Danyang Wang1, Duanhui Li1, Shiva Raj Mishra2, Carmen Lim3, Xiaochen Dai4, Shu Chen5, Xiaolin Xu6. 1. Second Affiliated Hospital and School of Public Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China. 2. Academy for Data Science and Global Health, Kathmandu, Nepal. 3. National Centre for Youth Substance Use Research, Faculty of Health and Behavioral Sciences, The University of Queensland, Brisbane, Australia; School of Psychology, Faculty of Health and Behavioral Sciences, The University of Queensland, Brisbane, Australia. 4. Department of Health Metrics Science, School of Medicine, University of Washington, Seattle, USA. 5. ARC Centre of Excellence in Population Ageing Research (CEPAR), University of New South Wales, Sydney, Australia; School of Risk & Actuarial Studies, University of New South Wales, Sydney, Australia. 6. Second Affiliated Hospital and School of Public Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China; School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Australia. Electronic address: xiaolin.xu@zju.edu.cn.
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.
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.