Abstract

Purpose: To investigate the relation between marital status and survival.

Data sources: The US 1989 national health interview survey (NHIS) merged with the 1997 US national death index.

Results: Among 1989 NHIS respondents, 5876 (8.77%) died before 1997 and 61 123 (91.23%) were known to be alive. Controlling for demographic and socioeconomic characteristics, the death rate for people who were unmarried was significantly higher than it was for those who were married and living with their spouses. Although the effect was significant for all categories of unmarried, it was strongest for those who had never married. The never married effect was seen for both sexes, and was significantly stronger for men than for women. For the youngest age group (19–44), the predominant causes of early death among adults who had never married were infectious disease (presumably HIV) and external causes. In the middle aged and older men and women, the predominant causes were cardiovascular and other chronic diseases.

Conclusion: Current marriage is associated with longer survival. Among the not married categories, having never been married was the strongest predictor of premature mortality. It is difficult to assess the causal effect of marital status from these observational data.