults aged 50-60 years who participated
in four longitudinal studies in the US, UK, Europe, and China (Health and Retirement
Study, English Longitudinal Study on Ageing, Survey of Health, Ageing and Retirement
in Europe, and China Health and Retirement Longitudinal Study). Respondents were followed
up in 2010-11 (baseline), 2012-13, and 2014-15. We used generalized estimating equations
to evaluate the associations between marital status (married/partnered or non-married
[separated/devoiced/widowed/never married]), marriage duration and multimorbidity,
adjusting for socioeconomic and lifestyle factors.
Results
Over 4-year follow-up, 24% (n=5699) of respondents experienced separation, divorce,
widowhood, or never-married status, and approximately 43% (n=10228) of respondents
reported multimorbidity. Those who were not married had a higher odds of multimorbidity
(age-, sex- and region-adjusted odds ratio 1.19; 95% confidence interval 1.14 to 1.25).
Those who had been married for 21-30 years had a lower odds of experiencing multimorbidity
than those married for less than 10 years. The associations remained robust after
adjusting for socioeconomic and lifestyle factors.
Conclusions
Marital relationship (status and length) was associated with multimorbidity in middle-aged
adults, highlighting the role of marital relationship in shaping the trajectory of
health and wellbeing across the life course. These findings provide insight for the
prevention and management of chronic disease and multimorbidity.
Keywords
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Article info
Publication history
Published online: October 02, 2021
Accepted:
September 24,
2021
Received in revised form:
September 23,
2021
Received:
June 1,
2021
Identification
Copyright
© 2021 Elsevier B.V. All rights reserved.
